Summary

In this study session, you have learned that:

• Patients on anti-TB drugs must be monitored throughout the course of treatment for adherence and potential side-effects.
• Sputum examination during follow-up is important for smear-positive TB patients and looking for symptom improvement is essential for other forms of TB.
• When a TB patient is referred to a hospital or clinician for special care, inform the patient and the receiving clinician that the patient is expected to return to the original health facility for continuing TB treatment after referral care is completed.
• When a patient moves and transfers to a new treatment facility, follow-up to ensure that the transfer is successfully completed.
• It is the originating (first) health facility’s responsibility to find out the treatment outcome for a patient who transfers out.
• The outcome ‘transfer out’ is used only if the patient was transferred and another outcome cannot be determined.
• If TB patients must travel, drugs may be provided for up to two weeks of self-administration (if the patient will be absent for more than two weeks, a transfer should be arranged).
• If a TB patient misses a dose for more than 24 hours, make a home visit within the next 24–48 hours, give patients the missed dose only, finding out reasons for missed treatment.
• If a TB patient on a self-administered regimen fails to refill the drug supply within a week of the scheduled day, use a home visit to find the patient, deliver the drugs and determine the problem.
• If a TB patient interrupts treatment, make every effort to find the patient through family, neighbours and the contact person listed on the TB registration form.