What is the management of tuberculosis?

  1. Multi-drug treatment with 3 or 4 drugs is essential to make sure that the tuberculosis is cured and that resistance to the anti-TB drugs does not develop.
  2. The most important aspect of treating a child with tuberculosis is to ensure that the medicine is taken correctly and regularly. This is often difficult as the treatment takes many months. It is essential that the health care workers at the clinic develop a good working relationship with the mother and child.
  3. While ill children need hospitalisation, most children with tuberculosis can be treated from a clinic.
  4. The child’s general nutritional status must be improved as most children with tuberculosis are underweight for age. The Road-to-Health Card is a valuable way of monitoring the child’s weight gain.
  5. If children are infected with both HIV and TB, both infections should be treated. These children have a damaged immune system and their HIV infection should be correctly managed with prophylactic co-trimoxazole and antiretroviral therapy if they qualify.

Multi-drug treatment for many months is essential to cure tuberculosis.

Because of severe drug interactions between anti-TB and antiretroviral drugs, similar adverse drug reactions in the 2 groups of drugs, and possible immune reconstitution inflammatory syndrome, it is recommended to delay antiretroviral treatment until after the TB treatment is completed or to postpone antiretroviral treatment until 2 months of TB treatment has been completed.

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