ILOILO DOCTORS’ COLLEGE

College of Nursing

West Avenue, Molo. Iloilo City

NCM 112,113,114 RLE

Case Scenario 3
Care of client with alterations in Oxygenation
(Tuberculosis)

PRESENTED BY:
Palmes, Judith P.
BSN 3-H

PRESENTED TO:
Mr. Kim Bacerra
 I. INTRODUCTION

Tuberculosis (TB) is a potentially serious infectious disease that mainly affects the lungs. The
bacteria that cause tuberculosis are spread from person to person through tiny droplets released
into the air via coughs and sneezes. Once rare in developed countries, tuberculosis infections
began increasing in 1985, partly because of the emergence of HIV, the virus that causes AIDS.
HIV weakens a person's immune system, so it can't fight the TB germs. In the United States,
because of stronger control programs, tuberculosis began to decrease again in 1993. But it
remains a concern. Many tuberculosis strains resist the drugs most used to treat the disease.
People with active tuberculosis must take many types of medications for months to get rid of the
infection and prevent antibiotic resistance.

Tuberculosis is caused by bacteria that spread from person to person through microscopic
droplets released into the air. This can happen when someone with the untreated, active form of
tuberculosis coughs, speaks, sneezes, spits, laughs or sings. Although tuberculosis is contagious,
it's not easy to catch. You're much more likely to get tuberculosis from someone you live or
work with than from a stranger. Most people with active TB who've had appropriate drug
treatment for at least two weeks are no longer contagious.

Although your body can harbor the bacteria that cause tuberculosis, your immune system usually
can prevent you from becoming sick. For this reason, doctors make a distinction between:

 Latent TB. You have a TB infection, but the bacteria in your body are inactive and cause
no symptoms. Latent TB, also called inactive TB or TB infection, isn't contagious.
Latent TB can turn into active TB, so treatment is important.

 Active TB. Also called TB disease, this condition makes you sick and, in most cases, can
spread to others. It can occur weeks or years after infection with the TB bacteria.
Globally, TB incidence is falling at about 2% per year and between 2015 and 2019 the
cumulative reduction was 9%. This was less than half way to the End TB Strategy milestone of
20% reduction between 2015 and 2020.

An estimated 60 million lives were saved through TB diagnosis and treatment between 2000 and
2019.

Ending the TB epidemic by 2030 is among the health targets of the United Nations Sustainable
Development Goals (SDGs).
 II. OBJECTIVES

General Objectives:

At the end of case presentation the participant will be able to have an idea and knowledge
in handling /Care of client with alterations in Oxygenation (Pulmonary Tuberculosis) and
provide nursing managements and a skill in providing care to the patient.

Specific Objectives:

At the end of case presentation the students will be able to:

KNOWLEDGE:

▪ Study what is the possible outcome and gain knowledge about caring of client with
Pneumonia.
▪ Interpret all the analyze data in line with the case of the patient and know what are the
causes, signs and symptoms will occur.

▪ Understand the Pathophysiology of Tuberculosis.

SKILLS:

▪ Implement a proper nursing care for the patient in managing the signs and symptoms by
following the nursing process and procedure.
▪ Document and record an accurate consideration in connection with the nursing diagnosis.

▪ Collaborate with other healthcare team.

ATTITUDE:

▪ To established rapport with the patient as well as the members of the family.
▪ To flourish the patient’s personal goals for development about the situation in a vigorous
way.
▪ Show outmost confidence in managing client’s care
 III. PATIENT DATA
Demographic Data

Client’s Name: Mrs. Reyes

Age: 35 years old

Sex: Female

Marital Status:

Occupation: Laborer

Source if Information: Patient

Admitting Impression/ Final Diagnosis: Pulmonary Tuberculosis

Physical Examination

Vital Signs: Taken upon hospitalization revealed:

 Temperature: 38°C

Pulse Rate:

 90 bpm

Respiratory Rate:

 25 cpm

O2 Saturation:

 90%

Weight:

 With dry and flushed skin and looks older than her age.
 IV. PHYSICAL ASSESSMENT

 Upon auscultation both lungs, revealed crackles breathe sounds.

