Operational Handbooks

The most common challenge in TB care is when a patient discontinues taking medicines or misses treatment appointments. For this reason, it is extremely important to have a plan to quickly follow up with the patient. If possible, this plan should involve a member of the TB treatment centre team (community nurse, doctor, TB treatment supporter) who will visit the patient at home the same day, if the patient has given you permission to visit their home. If they have not given you permission, another plan should be in place to contact the patient (e.g.

Patients and their caregivers should be prepared for TB treatment by giving them information (see Table 3) about:

Tuberculosis (TB), with an estimated incidence of 10 million people every year (range 8.9–11.0 million), is a major cause of ill health and one of the leading causes of death worldwide. Until the coronavirus disease (COVID-19) pandemic, TB was the leading cause of death from a single infectious agent, ranking above HIV, with an estimated 1.2 million TB deaths among people who are HIV-negative (range, 1.1–1.3 million), and an additional 208 000 deaths among people who are HIV-positive (range, 177 000– 242 000).

This section discusses how to counsel patients about TB treatment to help prevent them from stopping their treatment without medical advice.

This section focuses on what information about TB needs to be provided to patients and how that information should be provided.

Health education and counselling must be given in very simple and clear language. Even medical information should avoid technical terms and medical jargon. Sometimes a limited amount of information is shared in one meeting so that the patient can understand it and then can think about it and is prepared for further information at the next meeting. Sometimes, important information needs to be repeated to help the patient understand it.

Adverse event: Any untoward medical occurrence that may present in a person with tuberculosis (TB) during treatment with a pharmaceutical product but that does not necessarily have a causal relationship with the treatment.

Bacteriologically confirmed TB case: A case from whom a biological specimen is positive by smear microscopy, culture or a World Health Organization (WHO) recommended rapid diagnostic (e.g. Xpert® MTB/RIF).

Asking questions appropriately is an important technique that can help to:

Non-verbal communication includes eye contact, facial expressions, gestures, looking attentive, posture, nodding one’s head and other movements.

Actively listening is a specific communication skill which involves giving undivided attention to both verbal and non-verbal cues. It requires intense concentration; the health-care provider should show a deep interest in and respect for patients and should not interrupt them. In health counselling it is very important to listen to patients carefully so that the conversation can be adjusted to their individual needs.