Hesperian Health Guides
How to Treat TB
TB medicines can make hormonal methods of family planning (like birth control pills) less effective. Women being treated for TB should use a different family planning method.
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 been cured.
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.
After the first 2 months of treatment, it is sometimes possible to take medicines 3 times a week, instead of every day but not if you have HIV or if there is resistance to TB medicines in your area. Talk to a health worker to see if you can get this kind of treatment.
Anyone who is being treated for TB should follow these rules:
- Take all the medicine for as many months as is recommended. If you stop too soon, you may infect others and the illness will come back (see below).
- Learn which side effects are normal and which are serious for the medicines you are taking. If you have serious side effects, stop taking the medicines and see a health worker immediately.
- Get plenty of rest and eat as well as possible. If you can, stop working until you begin to feel better.
- Avoid spreading TB germs to others. If possible, sleep separately from those who are not sick with TB for one month after starting medicines. Cover your mouth when coughing and spit sputum into a piece of paper. Throw it into a latrine or toilet, or burn it.
- If you give birth during treatment, your sputum should be tested. If it is negative, your baby should be given a BCG (Bacille Calmette-Guerin) vaccine, but no medicines. If your sputum is positive, your baby will need medicines. You do not need to be separated from your baby or to stop breastfeeding.
- If possible, go to an experienced health worker to coordinate treatment for your TB and HIV if you have both infections. Because more medications are being taken, there is a greater possibility of side effects.
- Stop smoking.
Resistance to TB Medicines
If a woman is infected by someone with drug-resistant TB, the germs causing her sickness will also be resistant.
Health workers should always ask if a person has been treated for TB before. If she has, she is more likely to have drug-resistant TB.
If a person does not take enough of the right medicines, or stops taking medicines before the treatment is finished, not all theTB germs will be killed. The strongest germs will survive and multiply, and then the medicine may be unable to kill them. This is called ‘resistance’.
TB that has become resistant to both isoniazid and rifampicin is very difficult to treat. The treatment takes between 8 to 20 months, is often less successful, and is much more expensive than treatment for ordinaryTB. A person with multi-drug-resistant (MDR) TB can spread the disease to others for several months after beginning treatment.
Anyone whose sputum is still positive after 2 months of treatment may have MDR TB. She should see a health worker trained in treating TB to get other medicines.