Clinical Monitoring of DR-TB Patients

Clinical monitoring is one of the major components of the follow-up monitoring of Drug Resistant-TB (DR-TB) patients. 

The objective of regular clinical monitoring of patients is to ensure that the patient is adhering to treatment, progressing well and adverse effects are recognized early. 

Patients on any DR-TB regimen should be seen by a doctor trained in The National TB Elimination Programme Programmatic Management of Drug-resistant Tuberculosis (NTEP PMDT) guidelines for clinical evaluation on a monthly basis. Preferably, a day may be fixed for the monthly follow-up. 

During the follow-up visits the patient should be assessed for:

• Clinical, bacteriological and radiological response to DR-TB treatment
• Weight of the DR-TB patient
• Possible adverse events due to DR-TB treatment
• Other relevant investigations may be done as and when clinically indicated

Some patients may need to be hospitalized during the treatment for medical/ psychosocial reasons. ​The patient should be encouraged to continue the anti-TB treatment.

Specialist consultation needs to be sought based on the clinical requirements, for example, Psychiatrist, Ear Nose Throat (ENT) specialist, Paediatrician, Cardiologist, Gynaecologist, etc.

Resources

• Guidelines for Programmatic Management of Drug-resistant Tuberculosis in India, March 2021.
• WHO Consolidated Guidelines on Tuberculosis, Module 4: Treatment: Drug-resistant TB Treatment. ​

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