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b809867634d5446aa4f06bcdc71f2d88 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Reinfection and Treatment Compliance in TB | IV Basic TB Training Manual
Facilitator:
*NCAC - National Clinical Advisory Committee*
*PCAC - Provincial Clinical Advisory Committee* | IV B a s i c T B Tr a i n i n g M a n u a l Fa c i l i t a t o r *NCAC -National Clinical Advisory Committee. *PCAC -Provincial Clinical Advisory Committee. | REJECT |
4d7bb27214954790bb933dddbbf2e107 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Basic Tuberculosis Management Training Manual | The purpose of this course is to provide the necessary knowledge and skills to screen, test, diagnose, and effectively treat patients with Tuberculosis (TB), including those co-infected with HIV.
Who should use the manual? The manual is intended for facilitators of the Basic TB Management course.
Why was the manual... | The purpose of this course is to provide the necessary knowledge and skills to screen, test, diagnose, and effectively treat patients with Tuberculosis (TB), including those co-infected with HIV. • Who should use the manual? The manual is intended to be used by facilitators of the Basic TB Management course. • Why the ... | REJECT |
6a14482f34a2459889531c6b6c1ef780 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Teaching and Learning Methods in Medical Education | This course uses the following teaching and learning methods:
- Lectures
- Discussions
- Role plays
- Individual exercises
- Group work
- Demonstrations
- Practice | This course uses the following teaching learning methods: o Lectures o Discussions o Role plays o Individual exercises o Group work o Demonstrations o Practice | REJECT |
6f27d4fada5d4765bad139c44438a137 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Tuberculosis: Comprehensive Overview and Management | The course is split into modules covering the following topics: 1. Aetiology and Transmission 2. Prevention of TB 3. Clinical Presentation of Pulmonary and Extra-Pulmonary TB 4. Diagnosis of TB 5. TB Diagnostic Tests 6. TB Treatment, Side Effects, and Drug Interactions 7. Patient Education and Adherence Counseling 8. M... | The course is split into modules which cover the following topics: 1 Aetiology and Transmission 2 Prevention of TB 3 Clinical Presentation of Pulmonary and Extra-Pulmonary TB 4 Diagnosis of TB 5 TB Diagnostic Tests 6 TB Treatment, Side Effects and Drug Interaction 7 Patient Education and Adherence Counselling 8 Monitor... | REJECT |
5c8fa98cffe84e02a662b6e394d73921 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | TB Clinical Training Manual | A comprehensive TB basic training includes both clinical and recording and reporting components. This manual covers the clinical component, which lasts four days. This can be offered in four consecutive days or four non-consecutive days. Adding recording and reporting content is ideal to ensure participants are fully e... | A comprehensive TB basic training includes both clinical and recording and reporting components. This manual covers the clinical component which is four days. This can be offered in 4 consecutive days or 4 non-consecutive days. Adding recording and reporting content is ideal to ensure participants are fully equipped to... | REJECT |
a01cee32867d465b89c5382ba55d8780 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Understanding Tuberculosis: Aetiology, Transmission, and Treatment | By the end of this session, participants should be able to:
- Explain the aetiology of TB.
- Describe the transmission and pathogenesis of TB.
- Explain the difference between TB infection and TB disease.
- Explain risk factors and conditions associated with TB.
Commonly used antibiotics (e.g., penicillin) cannot... | By the end of this session, participants should be able to: -Explain the aetiology of TB. -Describe the transmission and pathogenesis of TB. -Explain the difference between TB infection and TB disease. -Explain risk factors and conditions associated with TB. • Commonly used antibiotics (e.g. penicillin) cannot penetrat... | REJECT |
e027131d48b3435d81862781674965c4 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Mycobacterium tuberculosis and Related Bacteria | Tuberculosis (TB) is an infectious disease caused by a micro-organism (also referred to as a bacillus), called
Mycobacterium tuberculosis (MTB). This bacillus belongs to a group of bacteria, Mycobacterium tuberculosis
complex.
Other agents include:
- Mycobacterium bovis (transmitted through contaminated milk and milk... | • Special staining methods are needed because with the usual staining methods, the stain cannot penetrate the waxy layer. The mycobacterium is acid-fast rod-shaped bacterium. Acid-fast bacilli (AFB): When the mycobacterium is stained, it retains colour even after they have been washed in an acid or alcohol solution. Th... | ACCEPT |
3b7a5786f0124906afa0cf2d45aa82ef | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Waxy Cell Walls and Tuberculosis Transmission | A large family of bacteria has unusually waxy cell walls that are resistant to digestion. The consequences of this cell wall structure include the transmission of TB bacilli. | A large family of bacteria that have unusually waxy cell walls that are resistant to digestion. The consequences of the cell wall structure are that: 1.2.1. How is TB transmitted? Exposure to TB bacilli 1.2. | REJECT |
59bd46c0ede6469a95cc584599a50e12 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Transmission of Tuberculosis | TB is an airborne infectious disease transmitted through the airborne route. When a person with pulmonary or laryngeal tuberculosis coughs, sneezes, talks, laughs, or sings, small droplets containing tubercle bacilli are released into the air. Droplet nuclei can also be produced by aerosol-generating procedures such as... | TB is an airborne infectious disease and is transmitted through airborne route. When a person with pulmonary or laryngeal tuberculosis coughs, sneezes, talks, laughs or sings, the small droplets of tubercle bacilli are spread into the air in tiny droplets. Droplet nuclei can also be produced by aerosol which produces i... | ACCEPT |
