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TB PATIENT EDUCATION

CHART 5

4 MONTHS

IS IT POSSIBLE TO CURE TB?

CHART 1 SIGNS AND SYMPTOMS OF TB

Common symptoms of TB are: 1. a cough for more than 2 weeks 2. loss of appetite 3. tiredness 4. chest pain 5. fever 6. night sweats 7. weight loss

SIGNS AND SYMPTOMS OF TB

CHART 1

BRRR

SIGNS AND SYMPTOMS OF TB

CHART 2 HOW IS TB TRANSMITTED?

TB bacteria are spread from an infectious person to other people through the air. This happens when a person with infectious TB coughs, sneezes, talks or spits. The TB bacteria fly through the air and are breathed in by another person who is close by. This happens usually in a closed space with not much ventilation or sunlight, such as a closed house or room, on the train or on the bus for example.

HOW IS TB TRANSMITTED?

CHART 2

HOW IS TB TRANSMITTED?

CHART 3 RELATIONSHIP BETWEEN TB AND HIV Some people might have the bacilli in their bodies and yet not be sick.This is because their immune systems are strong and they keep the TB bacteria under control. It is like the immune system makes the TB bacteria go to sleep so they don't cause any disease. But sometimes people's immune systems get weak and the TB bacteria wake up and then cause the TB disease with the symptoms we mentioned before. This could be for many reasons such as poor nutrition, overcrowded living conditions or smoking; and could happen many years after the TB first got inside their body. As you know, the HIV virus attacks and weakens the body's immune system. Therefore, in a person living with HIV, it is more likely they will get TB disease. That is; having HIV increases your risk of getting TB disease and it can happen at any CD4 count. In fact TB is one of the most common opportunistic infections amongst people living with HIV/AIDS. Note that, as with other infections, having TB makes the immune system weaker, which makes the CD4 count go down. It is important you continue taking the ARV medicines to keep the HIV virus under control and your immune system strong. RELATIONSHIP BETWEEN TB AND HIV

CHART 3

HIV NEGATIVE

HIV POSITIVE

RELATIONSHIP BETWEEN TB AND HIV

CHART 4 WHY DOES TB TAKE SO LONG TO BE TREATED?

There are at least two places where bacilli live in your lungs: 1. There are bacilli that are replicating very quickly in the upper parts of your lungs, because the oxygen level is higher here and it helps the bacilli to grow (TB survives with the air). They are the first to be killed by the medicines and it is likely that you feel a lot better after 1 or 2 months because they are causing the symptoms. At this stage you may think you are cured from TB and maybe you want to stop the drug intake or leave it a few days out. DO NOT STOP because you are risking your life by stopping the treatment at this stage since you are not cured yet. 2. There are other bacilli hiding deeper in the lung tissues or other affected tissues. These are the most difficult to kill and they need drugs for a longer period of time. Thats why the duration of treatment is so long.

WHY DOES TB TAKE SO LONG TO BE TREATED?

CHART 4

WHY DOES TB TAKE SO LONG TO BE TREATED?

CHART 5 IS IT POSSIBLE TO CURE TB?

TB can be cured 100%. The treatment usually consists of 4 or 5 medicines which must be taken over a long period of time. The minimum period is 6 months. The treatment can only be effective if you take all your drugs, every day, for a minimum of 6 months If you stop to take the drugs before the treatment is finished, or you interrupt it: a) The bacilli will multiply again and you will get sick again b) You might spread TB to others c) You could die d) You can develop a resistant type of TB, which is difficult to treat, very long and has more side effects.

IS IT POSSIBLE TO CURE TB?

CHART 5

4 MONTHS

IS IT POSSIBLE TO CURE TB?

CHART 6 SIDE EFFECTS

The TB medicines can cause some side effects such as: Nausea and vomiting, orange discoloration of urine and other body fluids. This is normal and you shouldn't worry too much. Discuss these with your doctor/ nurse and they can help you to deal with these side effects. Never stop taking your medicines unless your doctor tells you to! Go to the clinic immediately (within one week) if you have any serious side effects such as: - Vomiting or diarrhea for more than 4 times in 1 day - Severe abdominal pain - Yellow skin or eyes - Skin rash - Loss of sensation (peripheral neuropathy) - Poor vision (loss of sight)

Never stop taking your medicines unless your doctor tells you to!

