SECTION 1

Table of Contents

1. SECTION 1 INTRODUCTION
2. SECTION 2 - TB AND TB CONTROL STRATEGY
3. SECTION 3 - INVESTIGATING TB
4. SECTION 4 - DIAGNOSE TB
5. SECTION 5 - PRESCRIBE THE CORRECT TREATMENT REGIMEN
6. SECTION 6 - FILL FORMS AND CARDS
7. SECTION 7 - EDUCATE AND MANAGE TB CONTACTS
8. SECTION 8 - SUPERVISION AND SUPPORT OF TREATMENT
9. SECTION 9 - REVIEW THE PATIENT
   1. Greet the patient, enquire about their health and any other problems and explain what will happen
   2. Review the process of community-based TB care
   3. Take action if patients have missed tablets
   4. DEMONSTRATION EXERCISE
   5. KEY POINTS
   6. ANSWERS
   7. Review and manage the Patients Health
   8. TB /HIV
   9. WRITTEN EXERCISE
   10. ANSWERS
   11. Re-educate the Patient
   12. KEY POINTS
10. SECTION 10 - IDENTIFY AND MANAGE PATIENTS WHO INTERRUPT TREATMENT

TB /HIV

In countries with significant HIV, many TB patients are also HIV positive. TB patients may have other opportunistic infections such as Candida of the mouth. These should be identified and treated. Side effects are more common in HIV positive patients.

If the TB patient has not yet had a test, then explain and arrange this. Explain that knowing their HIV status will help in providing the best care. This should be done routinely unless the patient refuses (opts-out) to have the test.

People with HIV with infections such as TB, should start on long term daily prophylactic treatment with Co-trimoxazole. If the patient is a pregnant woman, explain that she should have anti-HIV drugs when she delivers (and her newborn baby also is given the drug) to reduce the chances of passing on HIV to her baby.

If not done recently, HIV positive patients should have a CD4 test. If the CD4 count is low, they should start anti-retroviral drugs. Commonly, these drugs will be started at the end of the initial 2 months TB treatment. However, if the patient is very ill, they may start earlier. Make sure that TB patients understand about the benefits and explain where to get the HIV test and care.