RetourAn initial assessment for suffering related to TB should be done at the time of diagnosis. Palliative care should be initiated immediately as needed and should be combined with TB treatment to relieve any suffering due to the disease, to the adverse effects of treatment, to comorbidities, or to social problems. It is especially important for people with DR-TB (98). Tailored to the patient’s needs, palliative care should continue regardless of whether the cure is expected or whether treatment fails. It should be available at all levels of the health-care system (94–96), namely:
- TB and lung disease hospitals and general hospitals with TB units;
- district hospitals;
- TB clinics in the community;
- patients’ homes
Even when a patient recovers from TB disease, all the medical effects of TB may not be resolved. People that survive TB may have long-term impairment from TB disease (99–102). People who had bone or neurological infections may continue to have problems related to bone damage or neurological issues. It is also becoming more and more recognized that even people who had pulmonary TB may have serious long-term medical problems resulting from lung damage resulting from TB. Studies find that a majority of patients report respiratory symptoms after completing TB treatment. Patients may have continued shortness of breath, cough, decreased lung function, bronchiectasis and recurrent bacterial pneumonia. They may also develop heart failure due to lung damage. These symptoms often continue to affect their daily lives. Although many people improve with time, a significant number continue to have symptoms, and their symptoms may even worsen with time.
It is important to continue to monitor the health of TB patients even after they have finished their medications for TB disease. They may need to be followed by a lung or heart doctor to help treat ongoing symptoms. They may benefit from palliative care which can offer treatments to help with their symptoms such as shortness of breath, swelling from heart disease, pain, and psychiatric care to help patients who are facing long-term health problems.