1. Diagnosis Confirmation
- Tests: Before starting treatment, TB is diagnosed through tests such as:
- Sputum test (microscopy and culture)
- Chest X-ray
- Tuberculin skin test (TST) or Interferon-Gamma Release Assays (IGRAs)
- Molecular tests like GeneXpert
- This helps differentiate between active TB and latent TB infection (LTBI).
2. Types of TB Treatment
a) Treatment for Active TB
- Active TB requires a combination of antibiotics for 6 months or longer. The standard regimen is:
- Intensive Phase (2 months):
- Rifampicin (R)
- Isoniazid (H)
- Pyrazinamide (Z)
- Ethambutol (E)
- Continuation Phase (4 months):
- Rifampicin (R)
- Isoniazid (H)
- Intensive Phase (2 months):
b) Treatment for Latent TB
- For individuals with latent TB (no symptoms but a positive test), treatment may involve fewer drugs for a shorter duration:
- Isoniazid for 6-9 months
- Rifampin for 4 months
- A combination of Isoniazid and Rifapentine once weekly for 3 months.
3. Drug-Resistant TB (MDR-TB and XDR-TB)
- MDR-TB (Multi-Drug Resistant TB): Resistant to Rifampicin and Isoniazid. Treatment involves second-line drugs like:
- Fluoroquinolones (e.g., levofloxacin, moxifloxacin)
- Injectable agents (e.g., amikacin, kanamycin)
- New drugs: Bedaquiline, Delamanid
- Treatment duration: 18-24 months or longer.
- XDR-TB (Extensively Drug-Resistant TB): Requires specialized regimens, often including new and repurposed drugs.
4. Supportive Care
- Nutritional Support: A balanced diet to strengthen the immune system.
- Regular Monitoring: Monthly checkups to monitor progress, side effects, and drug adherence.
- Address Side Effects: Common side effects include nausea, liver toxicity, and visual disturbances.
5. Adherence to Treatment
- DOTS (Directly Observed Treatment, Short-course):
- Health workers supervise medication intake to ensure compliance.
- Reduces the risk of drug resistance.
6. Preventive Measures
- Vaccination: BCG vaccine is given in countries with high TB prevalence to prevent severe forms of TB in children.
- Isolation: Active TB patients may need isolation during the initial phase of treatment to prevent spreading.
- Screening of close contacts.
7. Consult Healthcare Professionals
TB treatment must be supervised by a medical professional to ensure the correct regimen and to manage complications or resistance. Self-medication or incomplete treatment can lead to drug resistance and treatment failure.
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