Shamsher Thapa Case Study

Shamsher Thapa (name changed), 45, resident of Pyuthan, was diagnosed with tuberculosis on February 7, 2018 through GeneXpert. Narayani KC, FCHV and one of the volunteers of TB REACH, thought Thapa might be suffering from tuberculosis during her contact tracing process. Mr Thapa and his wife were diagnosed with HIV three years ago and both are receiving anti-retroviral therapy in district hospital of Pyuthan.

Mr Thapa was working as a laborer in India for fifteen years when he was diagnosed with HIV and sent back to Nepal. Months later, his wife was also confirmed as HIV positive. Seeing the family’s poor economic background and lack of income source, Mr Thapa’s wife was offered a job at a local NGO working for People Living with HIV. Having HIV infection increases the risk of tuberculosis and so both Mr Thapa and his wife were previously tested for TB many times through smear microscopy but the results were negative every time. Mr Thapa had been coughing continuously for three weeks before our volunteer visited his house. Narayani collected early morning sputum samples of Mr Thapa, his wife and his son to be directly tested with GeneXpert this time. Due to negative results in the past, Mr Thapa was unwilling to re-test for TB. However, our team convinced the family to test their sputum samples with the new GeneXpert machine, newly installed in the district. His sample result was positive this time; however, his wife and son tested negative. Mr Thapa was immediately enrolled in DOTS and his two-month follow- up result is negative. He is recovering his health.