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Is my mother suffering from tuberculosis?

Q: My 60 years old mother is suffering from diabetes. Based on a report of ELISA for tuberculosis (Anti TB IgA - 394 u/ml), the doctor has prescribed Combunex 800, which she is taking for the last one year. The doctor gets angry when queried as to why he has prescribed medicine for tuberculosis. He refused to carry any further tests and told us that she has to complete the course for one year. Could you please guide if this test is a correct indication for TB. Is my mother suffering from tuberculosis?

A:Firstly we need to establish the reason for starting Anti-tubercular treatment - was she having any symptoms like persistent fever, cough, weight loss? Secondly, if ATT is given, a patient is started on a combination of atleast 4 drugs including rifampicin, isoniazid, ethambutol and pyrazinamide. In India, we do not use prophylactic (preventive) ATT unlike the western population since the incidence of tuberculosis is high. So you need to find out why she is on a 2 drug regime - isoniazid and ethambutol. 2 drug therapy is only in the maintenance phase of disease after the initial 4 drug therapy for atleast 2 months.

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