Page 211 - fourth year book

COMMUNICABLE DISEASES (T.B)

number of doses and encounters with the health-care provider or
outreach worker,

III- Treatment for Drug -resistant Tuberculosis

 Drug resistance is proven by drug-susceptibility testing. However,
since this testing can take weeks, treatment should be started with
an empirical treatment regimen based on expert advice as soon as
drug-resistant TB disease is suspected.

 Drug-resistant TB disease should always be treated with a daily
regimen and under DOT. There are no intermittent regimens for
treatment of multidrug-resistant (MDR) TB.

Infection Prevention and Control Measures in Health Care facilities

The TB infection control program should be based on a three-level
hierarchy of control measures and include:

1. Administrative measures: Decrease the risk of exposure through the
following activities: -

- Assign a responsible person for infection control in the setting

- Presence of written TB infection control plan for early detection,
separation, treatment of suspected or confirmed cases

- Ensuring availability of a system for lab. testing and reporting of
results

- Ensure proper cleaning and sterilization or disinfection of potentially
contaminated equipment

- Developing effective management strategies (isolation room)

- Education and training of staff, patients and visitors about TB disease
and infection control

- Testing and evaluating workers who are at risk for exposure to TB

disease
- Using posters or signs to remind patients and staff of proper cough

etiquette and respiratory hygiene

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