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Antenatal Clinics/MCH clinics
Antenatal clinic attendee rates are very high in the country as the RCH programme
receives high priority and is a leading public health programme in the country.
Screening pregnant women for TB in MCH clinics provides an exceptional
opportunity to identify and reach women in need of TB case diagnosis as a majority
of women access health care during pregnancy at least once. Strengthening
linkages between maternal health and TB management can contribute to the
reduction of maternal and newborn mortality too.
TB Symptoms screening must be undertaken for all mothers attending the
antenatal clinics at every visit and those who are symptom screen positive
must be immediately linked to the nearest laboratory for early TB diagnosis
and decision on TB treatment initiation.
Prison inmates
Predisposing factors such as overcrowding, long-term close contact with inmates
and lack of easy access to adequate health services may lead to high rates of TB
transmission in prisons. Duration of stay of inmates in the prison is unpredictable and
turnover is also high, resulting in undiagnosed or delayed diagnosis of TB.
The intensified case finding activity should include:
Symptom screening at
Entry;
when prisoners enter the prisons.
Periodic mass screening
with chest X-ray. If chest x-ray is not available
then symptom screening should be done.
Patients with Co morbidities
Patients with chronic illness like malignancy, on dialysis, on immune-suppressants,
long term steroids have higher risk of tuberculosis - Symptom screening for TB
should be done on all patient visits to the health facilities for follow up examinations
Patients with past history of TB
Chances of TB relapse or recurrence is higher in people with a past history of TB.
Efforts to actively screen for TB symptoms in this group could be a high case yielding
activity. The programme now advocates that all TB cases after successful
completion of treatment need to be followed up for a period of one year after with
follow up examinations at 6
th
, 12
th
,18
th
and 24
th
month.
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