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Assignment in Community Health Nursing

Savarez Aliza Grace F. BSN II-A

Tuberculosis is a disease caused by a bacterium called Mycobeacterium

tuberculosis that is mainly acquired by inhalation of infectious droplets containing viable
tubercle bacilli. Infectious droplets can be produced by coughing, sneezing, talking and
singing. Coughing is generally considered as the most efficient way of producing
infectious droplets.

Goal: To reduce by half TB prevalence and mortality compared to 1990 figures by 2015
The NTP aims to:

Reduce local variations in TB control program performance


Scale-up and sustain coverage of DOTS implementation


Ensure provision of quality TB services


Reduce out-of-pocket expenses related to TB care

Under Phil PACT, there are 8 strategies to be implemented, namely:

Localize implementation of TB control


Monitor health system performance


Engage all health care providers, public and private


Promote and strengthen positive behavior of communities


Address MDR-TB,TB-HIV and needs of vulnerable population


Regulate and make quality TB diagnostic tests and drugs


Certify and accredit TB care providers


Secure adequate funding and improve allocation and efficiency of fund utilization

Signs and Symptoms

A Person with Latent TB Infection A Person with TB Disease

Has symptoms that may include:
- a bad cough that lasts 3 weeks
or longer
- pain in the chest
- coughing up blood or sputum
Has no symptoms:
- weakness or fatigue
- weight loss
- no appetite
- chills
- fever
- sweating at night
Does not feel sick
Usually feels sick
Cannot spread TB bacteria to
May spread TB bacteria to others
Usually has a skin test or blood Usually has a skin test or blood
test result indicating TB infection test result indicating TB infection
May have an abnormal chest x Has a normal chest x-ray and a
ray, or positive sputum smear or
negative sputum smear
Needs treatment for latent TB
Needs treatment to treat active
infection to prevent active TB
TB disease

Treatment and its side effects :

The different medications used to treat tuberculosis are associated with specific side

Isoniazid may make you feel tired or nauseous or make you lose your
appetite. It can cause numbness or tingling in your hands or feet, but this is rare
in well-nourished people.

Rifampicin can reduce the effectiveness of the contraceptive pill and some
other medications. It is important to advise the doctor who prescribes your TB
treatment about any other medicines you are taking. Women taking the
contraceptive pill may need to discuss other forms of contraception with their
general practitioner or an advisor at a family planning clinic. If you have lens
implants or wear soft contact lenses, inform your doctor, as rifampicin can stain
them. Rifampicin will cause a pinkish/orange discolouration of your urine, saliva
and sweat. This side effect is harmless so you should not be concerned.

Ethambutol or Myambutol can cause visual problems. Your eyesight will be

checked during treatment, but you should stop taking the medication if your
vision is affected and call your doctor straight away.

Pyrazinamide can lead to nausea and a loss of appetite. It is usually only

taken for the first two to three months of treatment. Consult with your doctor if
you develop unexplained rashes, fever, aches or joint pains.

Diagnosis :
Blood tests
Blood tests may be used to confirm or rule out latent or active tuberculosis. These tests
use sophisticated technology to measure your immune system's reaction to TB bacteria.
QuantiFERON-TB Gold in-Tube test and T-Spot.TB test are two examples of TB blood
Imaging tests
If you've had a positive skin test, your doctor is likely to order a chest X-ray or a CT
scan. This may show white spots in your lungs where your immune system has walled
off TB bacteria, or it may reveal changes in your lungs caused by active tuberculosis.
CT scans provide more-detailed images than do X-rays.
Sputum tests

If your chest X-ray shows signs of tuberculosis, your doctor may take samples of your
sputum the mucus that comes up when you cough. The samples are tested for TB
bacteria. Sputum samples can also be used to test for drug-resistant strains of TB. This
helps your doctor choose the medications that are most likely to work. These tests can
take four to eight weeks to be completed.