Post-Treatment Follow Up
All patients who successfully complete treatment need to be evaluated twice, 6 and 12 months post-treatment. During these visits a physical examination must be conducted; and a sputum must be collected for TB microscopy and TB culture. Laboratory results must be documented in the patient folder and the electronic treatment register. Individuals may develop various conditions during treatment for
All patients who successfully complete treatment need to be evaluated twice, 6 and 12 months post-treatment. During these visits a physical examination must be conducted; and a sputum must be collected for TB microscopy and TB culture. Laboratory results must be documented in the patient folder and the electronic treatment register.
Individuals may develop various conditions during treatment for RR-TB that require ongoing treatment and follow up. These conditions may be due to the impact of RR-TB on the lungs (including fibrosis, scarring, and reactive airway disease) or due to side effects of RR-TB treatment (e.g. hearing loss). People with RR-TB should be followed for these conditions even after completion of RR-TB therapy [11]. Although most patients will be managed through PHC following completion of RR-TB treatment, some patients with post-TB lung disease may benefit from functional respiratory assessment (e.g. lung function tests, CT imaging) and long term follow up by pulmonology services in tertiary centres.
The table below summarizes some of the more common chronic conditions that affect people with RR-TB and management options.
| Condition | Management following completion of RR-TB treatment |
| Reactive airway disease | - Inhaled beta-2-agonists and inhaled corticosteroids. Management in PHC. |
| Chronic bronchitis | - Inhaled beta-2-agonists and inhaled corticosteroids; antibiotics as needed for flare ups. Management in PHC. |
| Pulmonary insufficiency | - Oxygen therapy. |
| Hearing loss | - Hearing aids, cochlear implants. - Management in audiology, rehabilitation medicine. |
| Peripheral neuropathy | - Physical therapy, sturdy shoes. - Management in PHC, rehabilitation medicine. |
| Depression/anxiety | - Counselling, antidepressants, anxiolytics. - Management in PHC, with access to psychiatry services. |
| Right heart failure (core pulmonale) | - Tailored therapy with diuretics, inotropes, afterload reduction. - Management in PHC, with access to cardiology services. |
| Chronic haemoptysis | - Volume repletion, consideration of surgical intervention. - Management in PHC, with access to surgical services. |
| Super-infections (e.g. aspergilloma, nocardia) | - Targeted antimicrobial therapy, consideration of surgical intervention. - Management in PHC, with access to infectious diseases specialists and surgical services. |
National Department of Health Clinical Management of Rifampicin-Resistant Tuberculosis, September 2023
Post-Treatment Follow Up