West Visayas State University

COLLEGE OF NURSING
La Paz, Iloilo City

Journal
Reading
MEDICAL ISOLATION WARD

Submitted by:
Khryss Paula S. Baldonado
BSN III-C

Submitted to:
Sir Rodolfo A. Guillergan Jr., RN, MAN
Clinical Instructor
Summary

Of the 6.3 million notified cases of TB that occurred in 2014, 81% had lung TB. Based on recent
trends in treatment outcomes, about 86% of the new and relapse PTB cases notified in 2014 were
successfully treated. However, several studies have demonstrated persistence of symptoms,
reduced quality of life, abnormal radiological findings and impaired pulmonary function tests in
patients successfully treated for PTB. Pulmonary TB is associated with various long term lung
complications. There is however very limited data on the full spectrum of these complications in
cohorts of patients treated for PTB. For many of these complications the published literature is
based mostly on case reports and small case series. Structural and functional residual changes
were more common in patients with cavitary than non-cavitary disease.
A recent systematic review examining the relationship between pulmonary TB and COPD in
community based studies found a consistent association across the two community based studies
identified with odds ratios ranging from 1.78 to 6.31, between a reported history of TB and
Spirometry confirmed COPD among people aged 40 years and above. The incidence of
bronchiectasis post PTB was in the range of 1965% and in etiological studies of bronchiectasis.
In post TB CPA, the fungus, most commonly Aspergillus fumigatus, colonizes cavities in the
lung left behind by the TB. Precise estimates of the proportion of PTB patients who eventually
develop CPA are not available and neither have the risk factors for this disease been fully
identified. Aspergilloma of up to 22% were found in patients with residual cavities following
treatment for TB, Denning et al estimated that the incidence of CPA in patients previously treated
for PTB globally was 372,000 in 2007.
The WHO's ambitious End TB Strategy approved by all countries targets to reduce TB deaths by
90% in 2030 with intermediate milestones of reduction by 35% in 2020 and 75% in 2025. The
WHO proposed a list of actions that the global TB community including national TB
programmes need to undertake to elaborate and evolve appropriate public health programs to
confront these problems.

Reaction

Pulmonary tuberculosis is one of the leading diseases that kills millions around the globe and
even though it might be curable we shouldnt neglect the possible complications after the
treatment. Many of its complication may worsen the condition of the patients. Continuous
monitoring of the patient even outside the hospital premises might help prevent other
complications. Completing a PTB treatment for several months doesnt assure total recovery and
the need of care should not stop. It may be a burden for the patient and for the family but this is
important.
My patient in the ward had finished his PTB treatment but considered relapse. Compliance to
medications are a must and should be taught to every patient undergoing the treatment. Financial
matter may be a part of the problem in developing countries like Philippines, but hopefully WHO
and DOH may help them through their programs and projects.
The main management approach is to eliminate the pathogen at its source. Thus, an
understanding and good knowledge of PTB will be essential for controlling the spread and
dissemination of TB.