 During palpation, there are enlarged lymph nodes and she has distended abdomen .

PARTS TECHNIQUES ASSESSMENT FINDINGS

LUNGS AUSCULTATION -Wheezing and crackles ABNORMAL
sound are heard during -Due to narrowed
inhalation. airways.

HEART AUSCULTATION -complained of chest Normal

tightness but upon
auscultation heart has no TB sometimes
significant abnormalities. causes
inflammation
around the heart,
with chest pain or
shortness of breath.
NECK PALPATION -enlarged lymph nodes ABNORMAL
Swollen lymph
nodes usually
indicate a common
infection, but they
can also signal a
medical condition,
such as an immune
disorder
ABDOMEN PALPATION -distended abdomen. ABNORMAL
-because TB
cause bowel
obstruction
secondary to
hyperplastic mural
thickening,
SKIN  Inspection dry and flushed skin and Smoking reduces
 Palpation looks older than her age oxygen to the
skin, which also
decreases blood
circulation, and
that can result in
weathered,
wrinkled, older-
looking skin.
 V. PAST AND PRESENT MEDICAL HISTORY

Chief Complaint

 Mrs. Reyes complained of low grade fever, night sweats and loss of appetite.
 She also complained of chest tightness but upon auscultation heart has no significant
abnormalities.

Past Medical History

▪ A month prior to admission, She experienced easy fatigability , nocturnal sweats

and weight loss. She sought consultation and she was able to have an
apicolordotic X-Ray result of PTB and a Genexpert result of POSITIVE.

History of Present Illness

▪ Mrs. Reyes rushed to the emergency room after experiencing hemoptysis.

Apparently she complained of low grade fever, night sweats and loss of appetite.

Family Health History:

 Her mother died of TB disease and her father constantly experienced chronic asthma
attacks.
 VI. PATHOPHYSIOLOGY

Predisposing Factors: Precipitating Factors:

Age: 35 years old  During her teenage years

she was a smoker, alcohol
Her mother died of TB disease drinker and a drug user.
 works as a laborer who
asks her neighbors to let
her clean the house or even
wash their laundry and she
also works as a street
cleaner or sweeper in their
barangay

Inhalation of airborne droplets containing

Mycobacterium Tuberculosis.

Entry of microorganism through droplet nuclei.

Bacteria is transmitted to alveoli through airways.

Deposition and multiplication of bacteria.

Bacilli are also transported to other parts of the body through bloodstream and
lymphnode.

Formation of Granulomas

Symptomatology
The symptoms of tuberculosis (TB) vary depending on which part of the body is affected. TB
disease usually develops slowly, and it may take several weeks before you notice you're unwell.
Your symptoms might not begin until months or even years after you were initially infected.
Although your body can harbor the bacteria that cause tuberculosis, your immune system usually
can prevent you from becoming sick.

Latent TB. You have a TB infection, but the bacteria in your body are inactive and cause no
symptoms. Latent TB, also called inactive TB or TB infection, isn't contagious. Latent TB can
turn into active TB, so treatment is important.

Active TB. Also called TB disease, this condition makes you sick and, in most cases, can spread
to others. It can occur weeks or years after infection with the TB bacteria. Signs and symptoms
of active TB include: coughing for three or more weeks, coughing up blood or mucus, chest pain,
or pain with breathing or coughing, unintentional weight loss, fatigue, fever, night sweats, chills
and loss of appetite
 IV. ANATOMY AND PHYSIOLOGY

Anatomy of the Lungs

The lungs are the major organs of the respiratory system, and are divided into sections, or lobes.
The right lung has three lobes and is slightly larger than the left lung, which has two lobes.