SIDE EFFECTS

CHART 6

SIDE EFFECTS

CHART 7 MULTI-DRUG RESISTANT TB

If you skip doses of your TB medicines, stop taking them for a while and start again, or stop taking them before your doctor tells you to stop then they might stop working. The amount of the medicine in your blood will go down. Then the TB medicine cannot kill the TB bacteria. The TB bacteria can become stronger and more dangerous. This more dangerous type of TB bacteria is called "Drug Resistant TB or Multi-Drug Resistant TB". This means that 1 or more of the TB medicines (remember you are taking 4 different medicines in the same pill) will no longer work. This is extremely serious as this type of TB is very difficult and expensive to treat. You can also get MDR TB from the start if you get it from another person. You can then spread this dangerous type of TB to your loved ones.

MULTI-DRUG RESISTANT TB

CHART 7

N O T TA K EN
MULTI-DRUG RESISTANT TB

CHART 8 TREATMENT PLAN


The Rx you are starting is called DOT. This means that if you live close by, youll be coming to the hospital every day. If not, a VHW that the EHT will mention to you will support you regularly throughout your Rx. When you first start TB treatment, you will need to come after 2 weeks to get your medicines from the nurse. This is done so we can check how you are doing, whether you are having any reactions to the medicines or not. You are also free to ask questions. After that you will only need to come every month to receive your medicines, be checked by the doctor and to see the counselor if you wish. Duration of Rx: 6 months minimum, depending on the type of TB and the evolution of your Rx. M1 and M2: You will be given 4 different drugs combined in 1 tablet (2-5 per day, depending on weight). They have to be taken all on an empty stomach. If not, drug efficacy might be reduced by half. This is called intensive phase of the treatment. Last 4 months: You will get 2 different drugs combined in 1 tablet (2-5 day) They also have to be taken all on an empty stomach. This is called continuation phase. For those smear negative and EP forms, they continue another 4 months, taking 1 pill that combines 2 types of drugs. After 6 months*: If you have TB in your lungs, your doctor will repeat the sputum exam at the end of your treatment (after 6 months) if you were sputum positive before starting treatment. If you are sputum negative your treatment is finished. For TB in the lungs that was sputum negative and TB infection of other sites in the body, the doctor will assess your symptoms and decide if you can finish your treatment. If the doctor says your treatment is finished this means your TB disease has been cured. However, dont forget that some of the TB bacteria might have hidden from the medicines and could still be in your body sleeping. Therefore there is always the risk that they could wake up and cause the TB disease again, especially if your CD4 count remains low. The doctor will do regular tests (sputum, X-rays) to see how your treatment is going.

Many people feel that they want to stop their treatment during the 6 months. This is normal. But remember that in order for you to be cured you need to take all your drugs, every day, for the full course of the treatment.
* For patients who have been treated against TB in the past (category II patients) you should explain: If you have been treated for TB in the past, your treatment will last 8 months and will require daily injections for a period of 2 months. :

TREATMENT PLAN

CHART 8

TB TREATMEN T

CARD

4 MONTHS

TREATMENT PLAN

CHART 9 SUPPORTING YOUR TREATMENT AND WELL-BEING

It is important that you lead a healthy lifestyle so that you can get strong enough to help the medicines kill the germs that cause TB. Try to eat well. Eat at least 3 meals a day and eat a wide variety of foods from the different food groups. Take time to relax and do the things you enjoy. Get plenty of sleep. Have good hygiene practices. Always wash your hands after using the toilet and before eating or preparing food. Avoid smoking and alcohol. This will only make your TB disease worse. Avoid alcohol. It weakens your immune system.

SUPPORTING YOUR TREATMENT AND WELL-BEING

CHART 9

N O SM O K IN G

SUPPORTING YOUR TREATMENT AND WELL-BEING

N O
BEER

D R IN K IN G

CHART 10 INFECTION CONTROL

All patients, regardless of being infectious or not, should practice the following precautions: Practice cough hygiene: When coughing or sneezing, use a handkerchief or cough in your lower arm. Do not spit except in a sputum container, especially where children are around Ventilate your room as often as possible by opening the windows Go outside as often as you can. Remember that the TB Bacillus lives in the air and the more you go outside or refresh the air in your room the less chance there is that the bacilli can be inhaled.

Remember!
Take a forgotten dose as soon as possible, even if it means that 2 doses will be close from one another In case of vomiting, take the tablets again if vomiting happened less than half an hour after. The clinic/hospital staff is here to help you! Dont hesitate to come to us for any question or concern you have regarding your treatment.

INFECTION CONTROL

CHART 10

INFECTION CONTROL

PRIM

HEALTH Y R A

N
F

HE

ZI M

A LT H & C H

BAB WE

EA

I T A LT H Y N LD

EL

FA

RE

RE CA

MIN

IS T

ZIMBABWE

PRIM

HEALTH Y R A

N
F

HE

ZI M

A LT H & C H

BAB WE

EA

I T A LT H Y N LD

EL

FA

RE

RE CA

MIN

IS T

ZIMBABWE