Role of nurses in controlling TB
To control the spread of TB and ultimately
eliminate the infection, control programmes
must be focused on:
» Prompt identification of new cases;
» Timely start and support for patients to
complete treatment;
» Prevention of new cases.
Early diagnosis is pivotal, as it not only
improves patient outcomes but also
reduces the possibility of onward transmission
to others who are in close and regular
contact with the patient. In the UK,
between 2004 and 2013, more than a
quarter of patients with pulmonary TB
started treatment more than four months
after the onset of symptoms, and the proportion
of cases with this delay has risen
slightly in the past three years (PHE, 2014b).
Drug resistance is a growing problem
and is linked to failures to diagnose, prevent
and adequately treat TB. A new fiveyear
TB strategy for England aims to
address this and sets a target of 80% of
people with pulmonary TB starting treatment
within three months, and 100%
within six months of the onset of symptoms
(PHE and NHS England, 2015).
Nurses are essential to TB control and
elimination. While some specialist nurse
care solely for TB patients, the vast
majority work in other areas and encounter
patients for a wide variety of reasons.
These nurses are in an ideal position to
identify possible cases of undiagnosed TB
and refer these patients to TB services to
achieve earlier diagnosis. It is therefore
important that all nurses are aware of the
signs and symptoms of TB (Box 1), especially
those who work with high-risk populations,
such as migrants, substance
users, homeless people and patients who
are HIV positive.