Content Status where content has been uploaded and published on LMS.
Administration of drugs and adherence to therapy
Community Health Volunteers should ensure supply and regular consumption of TB drugs by a patient, so that TB patients adhere to their treatment.
Monitoring of Adverse Drug Reactions
Missed Dose recording in Nikshay:
For recording missed doses in Nikshay, following steps should be followed:
99DOTS is a low-cost digital adherence technology built-in Nikshay that uses inexpensive packaging(envelopes or stickers) with medication that enables people taking medication to engage with their treatment daily. This packaging, distributed to TB patients taking medications, has a hidden number behind perforated flaps on the external envelope; in some cases, the number may be fixed outside the medication blister or pill bottle. This number can be a toll-free number that can be called to register daily adherence or a code sent by SMS, USSD, or other communication channels.
Adherence to tuberculosis(TB) treatment is important for promoting individual and public health. Poor adherence to TB treatment results in:
Proper treatment of all forms of TB is critical to reducing individual morbidity and mortality and to interrupting transmission among family and community members.
For TB infection, there are two recommended tests which can be used to identify such patients.
Tuberculin Skin Test (TST)
The skin test is done by injecting a small amount (0.5 ml) of TB antigens into the top layer of skin on your inner forearm. If one has ever been exposed to TB bacteria (Mycobacterium tuberculosis), there will be a reaction indicated by the development of a firm red bump (induration) >= 10 mm at the site within 2 days.
After getting diagnosed with Drug-Resistant TB(DR-TB), the patient is referred to District DRTB Centre(DDR-TBC) for initiation of treatment. Few clinically complicated cases are referred to the Nodal DRTB Centre(NDR TBC).
Depending upon type of drug resistance, there are four broad DRTB Treatment regimen.
Drugs administered for DRTB Regimen:
All patients diagnosed with TB should have universal access to rapid DST for at least Rifampicin and further DST for at least Fluoroquinolones among all TB patients with rifampicin resistance, i.e. UDST.
Common Adverse events to second line treatment are as below
Figure: Adverse Drug Reaction to Second line drugs
Adverse events should be identified, monitored and be referred to
|
Symptoms |
Drug Responsible |
Action to be taken by Community Health Volunteers |
|
Gastrointestinal Symptoms |
Any Oral Medications |
|
