Content Status where content has been uploaded and published on LMS.
Adverse Drug Reactions (ADRs), such as gastritis and abdominal pain, may occur from the Drug-resistant TB (DR-TB) treatment regimen.
Suspected agent(s): Para Aminosalicylic Acid (PAS), Ethionamide (Eto), Clofazimine (Cfz), Linezolid (Lzd), Fluoroquinolone (FQs), Isoniazid (H), Ethambutol (E), and Pyrazinamide (Z)
The standard duration of the H Mono/ Poly DR-TB regimen is 6 months.
The treatment duration may be extended in the following conditions:
Whenever extending treatment, always it is extended directly to 9 months. There is no monthly extension in this regimen.
Longer oral Multi (M)/ Extensively-drug Resistant TB (XDR-TB) regimen is recommended for Multi-drug Resistant (MDR)/ Rifampicin-resistant TB (RR-TB) patients who are excluded from shorter oral Bedaquiline-containing MDR/ RR-TB regimen including for the XDR-TB patient.
A patient would be re-evaluated in any of the following conditions and initiated on a longer oral M/XDR-TB regimen at Nodal (N)/ District DR-TB Centre (DDR-TBC) with any modifications:
Compared to Drug-sensitive TB (DS-TB), Drug-resistant TB (DR-TB) is more challenging in terms of:
Certain drugs can be used safely while others need to be avoided along with Bedaquiline (Bdq).
The table below provides the list of drugs that should be avoided when Bdq is part of the regimen as well as the drugs that are safe to use with Bdq.
|
GROUP |
SAFE TO USE |
DRUGS TO BE AVOIDED |
|---|
The anti-TB drugs recommended for treatment of Multi- and Extensively Drug-resistant (M/XDR) TB patients are grouped into three groups – A, B and C (Figure below).
Figure: Groups A, B and C of Anti-TB Drugs used in Treatment of M/XDR-TB Patients
Figure: Summary of the Sustainable Development Goals
It is important to create a realistic Advocacy, Communication and Social Mobilisation (ACSM) budget.
General principles which would be helpful in creating a realistic budget are:
The National TB Elimination Programme (NTEP) expenditures are organised under 19 heads. These are:
1. Civil works - Initial establishment/ refurbishment costs and maintenance of civil works costs for Designated Microscopy Centres (DMC), Tuberculosis Units (TU), District TB Centres (DTC), Drug-resistant TB (DR-TB) centres and State Drug Stores (SDS).
The preparation of a research and evidence-based Programme Implementation Plan (PIP) is vital for conducting effective Advocacy, Communication and Social Mobilisation (ACSM) activities under the National TB Elimination Programme (NTEP). The plan for ACSM activities should be made based on the needs of the community.
Needs Assessment through Situation Analysis
Situation analysis should start at the TB Unit (TU) level. The Senior Treatment Supervisor (STS) should take the initiative under the guidance and supervision of the District TB Officer (DTO).