Guideline Detail

South African National Tuberculosis Management Guidelines

Source: South Africa National Department of Health
Publication Date: July 1, 2014

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2014 TB recommendations from the South Africa National Department of Health designed to guide primary healthcare providers in addressing tuberculosis (TB) control challenges, including reduce transmission of infection in the communities; diagnose drug-sensitive and drug-resistant TB early; diagnose DS-TB and DR-TB early; initiate treatment in all patients diagnosed with TB early; retain patients in treatment and care until completion of treatment; and prevent TB in people living with HIV by initiating all eligible HIV-positive people on ART and Isoniazid preventive therapy. Topics include: transmission and pathogenesis of TB; primary TB infection; clinical presentation of TB;  diagnosis of TB; TB diagnostic algorithms and interpretation; registration of TB patients; contact investigaton; principles of TB treatment; essential TB drugs; fixed-dose combination tablets; standard treatment regimens for adults (aged 8 years or older); standard treatment regimen dosages; adverse effects of TB drugs (isoniazid, rifampicin, streptomycin, ethambutol, pyrazinamide, and pyridoxine); symptom-based approach to adverse effect management; monitoring the response to treatment; measuring and promoting adherence to treatment; directly observed treatment; education and adherence counselling; TB support team; special adherence considerations for children and adolescents; managing and minimising treatment interruption; treatment regimens in special circumstances (pregnant women, breastfeeding women, women using contraceptives, liver disorders, established chronic liver disease, acute hepatitis, and renal failure); TB preventive therapy in HIV infection; diagnosis and treatment of TB in HIV-positive patients; diagnosis and treatment of HIV in patients with TB; issues related to antiretroviral therapy and TB infection, including drug–drug interactions, immune reconstitution inflammatory syndrome, and counselling; factors contributing to multidrug- and extensively multidrug–resistant TB; prevention, diagnosis, and management of multidrug–resistant TB; treating mono- and polyresistance; non–Mycobacterium tuberculosis, including epidemiology, pathogenesis, clinical manifestations, bacteriology, and management; admission and discharge criteria for patients with TB; essential elements of in-patient care in TB hospitals; TB in health care workers; infection control, including administrative, environmental, personal respiratory, and healthcare personnel protection control measures; TB monitoring, evaluation, and surveillance; the electronic TB register; standard reports and information flow; programme monitoring indicators; and the TB and HIV/sexually transmitted infection integrated audit tool.

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Keywords: Tuberculosis - Acute Infection, Tuberculosis - Resource-Limited Settings, Tuberculosis - Transmission and Prevention, Tuberculosis - Epidemiology, Tuberculosis - Pathogenesis, Tuberculosis - Tests and Assays, Tuberculosis - First-line Therapy, Tuberculosis - Adverse Events, Tuberculosis - Treatment Complications, Tuberculosis - Adherence, Tuberculosis - Pregnancy, Tuberculosis - Paediatrics, Tuberculosis - Drug Resistance, HIV - Tuberculosis, Tuberculosis - Biomedical Prevention, Tuberculosis - Drug-drug Interactions, Tuberculosis - IRIS