Proper diagnosis key to timely treatmemt

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BY DAVID NALO

Sometime in late August, 2011, I started feeling like I had an allergy that was always triggered by heat either in the evening or early morning. I was, therefore, itching and scratching most times. After checking with a few friends and doctors especially those who had suffered allergy and also some skin specialists, it was confirmed that yes “I had an allergy.”

On 24th November, 2011 since I was preparing to lead Kenya’s delegation to the 13th Summit of the EAC Partner States, I consulted a doctor with a view to get advice on medication and/or further examination to handle the situation given that I was leading the Kenyan delegation to Bujumbura and also chair the Coordinating Committee of EAC Permanent Secretaries of the EAC Partner States. So I was given some medication which somehow worked initially but largely failed on continued use. My assumption was that the allergy was either resistant to medicine or the medicine was just not working.

From 26th – 30th August, 2011, I was a man under siege seriously suffering from non-responsive treatment. Somehow the week was over, but one thing that was evident, I never got better and my condition worsened. In the circumstances, I had to fly back to Nairobi earlier so that I could seek proper medical attention.

In the meantime, interaction with several delegates revealed that a negotiation on health harmonization was not reached. Unfortunately a Tanzanian Senior Official, the PR to Secretary General; Members of EALA; and other senior officials faced serious health challenges. It is very urgent that EAC harmonize health standards – especially partner states that were adamantly reluctantly to take this root. This is beside the point.

Back to Kenya and because of my worsening allergy; and in consultations with doctors, I ran a total of 11 tests ranging from IG E level, Allergen, Skin Biopsy, and serologic tests including VDR, HIV, Bilharzia antibodies, Weil Felix and Brucella. Don’t ask me about the details of these tests because they deal purely with medical matters and very little with EAC matters. Three results worth referring to include:

(i) That my Ig E level stood at 290 instead of between 0 – 100;
(ii) That I had strong reaction to HDM House Dust Mite);
(iii) That Biopsy suggested cutaneous mastocytosis.

With a total 11 tests and results achieved, the pathologist recommended the following positive actions (i) further management in South Africa at an allergy centre and/or to the same dermatologist.

I must congratulate the team of doctors behind this enormous work. I must also commend that pathologist and lab technicians that ran these sophisticated tests. Despite this great work, in the circumstances, I continued with medication for allergy (antihistamine, piriton and steroid) with minimum change if any.

Perhaps a broad based approach to diagnostics initially, on a more precise and more interrogations could have led to a more precise diagnostics results (let alone change of the form of tests that could lead to more specific results). So with the diagnostic results, but they were sub-optimal, the disease continued.

The essence of this argument is that exact two weeks later, new symptoms began to emerge whose response required a totally different approach. So a good and accurate diagnosis would make disease identification efficient and treatment effective. However, assumptions are that all the necessary ingredients in public and private health care facilities are not only available but work.

Nalo is the Permanent Secretary in the Ministry of East African Community.

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