Posted on Tuesday 21 March 2017
Christian Henderson (left) and Amal Tinia
A 15-year-old has credited her recovery from Tuberculosis (TB) to the support of south east London’s first children’s TB nurse, who was recruited by Guy’s and St Thomas’ to tackle the problem of TB in the capital.
In 2015 the TB rate in London was 26.2 cases per 100,000 people compared with 10.5 cases per 100,000 in England as a whole. In 2016, Guy’s and St Thomas’ TB service saw 16 children with the condition. So far this year 12 children with latent TB have already received treatment.
Amal Tinia, from Enfield, noticed a large lump on the left side of her neck in June 2016. She says: “The lump kept getting bigger and bigger and I was feeling more and more uncomfortable because I sleep on my left side.”
Concerned about the growth on her neck, Amal’s mum took her to St Thomas’ Hospital Emergency Department (A&E) where a biopsy confirmed TB.
She was placed on a six-month course of treatment that involved taking four different types of antibiotics every day for the first two months, followed by a reduced amount for the following four months.
Christian Henderson, Amal’s children’s TB nurse, became involved in her care in November 2016 and phoned her every day for a week, after one occasion when she forgot to take her medication. Christian is part of a team of consultants and nurses at Guy’s and St Thomas’ who care for patients with TB.
Amal says: “Christian reminded me that if I don’t take my medication every day the TB can come back, and if that happens, it will be less easy to treat because it may be resistant to drugs. I don’t want to be sick and end up in hospital with needles in me. I’m so glad Christian helped me get through this.”
Every member of Amal’s immediate family, including her sisters, brother and cousins under the age of 11, were tested for the condition but thankfully are clear of the disease. Amal completed her treatment in December 2016 and has made a full recovery.
Guy's and St Thomas' Adult Community team, who recruited the new children’s nurse, run TB clinics at St Thomas' Hospital, Evelina London Children’s Hospital, King's College Hospital and University Hospital Lewisham. Staff also visit patients at home or in other locations that are more convenient to them.
TB rates are higher in London as people come to the capital from countries with higher rates of TB like Somalia and South Africa. Higher levels of poverty and increasing numbers of homeless people may also be contributing factors due to cramped living conditions.
Christian’s role is varied and includes supporting doctors and nurses so they give the right tests to children who are in contact with people with suspected TB. She also supports parents with dosage, storage and administration of the TB medication, particularly those with younger children who may find it difficult to swallow antibiotics in syrup or tablet form.
Christian says: “I’m a combination of friend, someone who rings up or sends text messages to remind teenage patients to take their medication, and someone to reassure anxious parents. The treatment is often challenging and requires a high level of commitment.
“For some people, their route to Europe can bring them in contact with people who have TB and put them at greater risk of the condition. The TB team at Guy's and St Thomas’ are seeing more cases of latent TB, where the condition is dormant in the system for years and all seems well.
“People can’t pass TB on during this phase but it can become active if someone’s immune system becomes compromised due to serious illness, for example.
“TB is not a disease of the past. In a city like London we have families who are living in overcrowded conditions. Some patients are homeless or destitute. We have a duty to care for them all.”
Dr Nuria Martinez-Alier, a consultant at Evelina London Children’s Hospital, says: “TB is often a family disease. It’s fantastic to have Christian, who gives parents the extra support they need, at a time when they are anxious about their children and may be sick themselves.”