The lungs are separated by the mediastinum. This area contains the heart, trachea, esophagus,
and many lymph nodes. The lungs are covered by a protective membrane known as
the pleura and are separated from the abdominal cavity by the muscular diaphragm.

With each inhalation, air is pulled through the windpipe (trachea) and the branching passageways
of the lungs (the bronchi), filling thousands of tiny air sacs (alveoli) at the ends of the bronchi.
These sacs, which resemble bunches of grapes, are surrounded by small blood vessels
(capillaries). Oxygen passes through the thin membranes of the alveoli and into the bloodstream.
The red blood cells pick up the oxygen and carry it to the body's organs and tissues. As the blood
cells release the oxygen they pick up carbon dioxide, a waste product of metabolism. The carbon
dioxide is then carried back to the lungs and released into the alveoli. With each exhalation,
carbon dioxide is expelled from the bronchi out through the trachea.

Physiology
The major function of the respiratory system is to supply the body with oxygen and to dispose of
carbon dioxide. The respiratory system performs this function by facilitating life-sustaining
processes such as oxygen transport, respiration, ventilation, and gas exchange. To do this, at least
four distinct events, collectively called respiration, must occur.

Etiology
Pulmonary TB is caused by the bacterium Mycobacterium tuberculosis (M tuberculosis). TB is
contagious. This means the bacteria are easily spread from an infected person to someone else.
You can get TB by breathing in air droplets from a cough or sneeze of an infected person. The
resulting lung infection is called primary TB. Most people recover from primary TB infection
without further evidence of the disease. The infection may stay inactive (dormant) for years. In
some people, it becomes active again (reactivates). Most people who develop symptoms of a TB
infection first became infected in the past. In some cases, the disease becomes active within
weeks after the primary infection

Disease Process
Primary TB occurs when the Mycobacterium organism comes into contact with a host for the
first time. The Ghon focus of primary TB is defined as primary TB that is localized to the middle
part of the lungs. The Ghon focus goes into latency in the majority of affected people. Latent
tuberculosis is the term for this condition.

After immunosuppression in the host, latent TB can be reactivated. Following initial exposure,
only a tiny percentage of persons would acquire an active illness. Primary progressive
tuberculosis is the name given to such patients. Children, underweight people, persons on
immunosuppression, and those on long-term steroid usage are all at risk for primary progressive
TB.

The majority of persons who get TB do so after a lengthy period of inactivity (usually several
years after initial primary infection). Secondary tuberculosis is the term for this condition.

Reactivation of latent TB infection is the most common cause of secondary tuberculosis. The
apices of the lungs are where secondary TB lesions appear. After contracting TB for the second
time, a lower percentage of patients acquire secondary tuberculosis (re-infection).
 V. DIAGNOSTIC AND LABORATORY
CHEST X-RAY
RESULTS
With densities in both lungs
Trachea is in midline
The cardiac silhouette is not enlarged.
The hemidiaphragms and costophrenic sulci
are intact
Apicolodortic views revealed Pulmonary
Tuberculosis
SIGNIFICANCE
If an area of lung is consolidated it becomes
dense and white. If the larger airways are
spared, they are of relatively low density
(blacker). This phenomenon is known as air
bronchogram and it is a characteristic sign of
consolidation.
Normal; The trachea should sit midline and be
in between the right and left clavicular heads.
Any tracheal deviations most commonly
caused by injuries or conditions that cause
pressure to build up in your chest cavity or
neck.
Normal; Cardiac silhouette refers to the
outline of the heart as seen on frontal and
lateral chest radiographs and forms part of
the cardiomediastinal contour. Enlargement of
cardiac silhouette shows underlying disease.
Normal; Sulci is plural for a groove or fissure.
A diaphragm is a muscle under the lungs that
helps with breathing. The sulci and diaphragm
are intact, which means they are not
damaged.
Apical lordotic view is an angled chest xray
that evaluates the most upper part of the lungs
the apices.
 VI. NURSING CARE PLAN