b1da80b5f6294c1ea337b9a7e889c206 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Transmission Risk of Tuberculosis Through Airborne Exposure | The length of time an exposed person breathes contaminated air is significant. Close contact and prolonged exposure increase the risk of transmission. Close contacts of patients with infectious TB, including household contacts, are at a higher risk of becoming infected with TB. | The length of time an exposed person breaths the contaminated air. Close contact and prolonged exposure increase the risk of transmission. Close contacts of patients with infectious TB including household contacts are at a higher risk of becoming infected with TB. | ACCEPT |
54f08a6681af4ba5b53334710ac75126 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Risk Factors for Tuberculosis in Immunocompromised Patients | Immunocompromised patients are at risk of developing tuberculosis (TB) and progressing from latent TB to active TB. Factors contributing to this risk include HIV, immunosuppressive conditions and drugs, malnutrition, and alcohol use. The risk of developing TB is higher in children under the age of 5 years, the elderly,... | Immuno-compromised patients are at risk of developing TB and progression from latent TB to active TB (HIV, immunosuppressive conditions and drugs, malnutrition, alcohol). The risk of developing TB is higher in children under the age of 5 years, elderly, miners, inmates in prisons, healthcare workers people sharing resi... | ACCEPT |
fc0cf0a0b6bb40e9b18d1b2bb0be7189 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Airborne Organism Concentration and Ventilation | Concentration of organisms in the air, space, and ventilation. The concentration of organisms in the air is determined by the volume of space and ventilation. | Concentration of the organisms in the air, space and ventilation. The concentration of organisms in the air is determined by the volume of space and the ventilation. | ACCEPT |
9fcf18080b4d44c18201fa9f726a4373 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Impact of Immune Status on Tuberculosis Progression | Once infected, the progression to active disease depends on the immune status of the individual. In those with normal immunity, 90% will not progress to active disease, while only 10% will develop it. People with suppressed immunity are more likely to develop active TB than those with normal immunity. | Once infected, the progression to active disease is dependent on the immune status of the individual. In those with normal immunity, 90% will not progress to active disease and only 10% will develop active disease. People with suppressed immunity are more likely to develop active TB than those with normal immunity. | ACCEPT |
321e48ea9bff4ec9b5b006c79cec6773 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Congenital Tuberculosis Transmission and Impact | Congenital TB is transmitted from an infected pregnant mother through the placenta, aspiration of infected amniotic fluid, or ingestion of infected material during passage through the birth canal. Mortality from congenital TB is high, estimated at 50%. Early diagnosis and commencement of treatment significantly improve... | Congenital TB is transmitted from an infected pregnant mother through the placenta, aspiration of infected amniotic fluid, or ingestion of infected material during passage through the birth canal. Mortality from congenital TB is high, estimated at 50%. Early diagnosis and commencement of treatment significantly improve... | ACCEPT |
17d2e1dcf06a4ea4a405fd74b7e3b9bd | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Risk Factors and Transmission of Tuberculosis | Household or close contacts are at higher risk due to exposure to an index patient. A household contact is someone who has shared the same enclosed living space for one or more nights or for extended periods of up to 8 hours during the day with the index patient in the 3 months before the start of current treatment. A ... | Household or close contacts are more at risk because of exposure to an index patient. -A household contacts is someone who shared the same enclosed living space for one or more nights or for extended periods of up to 8 hours during the day with the index patient during the 3 months before the start of current treatment... | ACCEPT |
7f0cbe66bf8f4cc58bbe659143d7ba8a | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Alcohol Consumption and Tuberculosis Risk | Excessive alcohol consumption, with or without an alcohol use disorder, is associated with a three-fold risk of developing tuberculosis (TB). Low to medium alcohol consumption is not linked to an increased risk of TB disease. Alcohol use disorders are associated with clinical conditions that may impair the immune syste... | Excessive alcohol consumption (with or without an alcohol use disorder) is associated with three-fold risk of developing TB. Low to medium alcohol consumption is not associated with an increased risk of TB disease. Alcohol use disorders are associated with clinical conditions that may impair the immune system and alcoh... | ACCEPT |
d9b72f594fc54161b4ebecad106fddd4 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Classification of Pulmonary Tuberculosis | Pulmonary TB disease involves the lung parenchyma/tissue. A patient with both a parenchymal lesion in the lungs (PTB) and extra-pulmonary TB is classified as having PTB. | Pulmonary TB disease involves the lung parenchyma/tissue. A patient with both a parenchymal lesion in the lungs (PTB) and extra-pulmonary TB is classified as PTB. | ACCEPT |
dfd95414792949f9aeedcf8cf2f24a06 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Management of EPTB and PTB Tuberculosis | The patient with both is reported as PTB; however, clinical management and monitoring are for both EPTB and PTB. The current Monitoring and Evaluation system categorizes miliary or disseminated TB under EPTB; hence, it should be recorded and reported as such. | Patient with both is reported as PTB, however clinical management and monitoring is for both EPTB and PTB. The current Monitoring and Evaluation system has miliary or disseminated TB under EPTB, hence it should be recorded and reported as such. | ACCEPT |
8d88e4407c954a1f8482ba7afbfeb35f | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Extrapulmonary Tuberculosis and Drug Resistance | EPTB (extrapulmonary tuberculosis) involves organs other than the lungs. Intrathoracic TB, such as mediastinal or hilar lymphadenopathy or pleural effusion without a parenchymal lesion in the lungs, is classified as extrapulmonary TB. When several sites are affected, the site representing the most severe form of diseas... | EPTB disease involves organs other than the lungs. Intrathoracic TB such as mediastinal or hilar lymphadenopathy or pleural effusion without a parenchymal lesion in the lungs, is classified as extra-pulmonary TB. Where several sites are affected, the site representing the most severe form of disease determines the case... | ACCEPT |
