Following treatment for extrapulmonary TB after a repeated trial of multiple nonspecific antibiotics, a 29 year old male patient presented to Hawassa University Hospital following insignificant improvement. The clinicians suspected and investigated MDR TB. When he went back to Yabello Hospital a month later, he was diagnosed with VL and severe malnutrition. After 30 doses of SSG there was still no improvement in his condition. Following a full dose of AmBisome, he was cured.
The distances required to travel between the multiple hospitals are significant: Bule Hora to Hawassa is 214 Km and Hawassa to Yabello is 535 km. The patient travelled a significant distance before being diagnosed properly. His clinical condition was also deteriorating due to the delay in the diagnosis. This problem occurred due to the absence of trained health professionals and available test kits in hospitals like Bule hora and Hawassa hospitals. Although these hospitals are not located in VL endemic districts themselves, patients from VL endemic districts in Oroma and SNNP regions are referred to those hospitals. This demonstrates the essential need to increase the VL knowledge and awareness of health professionals working in these hospitals to reduce the time between onset of symptoms and diagnosis of VL.