| How
to prevent transmission
I Primary Prevention
1) Health Promotion :
Health education to patients, contacts
and general public about
a) Mode of transmission
b) Disposal of sputum and infective materials
c) Methods to prevent spreads from patients to healthy individuals
d) Regularity of treatment and follow-up
2) Specific Protection :
a) Immunoprophylaxis - BCG vaccination is important component of Universal Immunization Programme (UIP). While it may not protect against development of TB disease in adults, it protects against severe forms of TB in childeran e.g. tuberculous meningitis and milliary tuberculosis.
b) Chemoprophylaxis - Isoniazid (INH) is advised in all under six contacts of sputum positive TB patients as a prophylactic agent. It protects against development of serious forms of TB as the cell mediated immunity is immature up to the age of 6 years.
II Secondary Prevention
1) Early diagnosis :
a) All patients with the following symptoms should be subjected to two sputum smear examinations. (SPOT-MORNING)
i) Cough for more than two weeks.
ii) Low grade, evening rise of fever and night sweats.
iii) Chest pain
iv) Hemoptysis
b) Contact-Screening: all family members and other close contacts of the pulmonary TB patient are screened for symptoms.
c) Tuberculin testing has less value in detection of Tb in adults but is a useful tool in pediatric TB.
d) X-ray chest is used as a supportive tool in diagnosis of sputum negative pulmonary TB
2) Prompt and effective treatment:
a) Domiciliary mode of treatment
b) Regular administration of drugs and follow-up
c) Directly Observed Treatment-Short Course Chemotherapy (DOTS)
d) Prompt defaulter retrieval actions
III Tertiary Prevention
1) Disability limitation - can be achieved through early diagnosis,
prompt and effective treatment and regular follow-up.
2) Rehabilitation -
a) Occupational rehabilitation may be required in certain cases,
due to decreased pulmonary functions.
b) Psychological rehabilitation of cured patients, in view of
the social stigma and the false beliefs associated with the disease.
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