af524b2343c84e22b1e5a1e144a288a9 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Understanding Tuberculosis: Infection vs. Disease | **TB Infection vs. TB Disease**
Infection is the invasion of an organism's body tissues by disease-causing agents, their multiplication, and the reaction of host tissues to these organisms and the toxins they produce. Infections are caused by infectious agents, including bacteria, viruses, parasites, and fungi. Diseas... | Infection is the invasion of an organism's body tissues by disease-causing agents, their multiplication, and reaction of host tissues to these organisms and the toxins they produce. Infections are caused by infectious agents including bacteria, viruses, parasites, fungi, etc. Disease is an impairment of normal physiolo... | ACCEPT |
940d9e66b00d4ef1915b196b39205045 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | TB Infection Prevention and Control in Healthcare Settings | TB Prevention Measures in Health Facilities
**Rationale for TB Infection Prevention and Control**
TB is a communicable disease spread from person to person. The high number of undiagnosed, untreated, and potentially contagious TB cases in health facilities can be missed. Additionally, the high number of HIV-positive... | At the end of this module, participants should be able to: -Explain TB prevention methods. -Explain the 7 steps for prevention of TB transmission in health facilities. -Discuss the hierarchy of infection control measures. Explain TB contact investigation. -Explain actions to be taken during TB outbreak. -Describe the t... | ACCEPT |
8760269408194b65ba5fd1db29af545f | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Tuberculosis Infection Control Measures | Facility TB risk assessments should be conducted annually, along with the development and review of the infection control plan. It is important to monitor the number of health staff diagnosed with TB on a monthly basis and to train and educate health workers on infection prevention and control measures. Ensuring the av... | facility TB risk assessments annually developing and reviewing infection control plan monitoring the number of health staff diagnosed with TB monthly train and educate health workers on infection prevention and control measures ensuring availability of appropriate commodities for TB IPC conducting IPC audits to monitor... | ACCEPT |
42794e772cb34eccb807dd1169073338 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Administrative Measures for Tuberculosis Control in Healthcare Settings | Administrative control measures aim to reduce droplet nuclei containing Mycobacterium tuberculosis (MTB) in healthcare facilities, thereby reducing the exposure of staff and patients. These measures have a significant impact on TB control and should be prioritized.
The seven steps to reduce droplet nuclei and TB tran... | Administrative control measures aim to reduce droplet nuclei containing MTB in healthcare facilities and thus to reduce the exposure of staff and patients. These measures have the greater impact in TB control and should be prioritised. The seven steps to reduce droplet nuclei and TB transmission in healthcare settings ... | ACCEPT |
069cf640410c47239b1e8a2ba843973a | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | FAST Strategy for Tuberculosis Control in Hospitals | Hospitals are implementing the FAST strategy, a focused approach to stopping the spread of tuberculosis (TB) in congregate settings. FAST stands for Finding patients with TB Actively, Separating safely, and Treating effectively. This strategy emphasizes the implementation and monitoring of administrative processes nece... | Hospitals are implementing FAST strategy. FAST is a focused approach to stopping TB spread in congregate settings. FAST stands for Finding patients with TB Actively, Separating safely, and Treating effectively. FAST focuses attention on implementing and monitoring the administrative processes and procedures necessary t... | ACCEPT |
cc6c9636d3cf4f5e818fb44e2796122c | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Tuberculosis Management and Infection Control | • Separate Safely
Whilst waiting for laboratory results, patients with TB symptoms should be educated on cough hygiene, which includes the importance of using surgical masks and maintaining separation. They must be provided with surgical masks and take their position in the waiting area; where feasible, they can wait... | • Separate safely Whilst waiting for the laboratory results patients with TB symptoms should be educated on cough hygiene which should include the importance of using surgical masks and separation. They must be provided with surgical masks and take their position in the waiting area or where feasible they can wait in a... | ACCEPT |
c6ec990575914b3bab46a66e2577a83a | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Environmental Controls in Tuberculosis Prevention | The environmental controls are the second line of defense in preventing the spread of TB. They are effective if administrative controls are in place. These include: | The environmental controls are second defence in preventing the spread of TB. They are effective if ` administrative controls are in place. These include: | ACCEPT |
5d40a2976a2e4446bc64de806d845dae | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Ventilation Methods in Buildings | Ventilation (Natural and Mechanical) allows the movement of air through a building, replacing indoor air with outdoor air.
- Natural ventilation: This relies on open doors and windows. There should be an adequate number of windows and doors opening to the outside, and windows on opposite sides of the room facilitate ... | Ventilation (Natural and Mechanical) allows the movement of air through a building so that it is replaced by air from outside. • Natural ventilation: Natural ventilation relies on open doors and windows. There should be adequate number of windows and doors opening to the outside and windows on opposite sides of the roo... | ACCEPT |
41d6fe93b6c6404a9c2a300e0eadab3a | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Airflow Management and Ventilation Strategies | Fans may be used to assist in air distribution and directing airflow. They are inexpensive, increase the effectiveness of natural ventilation, mix air in a room, reduce the concentration of particles, and help direct air movement.
