National TB Management Guidelines
National TB Management Guidelines, 2018 Edition. Ministry of Health, Malawi.
1INTRODUCTION
2Definitions
3Systematic TB screening in high risk groups
- 3Systematic TB screening in high risk groups
- 3.1Operational definitions
- 3.2Overall organization of the case finding strategy
- 3.3Screening and diagnostic algorithms
- 3.3.1Symptomatic TB screening
- 3.3.2X-ray screening
- 3.3.3Symptomatic screening followed by microscopy (for diagnosis)
- 3.3.4X-ray plus symptomatic TB screening followed by Xpert
- 3.4Contact investigation
- 3.4.2Appropriate clinical evaluation of TB contacts
- 3.5Active case finding
- 3.5.1House-to-house TB screening
- 3.5.2Mobile unit
- 3.5.3Silica Exposed workplaces or Occupations
- 3.5.4Prisons
- 3.5.6Systematic TB screening among health care workers
- 3.6Systematic TB screening in health care setting
4Approach to TB diagnosis
- 4Approach to TB diagnosis
- 4.1Clinical presentation
- 4.1.1Pulmonary TB (PTB)
- 4.1.2Extra-pulmonary TB (EPTB)
- 4.2Laboratory diagnosis of TB
- 4.2.1Sputum collection
- 4.2.2Sputum smear microscopy
- 4.2.3Sputum culture
- 4.2.4Drug susceptibility testing
- 4.2.5Xpert MTB/RIF Assay
- 4.2.6Limitations of Xpert MTB/RIF
- 4.2.7Line Probe Assay
- 4.2.8Advantages of LPA
- 4.2.9Disadvantages of LPA
- 4.2.10Histopathological Examination
- 4.2.11The role of chest radiography
5Paediatric TB
- 5Paediatric TB
- 5.1Physical findings suggestive of TB in children
- 5.2.1Sputum collection
- 5.2.2Fine needle aspiration
- 5.2.3Lumbar puncture (LP)
- 5.2.4Chest x-ray
- 5.3Treatment of paediatric TB: first-line TB regimen
- 5.4Neonates exposed to a mother with TB
- 5.5BCG vaccine
- 5.6TB and HIV infection in children
- 5.6.1ART in children with TB HIV co-infection
6Treatment of latent TB infection
7Tuberculosis Management and Monitoring
- 7.1Treatment of TB
- 7.1.1Directly observed treatment (DOT)
- 7.1.2Treatment of susceptible TB
- 7.1.3Sputum monitoring by smear microscopy in new PTB patients
- 7.1.4Interpretation of follow-up AFB microscopy results
- 7.1.5TB meningitis
- 7.1.6Treatment regimens for patients previously treated for TB
- 7.1.7Clinical Monitoring of TB patients
- 7.1.8Use of anti-tuberculosis drugs in special situations
- 7.1.9Management of hospitalised TB patients
- 7.1.10Corticosteroids and tuberculosis
- 7.1.11Default tracking action
- 7.1.12Managing transfer-out and transfer-in patients
- 7.1.13Recording TB treatment results
8TB and HIV
- 8.1HIV infection
- 8.1.1The interaction between TB and HIV
- 8.1.2Impact of HIV on TB
- 8.2Collaboration and coordination between the TB and HIV programmes
- 8.3PITC for TB patients
- 8.4Provision of ART in co-infected TB patients
- 8.5Provision of CPT
- 8.6Management of HIV-positive patients with active TB
- 8.6.1Immune reconstitution inflammatory syndrome
- 8.6.2Management of TB-related IRIS
- 8.6.3Overlapping ARV and TB drug side effects
9TB Infection Control
10Programmatic and Clinical Management of Drug-Resistant TB
- 10Programmatic and Clinical Management of Drug-Resistant TB
- 10.1Introduction to drug-resistant TB
- 10.2.1DR-TB service arrangement
- 10.2.2Minimum requirements for health facilities for RR-/MDR-TB treatment
- 10.2.3Supply chain management for DR-TB commodities
- 10.2.4Site level Program Management and Support
- 10.3Drug-resistant TB case finding strategy
- 10.3.1Presumptive DR-TB /risk groups
- 10.3.2Diagnosis of drug-resistant TB’
- 10.3.3Drug-resistant TB patient classification and definition of terms
- 10.4.1Treatment approach
- 10.4.2Treating mono and poly-drug resistant TB
- 10.4.3Standardized / Conventional Treatment of RR/MDR-TB patients
- 10.4.4Introduction of Shorter MDR-TB treatment regimen
- 10.4.5Individualized DR TB treatment regimen
- 10.4.6Adjuvant therapies in drug-resistant TB treatment
- 10.4.7Treatment of drug-resistant TB and HIV
- 10.4.8Treatment of drug-resistant TB in special conditions and situations
- 10.5Monitoring of patients on MDR-TB treatment
- 10.6.1Management of adverse effects
- 10.7.1Clinical evaluation and investigation of contacts of M/XDR-TB
- 10.7.2Management of symptomatic contacts
- 10.8ACTIVE TB DRUG SAFETY MONITORING AND MANAGEMENT (aDSM)
- 10.8.1aDSM objectives
- 10.8.2To whom applies aDSM
- 10.8.3aDSM components
- 10.8.4A DSM Definitions
- 10.8.5Levels of monitoring in aDSM
Ministry of Health publication, permission pending.