Patient Care and Monitoring

1. Rapidly identify a new TB case.

2. Assess the patient's risk factors and signs and symptoms to determine if the patient might be infected with TB.

3. Isolate the patient with active disease to prevent the spread of the disease.

4. Collect appropriate samples for smears and cultures.

5. Obtain a thorough medication history.

6. Select and recommend appropriate antituberculosis treatment. Consider HIV status, pregnancy, type of TB infection, renal function, liver function etc.

7. Ensure adherence to the treatment regimen by the patient.

8. Obtain AFB stains to evaluate the effectiveness of treatment.

9. Consider TDM if no clinical improvement.

10. Secondary goals are identification of the index case that infected the patient, identification of all persons infected by both the index case and the new case of TB, and the completion of appropriate treatments for those individuals.

Abbreviations Introduced in This Chapter

AFB ALT AST BCG DOT HTN IFN-y IGRA TTBT MGLT NIDDM NRT1 PGR PPD RFLP TB TDM

Acid fasi bacillus Alanine transaminase Aspartate transaminase Bacille Calmette-Guér in Directly observed therapy Hypertension Interferon-y

Interferon-gam m a release assay Latent tuberculosis infection Mycobacterial growth indicator tube Noninsulin dependent diabetes mellitus Nucleoside reverse transcriptase inhibitors Polymerase chain reaction P u ri fi ed p rote i n de ri vat ive Restriction fragment length polymorphism Tuberculosis

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