Entry point, Our clients are referred from the General Health Clinic, Nutrition Centre, Comprehensive Care Clinic and the Community. Once they are diagnosed with TB we counsel them on adherence, for its a long term condition. HIV test is mandatory to all newly diagnosed. At the same time, Health Education on Cough etiquette, Proper Ventilation and general hygiene is given. The client is taught on the mode of transmission and part of the body the TB bacilli can affect. Possible side effects of the medicine are informed to the patient especially the Red discolouration of urine otherwise if not addressed.
We then start treatment, which lasts from 6 – 12 months, depending on the diagnosis. Follow up sputum from the patients with positive sputum at month zero are done at 2 months, 5 months and 6 months. In case during follow up, sputum is found to be positive sputum cultures, Genexpert are done, to rule out resistance to any of the medicine, Rifampician, Isoniazid, Ethambutol, Pyrozinamide. Adherence counselling is done and closes follow up by our Community Health Volunteers and where necessary Directly Observed Theraphy is initiated to such a client.
Contact tracing is done to all smear-positive patients and contacts below 5 years of age are put on TB Preventive Theraphy (Rifampicin Isoniazid for 3 months). Those contacts screened and found with signs are investigated by Genexpert (AAFB) Active Acid Fast Bacelli test/Chest X-ray and managed accordingly. Home visits are done to all TB clients by our Community Health Volunteers. Nutritional support and counseling to all and those below 18.5 BNI are put on supplements. Children are also assessed by Nutrition and managed as per guidelines. Weight monitoring is done in every visit to assess their progress and aid in increasing dosen according to the guidelines. Blood sugars are taken monthly.
The newly diagnosed co-infected clients (HIV/TB) are initiated Highly Active Antiretroviral (HAART) 2 weeks post-initiation of TB medication.
- Viral loads are done accordingly
- Boosting of regimens based on DTG | Efavirenz (This is because Rifampicin (in TB Medication) lowers their effects).
- Adherence and close monitoring of clients.
For Drugs Resistance TB Clients, once diagnosed are done Directly Observed Therapy until 6 months. This is done by the community Health Volunteer in the TB clinic. Close monitoring of their progress is done through:
- Monthly culture/microscopy (Active Acid Fast Bacill Test).
- Ures and Electrolyles.
- Liver Function Tests.
- Thyroid function Tests.
- Weight taking.