I-TB ingayekela ukuzwela emithini emibili elamandla kakhulu okufanele siyelaphe - i-isoniazid le-rifampicin. Nxa  isifo sofuba singasakwazi ukwelatshwa ngeinye yaleyi mithi, sithathwa njenge-TB engazweli emithini eminengi.

I-TB engazweli emithini eminengi ludubo olukhulu. Ngokujwayelekile ukwelatshwa kwe-TB kusebenza kahle ngamaphesenti angu-90, kodwa ngenxa yokungazweli emithini, lokhu kusebenza kwehla kuze kufike ku-50%. I-TB engazweli emithi kakhulu ingenzeka nxa i-TB yomuntu ingazweli kwezinye izindlela zokwelapha zomhlobo wesibili kanye le-isoniazid le-rifampicin. Ingxenye eyodwa kwezintathu kuphela yabantu abale-TB engazweli emithini eminengi bayolapheka ngempumelelo.

I-TB engazweli emithini eminengi isemathubeni amanengi okuthi ibonakale  nxa umuntu engabambeleli ekwelatshweni. Lokhu ngezinye izikhathi kungaba yimphumela yokuthi amakhilinika angakuphathi ngendlela ukunakekelwa kwayo, njengokuthi, nxa inganikezi isiguli imithi esiyidingayo ngesikhathi esifanele. Kungenzeka futhi nxa umuntu ekuthola kunzima ukunatha imithi.

Lapho i-TB engazweli imithi ivamile emphakathini, kungenzeka ukuthi ungenwe luhlobo lwe-TB oseluvele lwaba lokungazweli ungakaqalisi ukwelatshwa.

Abenzi bezinqumo kanye labasebenzi bezempilakahle emhlabeni wonke bafuna izindlela zokubhekana lokwanda kwe-TB engazweli emithini eminengi. Okwamanje, okubaluleke kakhulu yikuthi abantu baphuze imithi yabo ngendlela efanele futhi bathole ukwesekwa okufanele mayelana lokubambelela.

Yebo, ivhakisini  ye-BCG ingavikela ku-TB. ivhakisini iphumelela kakhulu kumihlobo enzima kakhulu ye-TB, inikeza isivikelo esingafika ku-80%, lokho, ukuvikeleka ku-TB yamaphaphu kuphansi kancane.

Iziqondiso zokuthi ngubani okufanele avhakisinethwe zizotshiyana kusiya ngokuthi ungaphi kwakhona emhlabeni. Emazweni alamazinga aphezulu e-TB, i-World Health Organization ikhuthaza ukunikeza insane ivhakisini ye-BCG lapho zizalwa. Kodwa-ke, akukhuthazwa ezinganeni okungenzeka ukuthi zile-HIV, njengoba izingane ezile-HIV zingaba lokugula okufana le-TB ekutholenii ivhakisini.

Amagciwane e-TB afa kancane. Ukuze uqiniseke ukuthi wonke amagciwane ahambile udinga ukuqhubeka uthatha imithi yakho njengoba uyalelwe sikhathi sonke. Ungaqala ukuzizwa ungcono ngokuphangisa, kodwa kufanele uqhubeke uthatha imithi yakho kuze kube sekupheleni kwekhosi.

Nxa ungayiqedi yonke imithi yakho noma ungayithathi ngendlela efaneleyo, ingayekela ukusebenza.Lokhu kungenxa yokuthi nxa ungakawutholi umuthi owanele emzimbeni wakho, amagciwane asazobakwazi ukukhula futhi azofunda indlela yokudlula umuthi. Lokhu kutsho ukuthi esikhathini esizayo i-TB yakho izoba nzima ukuyelapha. Nxa i-TB yakho ingazweli, amathuba okuthi welapheke azoba mancane futhi kuzodingeka ukuthi unathe imithi kwesikhathi eside.
 

