15.3.1  Coordinating transfers when a patient is moving

Figure 15.1  A health worker discusses the needs of a TB patient who is about to move to another area.

If a registered patient plans to move out of the area permanently, find out when and where the patient is moving and identify an appropriate treatment facility in the new area. In your discussions with the patient in the period before the move, stress the need to continue treatment and the importance of reporting to the new health facility (Figure 15.1). Make sure that the patient understands that to be cured, he or she must continue taking all of the required drugs for the entire time required. If necessary, provide self-administered doses for several days until the patient has reached their new home.

If you do not receive confirmation from the receiving health facility, contact the facility to ask whether the patient has reported for treatment. If not, tell the facility where to locate the patient. Ask the District TB Coordinator whether there is any new information about the patient. If the transfer is never confirmed (i.e. the patient never reports to the new facility), the patient’s treatment outcome will be recorded as a ‘transfer out (transfer TB patient to other health facility)’. If the transfer is confirmed, at the appropriate time, ask the new health facility where the patient was referred about his or her treatment outcome, so that you can record it on the patient’s registration.

It is important that you are in contact with the District TB Coordinator — this is the person who controls and coordinates TB activity at district level. If the patient originates from your district, it is your district’s responsibility to find the treatment outcome for the patient.

So, remember that it is the responsibility of the originating health facility (in other words, the first one involved) to find out about the treatment outcome for a patient who transfers out, but you can help the process. When you receive a patient from another health facility, make a note that this is a transferred-in patient to remind you to report the treatment outcome to the originating health facility. When any patient completes treatment, check to see whether the patient has been transferred in. If so, contact the originating health facility and report the treatment outcome.

15.3  Referral of people suspected of being infected with TB and TB cases

15.3.2  Arrangements for patients who travel