A person with sputum AFB positive is newly diagnosed to have Tuberculosis. Which category of treatment will the person receive?

Appeared in: TMC Staff Nurse - 2019

Explanation

Category I is designated for all new cases of tuberculosis, regardless of whether they are sputum-positive, sputum-negative, or have extrapulmonary TB.
The patient is described as 'newly diagnosed' and 'sputum AFB positive', which is the classic definition of a new pulmonary TB case.
The standard first-line treatment regimen for new drug-sensitive TB cases consists of a 2-month intensive phase with four drugs (HRZE) followed by a 4-month continuation phase with three drugs (HRE).
This approach aims to rapidly kill the bacteria and then sterilize the remaining dormant bacilli to achieve a cure and prevent relapse.

Option B: Category II is reserved for patients who have been previously treated for TB.
Option C: Category III is an obsolete classification under the current NTEP guidelines.
Option D: Category IV is for patients with drug-resistant tuberculosis (DR-TB).

Clinical Relevance

Nursing practice connection: Knowing Treatment categories for Tuberculosis under the National Tuberculosis Elimination Program (NTEP/RNTCP) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
A nurse's primary role is to ensure the patient adheres to the DOTS strategy, which involves watching the patient swallow their daily FDC medication, especially during the intensive phase.
Patient education is vital. The nurse must teach the patient and family about the importance of completing the full course of treatment, potential side effects, cough etiquette, and proper ventilation to prevent transmission.
Nurses are responsible for monitoring the patient's response to treatment, including scheduling follow-up sputum examinations (e.g., at the end of the intensive phase) and observing for adverse drug reactions.

How to Approach the Question

First, identify the key information in the question stem: 'newly diagnosed' and 'sputum AFB positive'.
Recognize that the question is asking for the treatment classification under India's national TB program (NTEP/RNTCP).
Recall the definitions of the different treatment categories.
Match the patient's profile ('new case') to the correct category. A new, sputum-positive case is the standard definition for Category I.
Differentiate this from other categories: Category II (previously treated), Category IV (drug-resistant), and the obsolete Category III.
Select the option that corresponds to the classification for new TB cases.

Concept Tested & Keywords

Concept Tested: Treatment categories for Tuberculosis under the National Tuberculosis Elimination Program (NTEP/RNTCP).
Stem keywords: sputum AFB positive, newly diagnosed, Tuberculosis, treatment
Lead-in keywords: Which category
Clinical cues: The cue 'newly diagnosed' is critical, as it distinguishes the patient from those who have been treated before (relapse, failure, default).

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E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart B (pp 202-403 of 604) pp. 20-22, 29-31

Practise the full TMC Staff Nurse - 2019

Attempt every question from this paper in a timed mock, then review the full solution for each one.