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Counselling is of paramount importance for TB Preventive Treatment (TPT) initiation and completion as most of the target population screened and found eligible would know that they do not have TB disease, would be symptom-free or otherwise healthy and would not feel the need to take any treatment, especially Household Contact persons (HHC).

 

Stakeholders Involved in Counselling for TPT (Figure below)

Figure: Stakeholders involved in counselling for TPT 

Abbr: HWCs: Health and Wellness Centres; PHC: Primary Health Centre; ICTC: Integrated Counselling and Testing Centres; ART: Anti-retroviral Therapy; PLHIV: People Living with HIV

 

Components of Counselling for TPT

While counselling the person and family members, the treating doctors/ staff must follow the steps outlined in the table below for an effective counselling session.

Component Actions to be taken
Confidentiality Ensure confidentiality when seeking a person’s commitment to complete the course before initiating TPT.
Information

Provide information on:

  • TB infection
  • Need for TPT and protective benefits to the individual, household and wider community
  • TPT is available free of charge under National Tuberculosis Elimination Programme (NTEP)
  • TPT regimen prescribed, including duration, schedule of medication collection, and directions on how to take the medications
  • Potential side-effects and adverse events involved and what to do in the event of various side-effects. People treated with rifamycins should be alerted in advance about the pink discolouration of secretions due to this medicine
  • Importance of completing the full course of TPT
  • Reasons and schedule of regular clinical and laboratory follow-up for treatment and monitoring
  • Signs and symptoms of TB and advise on steps if they develop them
Medication adherence support Agree on the best way to support treatment adherence, including the most suitable location for drug intake and the need for a treatment supporter, if required.
Family support Involve family members and caregivers in health education when possible.
Openness Invite clarification questions and provide clear and simple answers.
Information, Education and Communication materials
  • Provide information materials in the local language and at the appropriate literacy level of the person concerned.
  • Reinforce supportive educational messages at each contact during treatment.
Call support (in case of emergencies) Provide a telephone number of the HCW staff/ TB Health Visitors and Senior Treatment Supervisors concerned to call for other queries or a need to contact health services for advice.

 

The National TB Elimination Programme (NTEP) national call centre (NIKSHAY SAMPARK – Toll-free number 1800116666) may be provided to index TB patients, those initiated on TPT and family members to serve as a resource for information, counselling and troubleshooting as required to enable TPT initiation, follow-up monitoring and completion.

 

Resources:

Guidelines for Programmatic Management of Tuberculosis Preventive Treatment in India.

Assessment

Question​ Answer 1​ Answer 2​ Answer 3​ Answer 4​ Correct answer​ Correct explanation​ Page id​ Part of Pre-test​ Part of Post-test​
Which of the following people are involved when counselling for TPT? Index TB patients Caregivers Family members All of the above 4 When counselling persons eligible for TPT, it is best to involve the index TB patients, their families and caregivers. ​ Yes Yes

 

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