Indlela eyodwa yokusiza abantu ukuthi banathe imithi yabo njalo yi '-directly observed therapy' (DOT). I-DOT iyindlela yokwelapha. Ihlanganisela  ukuhlangana lomsebenzi wezempilakahle ekhilinika, emphakathini noma ekhaya, ukuze abukele futhi aqinisekise unatha imithi yakho ngendlela efanele. Kuyindlela esetshenziswa kakhulu yokwelatshwa kwe-TB futhi ingaba lusizo ikakhulukazi lapho umuntu elobunzima bokunamathela ekwelatshweni.

I-DOT isebenza kangcono nxa abasebenzi bezempilakahle basebenzisa le mihlangano ukuze banikeze  abagulayo ukwesekwa okwengeziwe. Lokhu kungahlanganisa  ukubasiza ukuthi bakhangele imiphumela emibi  noma ukubanikeza ukwelulekwa. I-World Health Organization okwamanje ihlola ukuthi ngabe ukufonelana ngamavhidiyo kungasetshenziswa njengendlela yokunikeza i-DOT ngendlela engabizi kakhulu futhi engacithi sikhathi.

Kulendlela  ezithile ezingezelela ubungozi bokuthi abantu babulawa ngumkhuhlane wofuba. Lezizindlela zigoqela:

. Ukuba lomkhuhlane wetshukela.

. ukuba lamasotsha omzimba abuthakathaka ( ukuba legcikwane ikakhulu nxa lingancindezelwanga loba ingculaza)

. nxa ungondlekanga ulomzimba ozace kakhulu.

. ukubhema ugwayi.

. ukubalenkinga yokunatha utshwala.

. ukuhlala uhlangana labantu ababulawa ngumkhuhlane wofuba.

Abantu okumele baqakathekiswe nxa kuhlolwa umkhuhlane wofuba:

. ngabantu abahlala behlangana labantu ababulawa ngumkhuhlane wofuba

. abantu abalegcikwane.

. abantwana abancane  labathombayo.

. asebegugile.

. abaphathelane lezempilo

Kuphinda kugoqele abantu ababehlala endaweni eziminyeneyo, abaswela ukudla, abangenelisi ukufinyelela ezibhedlela :

. njengabantu abampofu ikakhulu abahlala emkhukhwini

. abantu ababaleka emazweni abo.

. abantu abasengozini yokuthola igcikwane ikakhulu abasejele labasebenzisa izidakamizwa. 

Ulwazi oluvela eWHO lutshengisa ukuthi abantu abalegcikwane basengozini okungalinganiswa letshumi lantathu ukwedlula abantu abangelagcikwane.

Umkhuhlane wofuba yiwo obangela ukuthi abantu abalegcikwane le HIV bafe. Igcikwane lomkhuhlane wofuba kungabumba isimo esiyingozi esenza ukuthi umkhuhlane munye ngamunye ukhwezele omunye.

Ukuze kwehliswe ubungozi obulethwa ngumkhuhlane wofuba ebantwini abalegcikwane kumele lababantu banathe amaphilisi egcikwane ngendlela eqondileyo.  Amaphilisi egcikwane aqinisa amasotsha omzimba ayiwo aqakathekileyo ekulwisaneni lomkhuhlane wofuba.

Laloba abantu benatha amaphilisi egcikwane ngendlela eqondileyo basengozini yokuhlaselwa ngumkhuhlane wofuba ukwedlula abantu abangelagcikwane ikakhulu nxa behlala endaweni eyande ukuhlaselwa ngumkhuhlane wofuba.

Lokhu kwenza ukuthi abantu abalegcikwane banikwe amaphilisi avikela umkhuhlane wofuba. Ingwalo zeWHO ziyatsho ukuthi wonke umuntu osegugile kanye labathombayo abalegcikwane le HIV kumele banathe amaphilisi avikela umkhuhlane wofuba okuyingxenye yokunakekelwa kwabo. Kumele banikwe lawo maphilisi egcikwane kungelani lokuthi igcikwane abalalo lisezingeni elinganani.