Defining Nursing Outcome Nursing Interventions Rationale Evaluation

Characteristics Diagnosis Identification

Subjective: Ineffective Long Term: Independent: After 8 hours

breathing nursing of
Chief Complaint of pattern related After 8 hours of - Monitor respiratory - Respiratory status
interventions
to acute nursing status, including vital assessment helps gauge
- low grade fever goal was met as
infection and intervention the signs, breath sounds, and the patient’s severity and
evidenced by:
decreased lung patient will: skin color. whether it’s progressing.
-night sweats
capacity with - Breathing
-Place the patient in semi- -To increase chest
- loss of appetite the respiratory returned to
-Promote good fowler’s position and expansion and to alleviate
rate of 25 cycles normal rate and
- chest tightness respiratory place the diaphragm in dyspnea.
per minute, pattern.
function and proper position to
oxygen - Expectorations may be
treat infection. contract.
saturation of different when secretions - Minimal or no
90%, night - Document respiratory are very thick. signs of
sweats, -Promote
secretions; character and infection.
Objective: hemoptysis, comfort -ABG levels and
amount of sputum.
crackles breath continuous pulse
- Dyspnea
sounds in both - Monitor ABG levels oximetry measures the
Short Term:
lungs, chest and oxygen saturation as blood’s oxygen content
- Hemoptysis
tightness, After 1 hour of ordered. and are good indicators of
enlarged nursing the lung’s ability to
-Crackles Breath Dependent:
lympnodes. intervention the oxygenate the blood.
sounds
patient’s - Administer oxygen -To provide relief from
- Temperature=38ºC temperature therapy as ordered. symptoms of hypoxemia
will decrease to
and hypoxia.
37.2ºC and - Administer medications
- RR= 25 cpm
Note: Nursing sustain as ordered by physicians.
Diagnosis respiratory rate.
- 90% oxygen Soniazid
saturation should be based
from (NANDA- Ethambutol
Approved
Nursing Rifampin
Diagnosis)
Rifampin with isoniazid
Pyrazinamide

Rifapentine
 Defining Nursing Outcome Nursing Interventions Rationale Evaluation
Characteristics Diagnosis Identification

Subjective: Ineffective Long Term: Independent: After 8 hours

airway nursing of
“I had this clearance After 8 hours of - Monitor infection - PTB is transmitted via
interventions
recurrent cough for related to nursing control through the use of droplet inhalation so proper
goal was
almost a week now presence of intervention the mask and performance of precaution should be
partially met as
and it seems that I bronchial patient will: hand washing before and performed to avoid
evidenced by:
am having difficulty infection and after contact with client. transmission.
secretion lung -able to readily - Patient’s
in breathing “as -Place client in high -Elevating the head of the
capacity with expectorate
verbalized by the fowler’s position and bed and turning client every participation to
the respiratory secretions and
patient. encourage reposition two hours help in breathing and
rate of 25 cycles will have
every two hours. decreasing the pressure coughing
per minute, absence or
placed on the diaphragm. exercises and
oxygen decrease in
ability to
saturation of episodes of
- Allergen may trigger more expectorate
90%, night dyspnea. -.Maintain room or
Objective: accumulation of secretion sputum upon
sweats, environment free from due to respiratory response. evaluation; still
- Dyspnea hemoptysis, any sorts of allergen.
Short Term: there are
crackles breath - These exercises hasten the
- Teach and encourage expulsion of sputum and episodes of
- Easy fatigability sounds in both After 1 hour of
deep breathing and aids in maintaining airway dyspnea as
lungs, chest nursing
coughing exercises. patency. claimed by the
- Chills at night tightness, intervention the
enlarged client.
patient’s - Emphasize increase - Fluids help loosen
- RR= 25 cpm lympnodes. temperature fluid intake. secretion in the lungs.
will sustain
- Loss of appetite as respiratory rate. Dependent:
claimed
- Administer oxygen
- 90% oxygen therapy as ordered
saturation
- Administer medications
as ordered by physicians.
- Chest X-ray and
Note: Nursing
Sputum Soniazid
Diagnosis
examination
should be based Ethambutol
revealed positive for
from (NANDA-
Pulmonary
Approved Rifampin
Tuberculosis.
Nursing
Diagnosis) Rifampin with isoniazid
Pyrazinamide