Mechanical ventilation is used in areas with high concentrations of infectious droplets.... | Fans may be used to assist in air distribution and directing the flow. Fans are inexpensive, increase natural ventilation effectiveness, mix air in a room, reduce concentration of particles, and assist in directing air movement. • Mechanical ventilation: It is used in areas where there may be high concentrations of inf... | ACCEPT |
7e01d20ae3ab4044b50f2e80522a1cd5 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Personal Protective Equipment for Tuberculosis Prevention | Personal protection refers to the use of respirators that contain special filter material to protect the wearer from inhaling TB bacilli. N95 or FFP2 masks are recommended for use in healthcare settings. Personal protective equipment (PPE) should be used in conjunction with other control measures to protect users again... | • Personal protection refers to the use of respirators that contain a special filter material to protect the wearer from inhaling the TB bacilli. N95 or FFP 2 are recommended for use in healthcare settings. PPE should be used together with other control measures to protect users against high-risk exposure. Healthcare w... | ACCEPT |
933cf39b93d8451189febc96f769febf | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Respiratory Protection Against Airborne Infections | • N95 respirator: The N95 is a particulate filtration respirator facepiece used for protection against airborne infections such as tuberculosis. It is NIOSH (National Institute for Occupational Safety and Health, part of the U.S. Centers for Disease Control and Prevention) certified and has the capacity to filter out 0... | • N95 respirator N95 is particulate filtration respirator face piece used for protection against airborne infections such as tuberculosis. It is NIOSH (National Institute for Occupational Safety and Health -part of U.S. Centers for Disease Control and Prevention) certified and has capacity to filter out 0.3-micron part... | ACCEPT |
aa8cfb04f56f44c48ead68f3a628c745 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Ultraviolet Germicidal Irradiation for Airborne Pathogen Control | Ultraviolet germicidal irradiation (UVGI) may be used as an adjunctive measure, or where natural ventilation is not feasible, UVGI may be a useful alternative. It requires ongoing maintenance and monitoring. Airborne pathogens are killed once they receive an appropriate amount of UV energy. | Ultraviolet germicidal irradiation (UVGI) may be used as an adjunctive measure or where natural ventilation is not feasible, UVGI may be a useful alternative. They require ongoing maintenance and monitoring. The airborne pathogens are killed once they receive an appropriate amount of UV energy. | ACCEPT |
133efb9e09f04001b16bda66df1d85c8 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Proper Use and Removal of Respirators | Healthcare workers must ensure that the respirators cover the nose, mouth, and chin, providing a tight seal around the edges.
- Wash your hands using soap and water or clean them with hand sanitizer.
- Inspect the mask to ensure that it is not damaged.
- Cup the respirator in your hand with the nosepiece at your fi... | Healthcare workers must ensure that, the respirators cover the nose, mouth and chin provide a tight seal around the edge. -Wash your hands using soap and water or clean with hand sanitizer -Inspect the mask to ensure that is is not damaged -Cup the respirator in your hand with the nosepiece at your fingertips, allowing... | ACCEPT |
985fd646246f4d9bbddd9eb2e4e2047f | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Respirator Use and Fit Testing Guidelines | A respirator that is extensively used should be discarded after 7 days. N95 respirators must be stored in a clean, dry, ventilated place. Deterioration of respirator efficiency occurs with humidity, dirt, and crushing; therefore, the condition of the respirator must be checked before reuse. Respirators are disposed of ... | A respirator extensively used should be discarded after 7 days. N95 respirators must be stored in a clean, dry, ventilated place. Deterioration of respirator efficiency occurs with humidity, dirt and crushing, therefore the condition of the respirator must be checked before re-use. Respirators are disposed as "soft was... | ACCEPT |
ee037792ebef4201a0670a983e8b563d | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Use of Face Mask and Infection Control Measures for Tuberculosis | Surgical masks are designed to prevent the spread of droplet nuclei into the air by capturing expelled particles near the source (mouth). However, they do not provide adequate protection from inhaling infectious droplet nuclei in the air due to their lack of a seal and limited filtration capacity. Masks should be worn ... | Surgical masks are meant to prevent the spread of droplet nuclei into the air by capturing the expelled particles near the source (mouth). They do not provide adequate protection from inhaling infectious droplet nuclei in the air because they are not sealed and have limited filtration capacity. They should be worn by p... | ACCEPT |
be1ba4b963a940eca7439e22079f031a | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Tuberculosis Exposure Control Measures for Employees | Exposures when a suspected or confirmed TB patient is identified:
d) Minimizes the risk of exposure for employees.
e) Alerts employees to hazards.
f) Screens employees for TB.
g) Uses and maintains environmental controls implemented to reduce the risk of exposure.
h) Uses respiratory protection.
i) Trains e... | exposures when a suspected or confirmed TB patient is identified d) minimises the risk of exposure for employees e) alerts the employees to hazards f) screens employees for TB g) uses and maintains environmental controls implemented to reduce risk of exposure h) uses respiratory protection i) trains employees on TB j) ... | ACCEPT |
b7b8beff9984464b98f001f840bfc9fe | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | TB Contact Management and Prevention Strategies | Facilitator notes:
- Introduce this section by emphasizing the importance of TB prevention in TB contacts.
- Go through slides 50-64, providing information on contact management in relation to the prevention of TB.
- Ask participants how contacts of TB are managed.
- Emphasize the new information on the topic, ... | Facilitator notes: • Introduce this section by emphasising the importance of TB prevention in TB contacts. • Go through slides 50-64 providing information on contact management in relation to prevention of TB. • Ask participants how are contacts of TB managed. • Emphasise the new information on the topic i.e. investiga... | REJECT |
e741726aa4294216b29ef46ea59b23fa | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Identification and Management of TB Exposure in Close Contacts | It is the systematic identification of individuals with undiagnosed TB disease and TB infection among those who have recently been exposed to an index TB patient in the household and other settings where transmission of infection is likely to occur (significant TB exposure). This process includes identification, tracin... | It is systematic identification of people with undiagnosed TB disease and TB infection among the people who have been recently exposed to the index TB patient in the household and in other settings where transmission of infection is likely to occur (significant TB exposure). This includes identification, tracing, clini... | ACCEPT |
bdd4baed6e244f169c5dc0e263c06b5d | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Objectives of Contact Tracing in Tuberculosis Management | The objectives of contact tracing are to:
- Conduct TB testing as an entry point to treatment (treatment of TB disease and treatment of LTBI).
- Identify contacts with active TB disease and initiate treatment early to reduce transmission in the community.
- Identify those infected with TB who are at high risk of deve... | The objectives of contact tracing are to: -conduct TB testing as an entry point to treatment (treatment of TB disease and treatment of LTBI) -identify contacts with active TB disease and initiate treatment early to reduce transmission in the communities identify those infected with TB and at high risk of developing act... | ACCEPT |
b290b0ea7e56485e81f85460b63883de | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Definitions of Close and Household Contacts in Medical Context | Close contact: A person who is not in the household but shared an enclosed space, such as a social gathering place, workplace, or facility, for extended periods during the day with the index patient in the three months before the commencement of the current treatment episode.
