Pharmacist/ Storekeeper (SDS)

To know the TB treatment response and to determine that if patient is cured, TB patients are clinically evaluated at the end of every four weeks of treatment, and they are also followed up by performing sputum test at end of each treatment phase (i.e. Intensive phase and Continuation phase)

TB patients during clinical evaluations are assessed to

• New case - A TB patient who has never had treatment for TB or has taken anti-TB drugs for less than one month is considered as a new case. 
• Previously treated patients have received 1 month or more of anti-TB drugs in the past. They could be further classified as:
• Recurrent TB case - A TB patient previously declared as successfully treated(cured/treatment completed) and is subsequently found to be microbiologically confirmed TB case is a recurrent TB case. 

Daily Regimen is prescribed for TB patients, where patients need to consume the medicine daily.

Daily Regimen comprises of the first line Anti TB drugs, based on

• Age: Adult/Paediatric
• Weight of the patient: Weight Bands

Age: Based on the age, patients are categorized into

• Adults: Patient's age should be 19 years or more.
• Paediatrics: Patient's age up to 18 years and weight less than 39 Kgs

A regimen means a prescribed systematic form of treatment for a course of drug(s). For TB treatment, Multi drug combination of regimen is followed. 

All TB drug regimens have an initial intensive phase(IP) followed by a continuation phase(CP). 

Following are some of the main TB drug regimens used based on the drug resistance pattern detected for TB patients.

What is Drug-Resistant Tuberculosis?

• Drug-Resistant TB occurs when bacteria become resistant to the drugs used to treat TB. This means that the drug can no longer kill the TB bacteria.

• Multidrug-resistant TB (MDR TB) is a type of DR-TB where TB bacteria is resistant to both Isoniazid and Rifampicin, the two most potent anti-TB drugs.

The World Health Organisation End TB Strategy, adopted by the World Health Assembly in 2014, aims to end the global TB epidemic. The strategy draws on the opportunities presented by the Sustainable Development Goals (SDGs), especially those goals aimed at achieving universal health coverage and social protection from disease.

The table given below provides information on the vision, goal, milestones and targets for the End TB Strategy.

The Senior Treatment Supervisor (STS) interacts with the patient care ecosystem from the time a TB case is notified, diagnosed and anti-TB treatment is initiated.

The key interactions include:

The Epidemiologic Triad is a model used in the field of epidemiology to study diseases and how they are spread. It consists of a triangle with three vertices or corners. 

The three vertices for infectious diseases consist of:

1. Agent, or microbe that is the factor causing the disease.

2. Host, or organism harbouring the disease.

3. Environment, or those external factors that cause or allow disease transmission. 

Chemotherapy for TB is the use of an anti-TB drugs to kill, or prevent the replication of, TB mycobacteria in the patient’s body. Effective anti-TB chemotherapy renders the patient non-contagious and cures the patient, thereby interrupting the chain of transmission. Mortality rates of TB range from 50-80% in untreated smear-positive individuals and drop to lower than 5% under chemotherapy.