Active TB disease has 4 major symptoms (the 4 Symptom complex). Presence of any one of these symptoms without any other reason warrants evaluation for TB. These are:
Figure: Signs and Symptoms of TB
Health Volunteers
Figure: Role of Health Volunteers
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Health Volunteers/ Treatment Supporters are often the regular point of contact for a TB patient in the community. They support the TB patient during the entire episode of TB and ensure complete diagnosis and treatment. The next points of contact are with the MPHWs who periodically visit the patients to ensure specific delivery of services.
After exposure to infective droplets containing M.TB, only a small proportion gets infected and further progresses to active TB disease.
For laboratory diagnosis of TB, different biological specimens are used.
Pulmonary TB: Sputum sample is used. Sputum is a thick fluid produced in the lungs and in the adjacent airways. Normally, a spot sample and a fresh morning sample is preferred for the bacteriological examination of sputum.
Extra Pulmonary TB:
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Presumptive TB case refers to a patient who presents with symptoms or signs suggestive of TB disease (previously known as a TB suspect) and where further diagnostic workup including bacteriological investigation is required.
Presumptive TB can be categorized into
Presumptive Pulmonary TB (P TB) - Symptoms are directly related to lungs (Cough, hemoptysis)
Presumptive Extra Pulmonary TB (EP TB) - Symptoms/ signs are specific to an extra pulmonary site (example: Lymph node swelling)
Nikshay is an Integrated ICT system for TB patient management and care in India. Nikshay was launched in 2012 and since then, various improvements have been made in the system.
Nikshay provides-
National Tuberculosis Elimination Programme (NTEP) strives for all presumptive TB patients to be microbiologically confirmed. Under NTEP, the acceptable methods for microbiological diagnosis of TB are:
TB cases are generally classified on the basis of previous history of TB treatment into New and previously treated cases.
New case - A TB patient who has never had treatment for TB or has taken anti-TB drugs for less than one month is considered as a new case.
Previously treated patients have received 1 month or more of anti-TB drugs in the past. They could be further classified as:
