Which of the measures given below is the secondary prevention for tuberculosis?

IGNOU PB Bsc Nsg Entrance-2017

Community Health Nursing

Medium

Appeared in: IGNOU PB Bsc Nsg Entrance-2017

Explanation

Secondary prevention aims to identify and treat diseases in their earliest stages to stop or slow their progression.
In tuberculosis, this involves early case detection (e.g., through sputum smear microscopy) and ensuring effective treatment to cure the patient and prevent further spread.
DOTS (Directly Observed Treatment, Short-course) is the internationally recommended strategy to ensure patient adherence to treatment, which is a key component of secondary prevention for TB.
By curing the individual, DOTS effectively breaks the chain of transmission in the community.

Option A: BCG vaccination is a measure of primary prevention, not secondary.
Option C: XDR (Extensively Drug-Resistant) tuberculosis is a severe form of the disease, not a preventive measure.
Option D: MDR (Multi-Drug Resistant) tuberculosis is a form of the disease where bacteria are resistant to the two most powerful anti-TB drugs, not a preventive measure.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Levels of Prevention in Tuberculosis as background academic context rather than a clinical decision trigger.
A nurse's role in DOTS is critical. It involves not just observing the patient taking medication but also providing health education, monitoring for side effects, and offering psychosocial support to ensure treatment completion.
Failure of secondary prevention (i.e., incomplete or inadequate treatment) is a primary driver for the development of MDR and XDR-TB, which are much harder and more expensive to treat.
What if a community has a low BCG vaccination rate? This increases the risk of severe TB forms in children. The nurse's role would shift to advocating for improved primary prevention through vaccination campaigns and health education about the vaccine's benefits.

How to Approach the Question

First, identify the core concept in the question: 'secondary prevention' for 'tuberculosis'.
Define 'secondary prevention' in your mind. It means taking action after a disease process has begun but before it is symptomatic or severe. Key actions are early diagnosis and prompt treatment.
Evaluate each option against this definition:
BCG vaccination: This is given to prevent disease. This is primary prevention.
DOTS treatment: This is a strategy for treating diagnosed cases to cure them and prevent spread. This fits the definition of secondary prevention.
XDR/MDR tuberculosis: These are types of the disease, not actions taken to prevent or treat it at an early stage. They are outcomes, not interventions.

Concept Tested & Keywords

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