Rifapentine

VII. DRUG STUDY

 Drug Classificatio Indications and Side Effects Special Nursing
Name n and Contraindicatio and Adverse Precautions Responsibilities
Mechanism ns Effects
of Action
Generic Classificatio Indications: First-
CNS:pyschosis Emphasize the
Name: ns line therapy , seizure If isoniazid importance of
Therapeutic ofactive overdose continuing
Isoniazid class: tuberculosis, in EENT: visual occurs,treatme therapy even after
antituberculo combination with disturbances nt with symptom shave
tics other agents. GI: drug- pyridoxine is subsided.
induced institiuted.
Trade/ Pharmacolog Prevention of hepatitis Caution patient
Brand ic class: tuberculosis in ,nausea, Advise patient to avoid alcohol
Name: Isonicotinic patients exposed vomiting to take during this
acid to active disease. medication therapy, as this
Isotamine hydrazines NEURO:periph once daily ,as may increase the
eral neuropathy indicated, and risk of
not to skip hepatotoxicity.
Dosage: MISC: fever doses or
300mg Contraindications double up on
: missed dose. Advise patient to
Hypersensitivity, notify physician
acute liver promplty ifs/sx of
Route: disease, previous hepatitis or
Actions: hepatitis from peripheral
May inhibits isoniazid. : neuritis occur.
Oral cell wall
biosynthesis
Frequency by interfering
and with lipid
Timing and DNA
synthesis.
Drug Name Classification Indications Side Effects Special Nursing
and and and Adverse Precautions Responsibiliti
Mechanism of Contraindicati Effects es
Action ons
Generic Classification: Indications: CNS: -Use cautiously - Watch out
Name: headache, in patients in for overdose
antimycobacte Rifampicin is fatigue, patients with S&S: nausea,
Rifampicin rial indicated in the drowsiness, liver disease or vomiting;
treatment of behavioral diabetes. abdominal
Mechanism of brucellosis, changes, pain;
Trade/Brand Action: legionnaires dizziniess, headache;
Name: disease, and mental increasing
Rifampin acts serious confusion, lethargy;
Rifadin via the staphylococcal generalized unconsciousne
inhibition of infections. numbness, ss; brownish
Dosage: DNA- Rifampicin ataxia, fever. red or orange
dependent should be used discoloration
600 mg. RNA in combination CV: shock of skin, urine,
polymerase, with another sweat, saliva,
Route: leading to a appropriate EENT: visual tears, and
suppression of antibiotic to disturbances, feces; facial or
Oral RNA synthesis prevent exudative periorbital
and cell death. emergence of conjunctivitis, edema;
Frequency resistant strains tooth hypotension ;
and Timing: of the infecting discoloration. tachycardia;
organism. ventricular
OD GI: arrythmia,
Contraindicatio pancreatitis, seizure,
ns: pseudomembr cardiac arrest,
anous colitis, liver
- epigastric enlargement,
Contraindicated distress, and jaundice.
fin patients anorexia,
hypertensive to nausea,
rifampin or vomiting,
related drugs. abdominal
pain, diarrhea,
flatulence,
sore mouth,
and tongue.

GU: acute,
renal failure,
hemoglobinuri
a, hematuria,
menstrual
disturbances

Hematologic:
thrombocytop
enia, transient
leukopemia,
eosinophilia,
hemolytic
anemia.

Hepatic:
hepatotoxicity

Metabolic:
hyperuricemia

Respiratory:
shortness of
breath,
wheezing

Skin: pruritus,
urticaria, rash.