Household contact: A person who shared the... | Close contact: A person who is not in the household but shared an enclosed space, such as a social gathering place, workplace or facility, for extended periods during the day with the index patient, during the 3 months before commencement of the current treatment episode Household contact: A person who shared the same ... | ACCEPT |
85738dad504f41fbb39184e9b1cf79f0 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Early Detection and Prevention of Tuberculosis | To reduce morbidity and mortality due to TB and to arrest further transmission, early detection of patients with TB is essential. This includes preventing future cases of TB in the population by providing prevention therapy to high-risk contacts, such as: a) children under the age of 5 years, and b) people living with ... | to reduce morbidity and mortality due to TB to arrest further transmission by early detection of patients with TB to prevent future cases of TB in the population by early detection, providing prevention therapy to highrisk contacts: a) Children under the age of 5 years b) People living with HIV | ACCEPT |
99cf761e4e9a4a3591df0f33553c3efb | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Contact Investigation and Risk Determinants of Tuberculosis Transmission | Contact investigation offers an opportunity to: a) provide individual and family education on TB disease and infection prevention measures; b) conduct an interview with the patient promptly to assess the need for urgent contact tracing and investigation.
Table 2.3: Determinants of risk of TB infection
1. Infectiousn... | Contact investigation offers an opportunity to: a) provide individual and family education on TB disease and infection prevention measures b) conduct interview with the patient promptly to assess the need for urgent contact tracing and investigation Table 2.3: Determinants of risk of TB infection 1. Infectiousness of t... | ACCEPT |
e17439f1e62f4efa9f2642257019d071 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Factors Influencing Contact Investigation Urgency | The urgency of contact investigation depends on several factors, including: a) the infectiousness of the index patient, where the index patient is "sputum smear-positive," indicating the highest potential for transmission; b) the immunity of contacts, such as children under 5 years and immunocompromised individuals. | The urgency of contact investigation depends on a number of factors with include: a) The infectiousness of the index patient, Where the index patient is "sputum smear-positive" have the highest potential of being transmitters b) The immunity of contacts (children <5 years, immuno-compromised people) | ACCEPT |
5b0f8ac153f64cd0a71b4bf4165dc7a3 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Screening and Management of Household Contacts of TB Patients | Household contacts of patients with active TB must be listed in the TB treatment record of the index patient. All contacts should be screened. Where available, chest X-rays may be conducted to screen for TB. Contacts should be tested for TB, regardless of symptoms (sputum specimens collected for TB NAAT testing). Those... | Household contacts of patients with active TB must be listed in the TB treatment record of the index patient. All contact should be screened. Where available chest x-rays maybe conducted to screen for TB. Contacts should be tested for TB, regardless of TB symptoms (Sputum specimen collected for TB NAAT testing). Those ... | ACCEPT |
8065bbee5b244be085709111a57e14f4 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Sputum Collection and Informed Consent in Tuberculosis Management | Efforts should be made to obtain sputum. If sputum cannot be obtained and the child is asymptomatic, initiate TPT. TST is not required in well asymptomatic children. Confidentiality during contact investigations must be maintained. Legal and ethical issues can be resolved by obtaining informed consent for the disclosur... | Efforts should be made to obtain sputum. If sputum cannot be obtained and the child is asymptomatic, initiate TPT. TST is not required in well asymptomatic children. Confidentiality, during contact investigations must be maintained. Legal and ethical issues can be resolved by obtaining informed consent for disclosure o... | ACCEPT |
80c0cb284f774ceda79ac53b80f5aa6e | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | TB Contact Investigation and Management | Contact household members and close contacts through phone calls, contact slips, and home visits. Interview the contacts, inform them about possible exposure to TB, and the need for screening and testing for TB disease. Obtain additional information regarding possible risk of exposure. Conduct a medical evaluation, whi... | Contact household and close contacts through phone call, use of contact slip and conducting home visits. Interview the contacts, inform them about possible exposure to TB and the need for screening and testing for TB disease. Obtain additional information about possible risk of exposure. Conduct medical evaluation. Med... | ACCEPT |
3d97d6b92aee4c2da5bffe5ab8fef0e1 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | TB Outbreak Response and Management | **Summary of Contact Management in TB Prevention**
- List household contacts.
- Investigate all household contacts irrespective of symptoms.
- Provide treatment for LTBI or TB disease.
A TB outbreak is defined as the occurrence of more TB patients than expected in a specific geographic area or population during a par... | Summarise information on contact management in relation to TB prevention. Emphasise the following points: -List household contact -Investigate all household contacts irrespective of symptoms -Provide treatment for LTBI or TB disease TB outbreak is an observation of more TB patients than expected in a geographic area or... | ACCEPT |
cb29327896c74628bab0c4dca058e3e8 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Tuberculosis Outbreak Response Discussion | - Introduce outbreak response by asking participants if they have been involved in any outbreak response.
- Allow one or two participants to share their experiences.
- Review slides 65-70 on TB outbreak response. | • Introduce outbreak response by asking participants if they have been involved in any outbreak response. • Allow one or two participants to share their experiences. • Go through slides 65-70 on TB outbreak response. | REJECT |
9d970f81262a4fcc914672b783ff7192 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | TB Prevention and Outbreak Response in Children | - Introduce BCG by asking participants which TB prevention method applies to children.
