Tuberculosis: Treatment and Management

Tuberculosis Management

Tuberculosis disease is one of the top 10 most common causes of death globally. India itself bears a large burden of death caused due to tuberculosis.  Due to its highly contagious nature tuberculosis is considered as one of the most infectious diseases. Mostly prevalent in developing nation, tuberculosis disease targets people with reduced immunity, elderly and individuals in direct contact with infected.  Tuberculosis, if diagnosed in time can be treated and is easily curable. But, lack of awareness, improper medical assistance gives this disease the power.

As a highly contagious disease, the Tuberculosis management starts with isolating the patient in order to prevent the further spread of the disease. Tuberculosis treatment involves a multi drug approach to avoid drug resistance for duration of 6 to 9 months. With proper tuberculosis treatment and patient compliance, this disease is almost always curable.

Tuberculosis Treatment

The correct tuberculosis check-up includes drug regimen decided on the basis of clinical findings which is mainly a combination of drugs for the tuberculosis treatment. The aim of the Tuberculosis drugs is to kill the disease-causing bacteria. However, the tuberculosis bacteria take a long time to be eliminated, thus the proper tuberculosis treatment usually last from six to nine months.

The prescribed drug must be taken for the entire period of Tuberculosis treatment or relapse can occur. Most regimens have an initial phase of high-intensity drug administration followed by a continuation phase. The main aim of the tuberculosis treatment is to cure the patient and restore the well-being of the patient. It also aims at preventing relapse and the complications of TB which include death. It also aims to prevent the development of drug-resistant TB and the further spread of infection to healthy individuals. One of the popularly used regimens is DOTS.

DOTS [Directly observed Treatment Short course] which is highly efficient and cost-effective. It is the internationally recommended strategy for TB treatment. It has five components:

  • Government commitment- Sustained political and financial commitment for the TB control and prevention is one of the major steps. This can be achieved by providing adequate resources and administrative support.
  • Diagnosis of TB by quality ensured sputum smear microscopy. Chest symptomatic helps in finding new TB patients and in the control of the spread of TB.
  • Standardized short course anti TB treatment [SCC] given under direct and supportive observation [DOTS] It ensures that the right drugs are administered for the complete duration of the treatment.
  • A regular uninterrupted supply of high-quality anti TB drugs helps to ensure that all the individuals get the required drugs.
  • Standardized recording and reporting. It keeps track of individual patient progress and the overall effectiveness of the program.

Side-effects of TuberculosisSide-effects of Tuberculosis Treatment

The side effects of Tuberculosis treatment depends on the medicines being properly administered. The side-effects can range from mild to severe and sometimes a change in drug regime is also required.

Managing the side effects is an important part of the therapy and ensures that the patient completes the treatment. It is also required to minimize the side effects to promote the well being of the patient. The isolation during the initial tuberculosis treatment is important until the patient becomes infection free. This prevents the further spread of TB. However, the common side-effects of tuberculosis treatment include:

  • Flu-like symptoms
  • Dizziness
  • Skin rash
  • Nausea or vomiting
  • Tingling or numbness of hand and feet
  • Joint pains
  • Visual problems
  • Jaundice
  • Orange/red colour of urine

The doctor should be informed about the side effects immediately. Most of these are mild effects and disappear with the continuation of the medication or can be managed. Severe effects may be treated by temporary discontinuation of the treatment or by changing the drug regime.

The mild pain or headache due to medicines can be managed by painkillers and skin rashes can be treated by applying lotions and creams. Nausea can also be treated with medication. Use of alcohol during TB treatment increases the risk of liver disease so alcohol consumption should be completely avoided. If the patient has drug-resistant TB, the use of second-line drugs is recommended. The duration of treatment also increases.

Tuberculosis PreventionPrevention for Tuberculosis

Prevention means stopping the spread of infection from one person to another. This is done by firstly identifying people with active Tuberculosis by screening tests and treating them. The proper preventive steps include:

  • Treating patients with active TB
  • Identifying people with latent infection and their treatment
  • Proper isolation
  • Educating people about TB and spreading awareness
  • Use of Tuberculosis vaccines
  • Use of respirators and masks in hospitals
  • Pasteurization of milk also prevents bovine Tuberculosis which usually affects the cattle but infection can spread to humans through milk.
  • Screening of high-risk individuals like HIV patients or babies and elderly individuals
  • Ensuring that the patients complete the treatment and routine follow-up