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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).

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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:
  1. Intensive Phase (2 months):
     • Rifampicin (R)
     • Isoniazid (H)
     • Pyrazinamide (Z)
     • Ethambutol (E)
  2. Continuation Phase (4 months):
     • Rifampicin (R)
     • Isoniazid (H)

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.

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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.

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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.

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5. Adherence to Treatment

• DOTS (Directly Observed Treatment, Short-course):
  • Health workers supervise medication intake to ensure compliance.
  • Reduces the risk of drug resistance.

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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.

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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.