Counselling is of paramount importance for TB Preventive Treatment (TPT) initiation and completion as most of the target population screened and found eligible would know that they do not have TB disease, would be symptom-free or otherwise healthy and would not feel the need to take any treatment, especially Household Contacts (HHC).
Stakeholders Involved in Counselling for TPT (Figure below)
To achieve high treatment completion rates and the desired epidemiological impact of the TB Preventive Treatment (TPT), monitoring TPT treatment adherence, including management of missed doses and Adverse Drug Reactions (ADRs), is of paramount importance under the National TB Elimination Programme (NTEP).
Significance of Monitoring Adherence to TPT
Adherence to the TPT course and treatment completion are important determinants of clinical benefit, both at the individual and population levels as:
Intensive Phase(IP): Consists of eight weeks (56 doses) of HRZE in daily dosages as per weight of patient.
Continuation Phase(CP): Consists of 16 weeks (112 doses) of HRE in daily dosages as per weight of patient.
Intensive Phase (IP)
Consists of eight weeks (56 doses) of HRZ in daily dosages as per weight of patient.
Daily Regimen is prescribed for Drug Sensitive TB patients (DSTB), where the patient needs to consume the FDC formulation daily.
Daily Regimen comprises the first line Anti TB drugs based on
Age: Based on age, patients are categorized into
There are five principal ways to prevent Drug-resistant Tuberculosis (DR-TB), as given in the figure below.
Treatment interruption is defined as a patient-initiated episode in which the patient discontinues TB treatment. All efforts must be made to ensure that TB patients do not interrupt treatment or are not lost to follow-up. Action should be taken to promptly retrieve patients who fail to come for their daily dose by the treatment supporter
The management of treatment interruptions is made based on the following criteria:
i. Type of case: Whether new, relapse or failure
The management principles of Extrapulmonary Tuberculosis (EPTB) are shown in the figure below.
Figure: Ten principles about what every EPTB patient in India needs as a basic standard of care
Abbr: CBNAAT:Cartridge-based Nucleic Acid AMplification Test; PTB: Pulmonary TB; NTEP: National TB Elimination Programme
Diagnosis of EP-TB
Follow-up Sputum Examination is useful for the clinical follow-up which helps in assessing the response to treatment, and to establish cure or failure at the end of treatment.
