Multi-drug-resistant tuberculosis primary prevention

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]

Primary prevention of tuberculosis is targeted to avoid the disease transmission and infection of healthy individuals. The BCG vaccines is used in children susceptible to TB infection. Infection control measures for multi drug resistant tuberculosis include prompt diagnosis and treatment, isolation of patients already infected with Mycobacterium tuberculosis , early diagnosis and treatment of HIV infected tuberculosis. Primary prevention also includes enviornmental control measures like improving ventilation and use of personal respiratory protection like respiratory masks.

Primary prevention in tuberculosis is targeted to avoid the disease transmission and infection of healthy individuals. The BCG vaccine is used in children susceptible to TB infections, such as children living in endemic areas or having a close contact with a confirmed case of TB. Several preventive measures are used to avoid the transmission of the mycobacteria, such as respiratory isolation, use of respiratory masks among health-care professionals, and advising respiratory hygiene and cough etiquette.

• Health care providers can help prevent drug-resistant TB by quickly diagnosing cases, following recommended treatment guidelines, monitoring patient’s response to treatment, and making sure therapy is completed.

• Another way to prevent getting drug-resistant TB is to avoid exposure to known drug-resistant TB patients in closed or crowded places such as hospitals, prisons, or homeless shelters. Isolation of the MDR-TB diagnosed patients.

• Appropriate anti tubercular drugs must be promptly initiated and the most important way to prevent the spread of drug-resistant TB is to take all TB drugs exactly as prescribed by the health care provider. No doses should be missed and treatment should not be stopped early. People receiving treatment for TB disease should tell their health care provider if they are having trouble taking the drugs.

• People who work in hospitals or health-care settings where TB patients are likely to be seen should consult infection control or occupational health experts.

• Early diagnosis and prompt treatment of MDR-TB in HIV infected people.

• It is effective in places where there is no primary transmission control measures. It includes isolation of patients based on their HIV status and sputum results.^[1]

• Engineering control measures can be used to prevent the spread and reduce the concentration of infectious droplet nuclei. Improvement of natural ventilation can prevent almost 33% of the future XDR cases.

• WHO recommendations consider personal respiratory protection as the third line of defense when the risk of tuberculosis transmission cannot be reduced by administrative or engineering services. It mainly includes respiratory masks which prevent the contamination by droplets.

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