How to Treat TB 389
The most common sign of TB is a cough that lasts for more than
3 weeks, especially if there is blood in the sputum (mucus that
comes up from the lungs). Other signs include loss of appetite
and weight, fever, feeling tired and night sweats.
But the only way to know for sure that a person has TB is to
have the sputum tested. To get a sample of sputum—and not just
saliva (spit)—a person must cough hard to bring up material from
deep in her lungs. The sputum is then examined in a laboratory to
see if it contains TB germs (is positive).
A person should take 3 sputum tests. If at least 2 of her
sputum tests are positive, the woman should begin treatment. If
only one test is positive, she should have her sputum tested again
and, if it is positive, begin treatment. If the third test is negative,
she should get a chest x-ray, if possible, to be certain that she
does not need treatment. She should also be tested for HIV since
negative sputum tests are more common in people with HIV.
IMPORTANT Because it is so common for people with HIV to be
sick and die from TB, all HIV-infected people should be tested for
TB. If the TB test is positive, the person should begin treatment right
away. And in countries where HIV is common, all people with TB
should consider getting an HIV test.
TB can almost always be cured if a woman takes the right
medicines in the right amounts for the full length of the treatment.
The basic treatment for a woman who has TB for the
first time has 2 parts, and always includes taking more than
1 medicine. At first, a woman takes 4 medicines for 2 months,
and then her sputum is tested. If it is negative, she begins part
2, in which she takes 2 drugs for another 4 months (a total of
6 months of treatment). When the treatment is finished, her
sputum should be checked again to make sure that she has
TB medicines include isoniazid, rifampicin, pyrazinamide,
ethambutol, and streptomycin. For information about these
medicines see the “Green Pages.” TB treatments vary from
country to country. A health worker should always follow the
recommendations of the TB program in her or his country.
If a woman’s sputum is still positive after 2 months of treatment,
she should be tested to see if her TB germs are resistant to the
medicines (see page 390).
Know if a
➤ If someone with
signs of TB in the
lungs has negative
sputum tests, she
should see a health
worker trained in
treating problems of
the lung. She may
asthma, or cancer of
➤ TB medicines
can make hormonal
methods of family
planning (like birth
control pills) less
being treated for
TB should use a
See page 200.
TB treatment during pregnancy
A pregnant woman should never take streptomycin, because it may cause
deafness in her baby when she is born. She should also avoid taking pyrazinamide
whenever possible, because its effect on the baby is not known. TB medicines may
cause pain and numbness in the hands and feet, especially during pregnancy. Taking
50 mg of pyridoxine (vitamin B6) daily will help.
Where Women Have No Doctor 2012