- Review slides 71-77 on TB outbreak response. | • Introduce BCG by asking participants what TB prevention method applies in children. • Go through slides 71-77 on TB outbreak response. | REJECT |
c5a418ba895e4f53988fc54d85d6b168 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Bacille Calmette-Guérin Vaccine for Tuberculosis | Bacille Calmette-Guérin (BCG) is a vaccine for tuberculosis (TB). It is a live attenuated form of Mycobacterium bovis, which is part of the Mycobacterium tuberculosis complex. BCG provides children with a degree of protection against disseminated and severe forms of TB. In South Africa, it is administered as part of th... | Bacille Calmette-Guerin (BCG) is a vaccine for TB disease. It is a live attenuated form of Mycobacterium Bovis (part of MTB complex) which provides children with a degree of protection against disseminated and severe forms of TB. In South Africa, it is given as part of Expanded Programme on Immunisation (EPI) schedule.... | ACCEPT |
9e214a0b956a431a99734b07344a2267 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | BCG Vaccination Guidelines for HIV-Exposed Neonates | It is recommended that asymptomatic HIV-exposed neonates receive BCG. It should not be administered to symptomatic HIV-exposed neonates born to mothers with TB. Children who receive BCG should be closely monitored for disseminated BCG disease. | It is recommended that asymptomatic HIV exposed neonates should be given BCG. It should not be given to symptomatic HIV exposed neonates born to mothers with TB. Children given BCG should be closely monitored for disseminated BCG disease. | ACCEPT |
5cc83dce82e44709ac2d516bf4ca9434 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | BCG Vaccination and Tuberculosis Prophylaxis in Infants | - Defer BCG vaccination in infants starting TPT until after TPT completion, as TB drugs impair the effect of the live BCG vaccine.
- For HIV-positive infants who have just received BCG and are not TB-exposed, TPT should be deferred for 14 weeks, as INH impairs the effect of the live BCG vaccine. | -Defer BCG vaccination in infant starting TPT to after TPT completion since TB drugs impair the effect of live BCG vaccine. -For HIV-positive infants who have just had BCG and are not TB-exposed, TPT should be deferred for 14 weeks as INH impairs the effect of live BCG vaccine. | ACCEPT |
61024940b37649e0933d69e39ed9f449 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Management of Tuberculosis in Infants and Young Children | Infants have a high risk of developing severe or disseminated TB if exposed to TB and not treated. TB-exposed infants are those born to mothers diagnosed with TB in the last two months of pregnancy, at birth, or after birth; born to mothers who are still infectious (smear/culture positive) at the time of birth; or born... | Infants have a high risk of developing severe or disseminated TB if exposed to TB and not treated. TB exposed infants are those: -born to mothers diagnosed with TB in the last two months of pregnancy, at birth or after birth, or born to mothers who are still infectious (smear/ culture positive) at the time of birth, or... | ACCEPT |
8c3deaea2e2143b397deeb99ccfa8aa2 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | TB Preventive Therapy Guidelines for HIV-Positive and HIV-Negative Individuals | cannot tolerate Isoniazid. Where possible, shorter TPT regimens should be prioritized.
**General algorithm for provision of TB preventive therapy in HIV-negative individuals: **
1st evaluation of all adults, adolescents, and children living with HIV and all household and other close TB contacts.
1st evaluation of... | cannot tolerate Isoniazid. Where possible shorter TPT regimens should be prioritised. Figure 2.1: General algorithm for provision of TB preventive therapy in HIV negative individuals 1 st evaluation of all adults, adolescents and children Living with HIV All household and other close TB contacts 1 st evaluation of othe... | ACCEPT |
6999c2d1c6974aa487327798a8a3546a | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Tuberculosis Preventive Treatment Regimens for Children with HIV Considerations | There are three potential regimens for children: 3RH and 6H. The choice depends on the child's weight and HIV status or exposure (maternal HIV status). In HIV-negative children weighing <25 kg, the priority regimen is 3RH. In children living with HIV who are on DTG (dolutegravir)-containing ART, the priority regimen is... | There are three potential regimens for children: 3RH and 6H. The choice depends on the child's weight, HIV status or HIV exposure (maternal HIV) status: In HIV-negative children <25kg, the priority regimen is 3RH -In children living with HIV and on DTG (dolutegravir) containing ART 6H to avoid drug-drug interactions wi... | ACCEPT |
412d2913d7f0464ba2e00f06a4acbd9d | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Dosage Guidelines for Pediatric Tuberculosis Treatment | Daily Dosage for 3RH in Children <25 kg
| Child's Weight (kg) | RH (Daily) | Fixed Dose Combinations | Duration |
|---------------------|------------|-------------------------|----------|
| 2 - 2.9 | ½ tablet | 5 ml | 3 months |
| 3 - 3.9 | ¾ tablet | 7.5 ml ... | Table 2.8: Daily dosage for 3RH in children <25kg 75/50 If dispersed in water 2-2.9 ½ tablet 5ml 3 months 3-3.9 ¾ tablet 7.5ml 4-5.9 1 tablet 10ml 6-7.9 1 ½ tablet 15ml 8-11.9 2 tablets 20ml TB symptom screen (adolescents/adults) TB symptom screen (infants and children) Child's weight RH (Daily) fixed dose combinations... | ACCEPT |
19da38c0832140d385fde46ffdcf69af | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Breastfeeding Treatment Regimens for HIV-Negative Women | For HIV-negative breastfeeding women, there are two regimen options: 3RH or 6H. Pyridoxine (vitamin B6) 25 mg daily should be added for the duration of treatment, irrespective of HIV status. | For HIV negative breastfeeding women, there are two regimen options: 3RH or 6H Pyridoxine (vitamin B6) 25mg daily should be added for the duration of treatment irrespective of HIV status. | ACCEPT |
9eefbb2cfa4949d2bc32426ce904f29a | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Tuberculosis Preventive Therapy Regimens for PLHIV on ART | Recommended regimen for 6H in PLHIV on ART
- Isoniazid 300 mg: 1 tablet daily for 6 months
- Or Isoniazid 100 mg: 3 tablets daily for 6 months
- If 300 mg tablets are not available, use 100 mg
Recommended regimen for 12H in PLHIV on ART
- Isoniazid 300 mg: 1 tablet daily for 12 months