Other: flulike
syndrome,
discoloration
of body fluids,
porphyria
exacerbation.
Drug Name Classification Indications Side Effects and Special Nursing
and and Adverse Effects Precautions Responsibilit
Mechanism of Contraindic ies
Action ations
Generic Classification: Indications: Before taking •
Name: Side Effects: pyrazinamide, Admini
Antituberculotic Initial • Nausea, tell your doctor ster 10 rights
Pyrazinamide treatment of vomiting or pharmacist of
active TB in • loss of if you are medications.
Mechanism of adults and appetite, allergic to it; or •
Trade/Brand Action: children with • mild if you have any Admini
Name: combined muscle/joint pain other allergies. ster in single
Bacteriostatic with other • Upset This product daily dose.
Rifater or bactericidal Treatment of stomach may contain •
against drug resistant • Fatigue inactive Consul
Dosage: mycobacterium TB as part of Adverse Effect: ingredients, t pharmacist
tuberculosis an Dermatologic: which can for rifamoin
2.0 G individualize • cause allergic suspension
d regimen Photosensi reactions or for patients
Route: tivity, rashed other problems. unable to
Gastric swallow
Oral Contraindicat Intestinal: capsules.
ions: • • Prepare
Frequency Hepatotox patient for the
and Timing: Hypertensivit icity, nausea, reddih-orange
y; Concurrent vomiting, coloring of
OD indinavir, diarrhea, body fluids
nelfinavir, anorexia (urine, sweat,
pyrazinamide Hematologic: sputum, tears,
, or • feces, saliva)
saquinavir. Sideroblas Soft contact
tic anemia, lenses may be
thrombocytopeni permanently
a, adverse effects stained;
on clotting advise patient
mechanism or not to wear
vascular them during
integrity. therapy.
Drug Name Classification Indications and Side Effects Special Nursing
and Contraindications and Precautions Responsibilities
Mechanism Adverse
of Action Effects
Generic Classification: Indications: CNS: Use cautiously  Perform
Name: dizziness, in patient with: visual
Synthetic anti- Adjunctive treatment fever, acuity and
Ethambutol tuberculotics for pulmonary TB hallucination, -Impaired renal color
headache, function, discriminati
Trade/Brand Actions: Contraindications: mallace cataracts, on test
Name: EENT: optic recurrent eye before and
May inhibit one Contraindicated in neuritis, inflammation, during
Etibi or more children younger than irreversible gout, diabetec, therapy
metabolites of 13, patients blindness retino pathy.
Dosage: susceptible hypersensitive to GI: abdominal  monitor uric
bacteria, drug, patients with pain, acid level
25mg/kg changing cell optic neuritis. anorexia,
metabolism nausea and  Observe
Route: during cell vomiting patient for
division, Metabolic: signs and
Oral bacteriostatic. hyperuricemia symptoms
Musko- of gout
Frequency skeletal: Joint
and Timing: pain
Skin: toxic
OD epidermal
necrolysis,
dermatitis,
and pruritus
Other:
anaphylactoid
reaction.
 VIII. DISCHARGE PLAN
Instruct the patient to take her home medications at the right time, right dose, and right route and
also emphasized the importance of taking them.

TEACHING:

Instruct the patient:

 Instruct patient to cover mouth when sneezing or coughing, to avoid the transmission of
bacteria.
 Inform patient to wash hands if he or she use it to cover when coughing.
 Disposed used tissue in a closed bag and throw it away.
 Tell the patient to avoid public areas and to stay at home.
 Observe proper hygiene such as bathing the patient daily to keep from infection.

DIET:

 Reminded to serve the food mentioned to the patient. Well-balanced diet.

 Advised to take vitamin supplementation.
 Encouraged oral fluids at least 8 glasses per day.
 Encouraged to eat green leafy vegetables such as malunggay, kangkong, and petchay
 Encouraged to eat fruits to provide adequate energy and to improve nutrition.

