Long Term Post-treatment follow up of TB patients

After completion of TB treatment, all patients should be followed up at the end of

  • 6 months,
  • 12 months,
  • 18 months &
  • 24 months

TB patients at the follow up should be screened for any clinical symptoms and/or cough. If found positive on screening, then sputum microscopy and/or culture should be considered. This is important in detecting the recurrence of TB at the earliest.

Adverse Drug Reactions

Adverse Drug Reactions(ADR) are unwanted or harmful reactions experienced following the use of a drug or combination of drugs and are suspected to be related to a drug. Severity of adverse effects varies from tolerable and mild ADRs to serious and life threatening ADRs.

 

Figure: Various Adverse Drug Reactions

 

Common ADR Symptoms:

TB Treatment Outcome

When a TB patient consumes all the doses under the prescribed regimen, then Treatment Outcome is declared for a Patient.

 

Treatment Outcome

Description

Cured

A TB patient who was microbiologically confirmed for TB at the beginning of treatment but who is smear or culture negative at the end of complete treatment

Treatment Complete

Follow-up of TB patient

To know the TB treatment response and to determine that if patient is cured, TB patients are clinically evaluated at the end of every four weeks of treatment, and they are also followed up by performing sputum test at end of each treatment phase (i.e. Intensive phase and Continuation phase)

TB patients during clinical evaluations are assessed to

TB Drug Regimen

regimen means a prescribed systematic form of treatment for a course of drug(s). For TB treatment, Multi drug combination of regimen is followed. 

 

All TB drug regimens have an initial intensive phase(IP) followed by a continuation phase(CP). 

Following are some of the main TB drug regimens used based on the drug resistance pattern detected for TB patients.

 

HIV in TB Patients

The primary impact of HIV on TB is that the risk of developing TB becomes higher in patients with HIV. Overall, HIV-infected persons have an approximately 8-times greater risk of TB than persons without HIV infection. 

Screen TB PLHIV patients for symptoms of TB and HIV

Figure: Screening steps for TB - HIV patients

Treatment Phases

Standard TB Treatment is divided into two phases

  • Intensive Phase(IP): In this phase,
    • Kills most of the TB bacteria during the first 8 weeks of treatment, but some bacteria can survive longer
    • Therefore, more drugs are administered to kill the bacteria and reduce the severity of disease.
    • Treatment in this phase usually is of short duration(2 to 6 Months or more) in comparison to Continuation Phase(CP)

 

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