Working for Change 391
Because treatment for TB is long, and the effects of stopping treatment are so
serious, extra care should be taken to make sure that a person takes all her medicine.
A health worker or community volunteer should watch and make a record of every
dose the sick person takes. This is called ‘directly observed treatment, short-course’,
or DOTS. Health workers should use DOTS whenever possible, but it is most
important for the first 2 months of treatment.
IMPORTANT The best way to prevent the spread of TB is to
cure people who are sick with TB.
These things can also help:
• Encourage people to get tested if they live with a person who is
sick with TB, or if they have a cough for 2 weeks or more.
• Immunize healthy babies and children with BCG vaccine to
prevent the most deadly forms of TB. Children sick with HIV
or AIDS should not be given BCG vaccine.
To Prevent TB in People with HIV
A person with a positive TB test, but no signs of TB sickness, can be given isoniazid
once a day (see Green Pages) to reduce the chance that they will get sick with TB. But
if a person has signs of being sick with TB, she must take the full TB treatment. Because
it prevents other infections, taking cotrimoxazole can also help a person stay healthy
(see the Green Pages).
Creating effective TB control in your community requires:
• community and family education about the signs of TB and
how it is spread. Encourage women to seek treatment if they
show signs of TB.
• trained health workers or community volunteers to participate
in the DOTS program, who will find and work with persons
sick with TB if they stop treatment early. DOTS programs must
be flexible to help meet each person’s needs.
• a continual supply of medicines so treatment does not get
• laboratory equipment and trained workers for testing sputum.
• a good system for keeping track of who has TB, how the
treatment is going, and when a person is cured.
A good TB program must give care to all people sick with TB,
including women. TB services can help more women by:
• providing care and treatment in women’s homes or as near
to the home as possible.
• including midwives and traditional birth attendants in TB
screening and DOTS programs.
• combining TB screening and treatment with other health
services women are likely to use.
Where Women Have No Doctor 2012