- Or Isoniazid 100 mg... | Table 2.10: Recommended regimen for 6H in PLHIV on ART Isoniazid 300mg 1 6 months Or 100mg 3 6 months • If 300mg tablets are not available, use 100mg Child's weight RH (Daily) fixed dose combinations Duration Weight band (kg) Daily INH 100mg tablet Duration Weight band (kg) Dosage* Number of tablets (daily) Duration Ta... | ACCEPT |
fcb111867a7946779dd40861e2a14f87 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Post-Tuberculosis Treatment Protocol for PLHIV | Post-TB treatment: Offer TPT to all PLHIV ≥25 kg after successfully completing treatment for TB disease and after active TB disease has been excluded. If previously treated with TPT and re-exposed to any close contact with TB, retest for TB and administer TPT once TB disease has been excluded. | Post TB treatment: Offer TPT to all PLHIV ≥25 kg after successfully completing treatment for TB disease, after active TB disease has again been excluded. Previously treated with TPT: If re-exposed to any close contact with TB, retest for TB and give TPT once TB disease has been excluded. | ACCEPT |
c04bab10ba7d4b29b7897d17464d5eb0 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Tuberculosis Prevention in HIV-Negative Contacts | Contacts: Evaluate all HIV-negative adults, adolescents, and children ≥25 kg in close contact with individuals diagnosed with TB, and start TPT once TB disease has been excluded. | Contacts: Evaluate all HIV-negative adults, adolescents and children ≥25kg in close contact with people diagnosed with TB and start TPT once TB disease has been excluded. | ACCEPT |
113ae71ec49545daa51d2bbf64102d62 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Tuberculosis Prevention in HIV-Negative At-Risk Populations | Evaluate all HIV-negative at-risk groups (those on anti-TNF treatment, on dialysis, preparing for organ or hematological transplant, or with silicosis). Once TB disease is excluded, start TPT. Evaluate HIV-negative adults and adolescents who previously received TPT if re-exposed to a close contact with TB, and start TP... | Evaluate all HIV-negative at-risk groups (on anti-TNF treatment, on dialysis, preparing for organ or haematological transplant, or with silicosis). Once TB disease is excluded, start TPT. Evaluate HIV-negative adults and adolescents who previously received TPT, if re-exposed to a close contact with TB and start TPT onc... | ACCEPT |
04f200136cef4260ae84eefd62227de2 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | HIV Management and Tuberculosis Prevention in Children | HIV+: Evaluate all children older than 14 weeks of age living with HIV for TB and start TPT once active TB has been excluded. ART should be started immediately if newly diagnosed with HIV. TPT should be initiated within 2 weeks of ART initiation. | HIV +V Evaluate all children older than 14 weeks of age living with HIV for TB and start TPT once active TB has been excluded. ART should be started immediately if newly diagnosed with HIV. TPT should be started within 2 weeks of ART initiation. | ACCEPT |
c06175b7822c4223b6125b8e9fbc8ba6 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | HIV-Negative Children and Tuberculosis Prevention | Evaluate HIV-negative children in close contact with a TB patient and start TPT after active TB disease has been excluded. | Evaluate HIV-negative children in close contact with a TB patient and start TPT after active TB disease has been excluded. | ACCEPT |
eee77f0811484834b4ca36d88b00ccd9 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | HIV and Tuberculosis Prophylaxis in At-Risk Populations | Test other HIV-negative at-risk children (weakened immune system, e.g., cancer, autoimmune diseases, transplant patients on immunosuppressive drugs, receiving dialysis, or inherited immunodeficiency) for TB and start TPT once active TB disease has been excluded. For adults, adolescents, and children ≥25 kg initiating a... | Test other HIV-negative at-risk children (weakened immune system e.g., cancer, autoimmune diseases, transplant patients on immunosuppressive drugs, receiving dialysis, or inherited immunodeficiency) for TB and start TPT once active TB disease is has been excluded *For adults, adolescents and children ≥25kg initiating a... | ACCEPT |
c0f388f5b51f4fbc8f4cff4360425813 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Tuberculosis Preventive Therapy Administration Guidelines | - 3 RH: Given on an empty stomach (before a meal).
- Isoniazid regimen only (6H or 12H): Give on an empty stomach (before a meal). Isoniazid is best absorbed on an empty stomach; there is up to a 50% reduction in peak concentration with a fatty meal.
- 3 HP: Give with a meal or directly after a meal (rifapentine is... | -3 RH: given on an empty stomach (before a meal). -Isoniazid regimen only (6H or 12 H): give on an empty stomach (before a meal). Isoniazid is best absorbed on an empty stomach; there is an up to 50% reduction in peak concentration with a fatty meal. -3 HP: give with a meal or directly after a meal (rifapentine is bett... | ACCEPT |
365df9071f074a6f96decec2abfa51d6 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Initiating Tuberculosis Preventive Therapy in Children | Prior to initiating TPT, active TB should be ruled out through clinical evaluation and testing for TB. If the client is asymptomatic, TPT initiation need not be delayed if TB GeneXpert results are outstanding.
**Patient Category: What to Do**
- TPT and ART can be initiated on the same day.
- A Tuberculin skin test (T... | Prior to initiating TPT, active TB should be ruled out through a clinical evaluation and by testing for TB. -If the client is asymptomatic, TPT initiation need not be delayed if TB GeneXpert results are outstanding. PATIENT CATEGORY WHAT TO DO REGIMEN B a s i c T B Tr a i n i n g M a n u a l Fa c i l i t a t o r 41 -TP... | ACCEPT |
644614c27a9240a29c88b709c7205034 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Pyridoxine Supplementation During Tuberculosis Preventive Therapy | Patients receiving TPT should be offered pyridoxine (vitamin B6) for the duration of their TPT: 25 mg/day if 5 years or older, and 12.5 mg/day if younger than 5 years of age. Lack of pyridoxine supply should not be a reason to withhold or postpone treatment. | Patients receiving TPT should be offered pyridoxine (vitamin B6) for the duration of their TPT: 25mg/day if 5 years or older, 12,5mg/day if younger than 5 years of age. Lack of pyridoxine supply should not be a reason to withhold or postpone treatment. | ACCEPT |
8efff1b33f004efdade3a79a96507d67 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Patient Education on Tuberculosis Infection and Treatment | Patient education should cover the following areas:
- What is TB exposure and infection?
