CHENNAI: Tuberculosis patients suffer from several physical symptoms including dyspnea, throat and chest pain, cough, hemoptysis, respiratory secretions, insomnia, anorexia-cachexia, and fatigue.
Being a long term illness, it can also cause mental distress due to the uncertainty of curability and it can make a patient feel anxious.
With multi-speciality approach required for the management of TB, experts recommend palliative care for the patients.
A research article by the experts at the Cancer Institute, Institute of Thoracic Medicine, and National Institute for Research in Tuberculosis, published in the Tamil Nadu Journal of Public Health and Medical Research states that palliative care is the need of the hour for TB patients.
TB patients can experience pain due to various reasons, including chest pain, back pain due to Pott's spine, headaches due to TB meningitis, while TB arthritis can lead to joint pain.
The primary symptom of cough can induce nausea and also lead to loss of appetite, resulting in weight loss. Persistent cough can also disrupt sleep and add to insomnia.
The article highlights that besides physical support, social support is also required for the TB patients.
The social workers can help by locating homeless TB patients, assist them with permanent lodging, and coordinating transportation to ensure patients get to their required TB appointments.
The intervention of nutritionists is also required as nutrition helps in timely recovery. Nutritional support also plays a crucial role in recovery from TB.
"Patients with diabetes have a higher risk of developing tuberculosis disease from a latent tuberculosis. A complete cure necessitates constant monitoring and good glycemic control. Diabetes, co-morbidities such heart problems, kidney failure, and liver dysfunction add to the burden and raise the need for palliative care, " the article by Jefrilla Nancy and V V Meenakshi from Cancer Institute stated.
The article has been co-authored by Vinod Kumar Viswanathan and C Padmapriyadarsini from Institute of Thoracic Medicine, and National Institute for Research in Tuberculosis respectively.
However, the article presents various challenges to palliative care for TB patients and lack of awareness is a primary concern.
"The use of palliative care in infectious diseases such as tuberculosis, rabies, malaria, and other illnesses is a new area that requires development. Despite receiving training in palliative care, understanding the application of tuberculosis necessitates specific knowledge and skills in the disease, " the article stated.
The research article recommends that the provision of community-based palliative care at the primary health care center level, and teaching pulmonologists and respiratory medicine specialists to provide primary palliative care, will help close this gap and promote patient care as a holistic undertaking.
Creating awareness among providers to extend palliative care even to drug susceptible patients is imperative.