Abantu abalegcikwane kumele banikwe okokuzihlola umkhuhlane wofuba kanye lamaphilisi nxa bengaqala ukuba lempawu zomkhuhlane wofuba.

Abantu abanengi abathola umkhuhlane wofuba abasoze bagule okubonakalayo kodwa amaphesenti amahlanu kusiya kwalitshumi bangagula. Ubungozi bokugula bungenxa yezizatho ezehlukeneyo ezigoqela legcikwane le HIV.

Kuqakathekile ukuthi umuthi loba amaphilisi avikela umkhuhlane wofuba anikwe abantu abasengozini yokuhlaselwa ngumkhuhlane wofuba. Nxa umuntu esengozini, abantu abakhangele ngezempilo kumele baqale bamhlole ukuthi akala mkhuhlane wofuba bengakakhangelu ukuthi engabe edinga amaphilisi wokuvikela umkhuhlane wofuba.

Amaphilisi avikela  umkhuhlane wofuba asebenza ngokubulala amagcikwane engakabangeli ukugulakanye lokubulala izitho zomzimba. Nxa lawo maphilisi enathwa ngendlela eqondileyo, umuntu uyavikeleka ekuguleni ebulawa ngumkhuhlane wofuba okweminyaka.

Sokulamaphilisi amatsha avikela umkhuhlane wofuba anathwa okwenyanga kusiya kwezintathu. Kwezinye izikhathi umuntu usenganikwa  amaphilisi anathwa okwenyanga eziyisithupha kusiya kweziyisificamunwe. Amaphilisi wokuvikela umkhuhlane wofuba ayanikwa umuntu obulawa ngumkhuhlane wofuba olwisana lemithi eminengi anathwa okwenyanga eziyisithupha. Nxa umuntu esengozini yokubulawa ngumkhuhlane wofuba, kuqakathekile ukuthi amukele yiloba wuphi umhlobo wamaphilisi avikela umkhuhlane wofuba ngoba impilo yakhe iyabe isengozini. 

I-WHO iyacabangela ukuthi ingxenye labantwana elilomkhuhlane wofuba alibanjwa lowo mkhuhlane ngenxa  yokungahlolwa esibhedlela sabantwana. Inani labantwana (1/3) elihlala labantu ababulawa ngumkhuhlane wofuba alinikwa umuthi wokuvikela umkhuhlane wofuba.

Ukuhlanganisa uhlangothi lwezempilo kanye lendlela ezigxile emphakathini kungancedisa ekuguquleni lokhu. Lokhu kugoqela:

. Ukufinyelela umphakathi ngokufundisa abantu ngomkhuhlane wofuba ebantwaneni, kwabathombayo lezimuli zabo.

. Ukuhlolwa kwabantwana, kwabathombayo ( kugoqela lokukhangela izimpawu).

. Ukunikwa komphakathi amaphilisi abantwana labathombayo okuvikela umkhuhlane wofuba ngoba kuyibo abasengozini yokuhlaselwa yilowo mkhuhlane.

I-WHO iyaxwayisa abemtholampilo ukuthi kumele bayenze amaphilisi womkhuhlane wofuba alungele abantwana labathombayo abalomkhuhlane wofuba. Lawomaphilisi kumele abengawenyanga ezine kulokuthi zibe yisithupha. Lokhu kuyadingakala kungelani lokuthi umuntu ulegcikwane loba akalalo.

Phakathi kwamaphilisi wokuvikela umkhuhlane wofuba lawokwelapha umkhuhlane wofuba obonakalayo, uhlupho olukhona yikuqinisekisa ukuthi abantwana labathombayo bayanatha amaphilisi abo baze bawaqede. Okungancedisa ukuthi banathe amaphilisi abo ngendlela eqondileyo yikwenza iqembu labantu abalinganayo loba ukwesekwa ngababanakekelayo kanye lokulandelela ukuthi banatha ngendlela eqondileyo.