Swach Bharat, Swsathya Bharat, TB Mukt Bharat
· TB harega desh jeetega
· TB sab ko nahin hoti; par kisi ko bhi ho sakti hai
· Do not ignore cough of more than 2 weeks, it may be TB.
· TB isn’t just somebody else’s problem, it could be yours. Coughing for more than 2 weeks, test for TB
· 2 hafte se jyada khansi, wajan ghatna, bukhaar aana, balgam mein khoon aane par turant doctor se salaah karein. Ye TB ho sakti hai
· Diagnose and treat every case of TB as per the IMA Standards for TB Care in India
· Serological tests for diagnosis of TB are banned
· Two consecutive negative sputum samples for AFB at the end of treatment means TB is cured
· TB treatment is available free at TB centers ( government or government approved private)
· MDR TB means that TB which is resistant to drugs INH, Rifampicin.
· MDR TB requires treatment for 24-27 months
· All diagnosed TB patients should be offered HIV counselling & testing.
· TB patients should be given dosages of the drugs depending upon body weight ( choose a drug fixed dose combination, which provides one tablet per 15 kg body weight)
· People living with HIV should be screened for TB
· Ensure all contacts of TB patients are screened for TB
· Counsel all TB patients for cough hygiene, nutrition & treatment adherence
· Dispose TB patient sputum in phenyl 5% or by burning it. You can collect it in tissue papers.
· All patients with cough of more than two weeks must wear surgical masks to prevent spread infection to others. They must be provided free surgical masks at medical center reception, X ray clinics, Labs etc.
· Doctors must use N 95 mask to prevent themselves and not surgical mask
· Cross ventilation is the best preventive strategy for TB spread. Split AC are the worst as they do not allow cross ventilation.
· Flu is droplet infection and TB is droplet nuclei infection. TB bacilli can remain in air for more than one day before settling down.
· Flu precautions will not prevent spread of TB
· All new cases of TB (pulmonary or extra pulmonary) needs to be treated for six months, starting with four drugs, and to be continued except Pyrazinamide which needs to be stopped at 2 months. In cases of bone, joint or brain TB continue treatment for additional three months.
· Retreatment case mean anyone who has taken treatment for more than one month and stopped. They should be treated for eight months, starting five drugs for two months, four drugs for additional one month, and rest three drugs till you complete eight months of treatment.
· Two sputum exam should be done in all cases of suspected Tb (one can do three sputum check also). Sputum may be positive in the second or third sample
· Take the first sample as the patient is seen for the first time
· 2% of all new cases of Tb may be MDR TB and 7% of all MDR TB may be XDR TB
· Go for gene expert molecular TB test, for all new TB cases. It can give results in 4 hours, can detect 67% of TB in suspected sputum negative cases, can detect Rifampicin resistance
· In a new case if rifampicin resistance is detected, repeat the test before labeling MDR. In retreatment cases only one test is sufficient.
· Hate TB, not the patient, treat with dignity and confidentiality.