EXERCISE:

 Encourage patient to do mild exercises such as walking and to have an adequate sleep
and rest.
 Instruct the patient to avoid strenuous activities, avoid straining, and lifting heavy objects

HEALTH

 Instruct the patient to observe proper hygiene like taking a bath every day, brushing teeth
3 times a day, and washing hands before and after eating.
 Advise patient to maintain proper environmental sanitation.
 IX. REVIEW OF RELATED STUDIES/ LITERATURE

Quality of Life with Tuberculosis

Tuberculosis diagnosis and treatment currently revolves around clinical features and
microbiology. The disease however adversely affects patients’ psychological, economic, and
social well-being as well, and therefore our focus also additionally needs to shift towards quality
of life (QOL). The disease influences all QOL domains and substantially adds to patient
morbidity, and these complex and multidimensional interactions pose challenges in accurately
quantifying impairment in QOL. For this review, PubMed database was queried using keywords
like quality of life, health status and tuberculosis, and additional publications identified by a
bibliographic review of shortlisted articles. Both generic and specific QOL scales show a wide
variety of derangements in scores, and results vary across countries and patient groups. In
particular, diminished capacity to work, social stigmatization, and psychological issues worsen
QOL in patients with tuberculosis. Although QOL has been consistently shown to improve
during standard anti-tubercular therapy, many patients continue to show residual impairment. It
is also not clear if specific situations like presence of comorbid illnesses, drug resistance, or co-
infection with human immunodeficiency virus additionally worsen QOL in these patients. There
is a definite need to incorporate QOL assessment as adjunct outcome measures in tuberculosis
control programs. Governments and program managers need to step up socio-cultural reforms
and health education, and provide additional incentives to patients, to counter impairment in
QOL.

Worldwide, tuberculosis (TB) continues to be an important public health issue, and a major
cause of morbidity and mortality. Despite advances in diagnosis and therapy nearly ten million
incident TB cases were reported, and an estimated 1.6 million deaths occurred due to TB,
globally in 2017. Almost a quarter of the world's population is latently infected with TB, and
therefore at risk of progressing to active disease sometime during their lifetime.

According to the World Health Organization, health is defined as a state of complete physical,
mental, and social well-being and not a mere absence of disease or infirmity. The impact of any
disease, especially a chronic illness like tuberculosis, on an individual patient is therefore often
all-encompassing, affecting not only his physical health but also his psychological, economic,
and social well-being.

At present, the TB control services are geared towards optimizing microbiological cure, and
using this parameter as an indicator for successful treatment. Although this is extremely
important from a public health perspective, such an approach does not adequately address the
physical, mental and social suffering of patients due to TB. Patients suffer not only because of
the symptoms of the disease, but also because of the resultant general deterioration in their
quality of life (QOL). Despite this, patient perceptions about disease and their health have
remained largely unknown.

QOL is a broad and complex multidimensional concept that incorporates physical, social,
psychological, economic, spiritual and other domains. It is therefore difficult to define and
measure, but may be broadly described as individuals’ perceptions of their position in life in the
context of the culture and value systems in which they live and in relation to their goals,
expectations, standards and concerns. QOL therefore is an expression of patient preferences and
values rather than clinician's assessment. For the latter, one simply needs to ask the patient “How
high is your fever?”, while for the former, patient response to the question “How much are you
bothered by your fever?” or “To what extent do you feel that fever prevents you from doing what
you need to do?” can be recorded. Self-reported health-related QOL is therefore an important
adjunct measure in understanding and quantifying the actual impact of TB on patients.

This review was conducted to summarize the various issues related to QOL among patients with
all forms of TB. A broad search was conducted through the PubMed platform using keywords
like quality of life, health status and tuberculosis. Relevant publications for detailed evaluation
were identified through an abstract review of the search results. Additional key references were
identified from bibliography of shortlisted publications during their full-text review. Data from
large and well-conducted studies was preferentially used to summarize and tabulate important
findings.

References:

Aggarwal, A.: Quality of life with Tuberculosis

https://www.sciencedirect.com/science/article/pii/S2405579419300622