- Why is it important to treat TB infection?
- Who must be treated for TB infection?
- What are the benefits and risks of taking treatment for TB infection?
- What are the treatment options for TB infection and their duration... | Patient education should cover the following areas: • What is TB exposure and infection? • Why is it important to treat TB infection? • Who must be treated for TB infection? • What are the benefits and risks of taking treatment for TB infection? • What are the treatment options for TB infection and the duration? • The ... | ACCEPT |
a9ea467595df431697bd17bbaf8246ec | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Monitoring and Management of Long-term Treatment in Patients with Comorbidities | Individuals may be monitored monthly, every 3 months, or every 6 months depending on the duration of treatment. For individuals with comorbidities, try to align appointments with other scheduled chronic disease or ART visits to avoid multiple visits for care.
- TB symptom screening must be conducted at each visit. If... | Individuals may be monitored monthly, 3-monthly, or 6-monthly depending on the duration of treatment. For individuals with comorbidities, try to align appointments with other scheduled chronic disease or ART visits to avoid individuals making multiple visits for care. • TB symptom screening must be conducted at each vi... | ACCEPT |
92e462971926418eb588604f747ec2c5 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Management of Adverse Events Related to Isoniazid and Rifampicin | While most adverse events (AEs) are minor and occur rarely, major adverse events may require urgent attention, including the possibility of stopping treatment. Patients should be educated about side effects and what to do if they occur. The table below shows the management of common side effects.
**Management of Commo... | While most of the AEs are minor and occur rarely, major adverse events may occur which may require urgent attention even stopping treatment. Patients should be educated about side effects and what to do should they occur. The table below shows the management of common side effects. Table 2.15: Management of common adve... | ACCEPT |
a5cbb82fdd6f4011a07c4325d5fd338d | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Management of Adverse Events Related to Isoniazid and Rifampicin | While most adverse events (AEs) are minor and occur rarely, major adverse events may require urgent attention, including the possibility of stopping treatment. Patients should be educated about side effects and what to do if they occur. The table below shows the management of common side effects.
**Management of Commo... | While most of the AEs are minor and occur rarely, major adverse events may occur which may require urgent attention even stopping treatment. Patients should be educated about side effects and what to do should they occur. The table below shows the management of common side effects. Table 2.15: Management of common adve... | ACCEPT |
60f7aa7af5ad4dd1acaa1b74eb13d3b6 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Drug-Drug Interactions and Treatment Guidelines in ART | To drug-drug interactions: Rifapentine and INH (3HP) should not be offered to ART-naïve individuals starting Dolutegravir-containing ART due to lack of evidence at this stage. 3HP should be deferred until individuals have been on ART with a Dolutegravir-containing regimen and are virally suppressed.
Common Drug-Drug I... | to drug-drug interactions. -Rifapentine and INH (3HP) should not be offered to ART-naïve individuals starting Dolutegravir containing ART due to lack of evidence at this stage. 3HP should be deferred until individuals have been on ART with a dolutegravir containing regimen until virally suppressed. Table 2.16: Common D... | ACCEPT |
e002926b071a458eab00499ffa8005a8 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Categorization of Treatment Interruptions in Shorter Regimens | People who are initiated on the shorter regimens (3-4 month regimens) and interrupt treatment should be categorized as follows: a. interrupted treatment for less than 4 consecutive weeks; b. interrupted treatment for more than 4 consecutive weeks; c. interrupted treatment for a second time, regardless of the duration o... | • People who are initiated on the shorter regimens (3 -4-month regimens) who interrupt treatment should be categorised as follows: a. interrupted treatment for less than 4 consecutive weeks b. interrupted treatment for more than 4 consecutive weeks c. interrupted treatment for a second time regardless of duration of in... | ACCEPT |
5c7de364a791457589f9e26e904146ab | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Guidance for Managing Missed Doses | Patients should be educated on what to do when they miss doses. The table below provides guidance on how missed doses should be managed. | Patients should be educated on what to do when they miss doses. The table below gives guidance on how missed doses should be managed. | ACCEPT |
665c7408aa2749689799dd9514f5ae99 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Missed Dose Guidelines | If one dose is missed, the individual should take the missed dose as soon as they remember within the same day. If the day's dose is missed, take the next scheduled dose and continue with the regular schedule. Do not take two doses on the same day. For weekly doses, take the missed dose as soon as remembered; if this i... | If one dose is missed -The individual should take the missed dose as soon as they remember within the same day -If the day's dose is missed, take the next scheduled dose and continue with the regular schedule. Do not take two doses on the same day -For the weekly doses, take the missed dose as soon as they remember, if... | ACCEPT |
40120c591b4f4de28877b8d94a9f13f2 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Patient Category for Tuberculosis Treatment | Table 2.18: Patient Category - New: Never had treatment for TB infection in the past or who took treatment for less than 4 weeks. | Table 2.18: Patient category New Never had treatment for TB infection in the past or who took treatment for <4 weeks | ACCEPT |
e693d4846b5c4141b3efdd84af32cc11 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Management of Previous TB Treatment | Treatment for TB infection in the past for ≥4 weeks, either completed or stopped for any reason (e.g., due to adverse events, developed TB, or lost to follow-up). | Treatment for TB infection in the past for ≥4 weeks and either completed or stopped for any reason (e.g., due to adverse events, developed TB, lost to followup) | ACCEPT |
e262acd63a2c4718bdd6e90cde924489 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Treatment Compliance and Outcomes | Treatment outcomes
- Treatment completed
- Treatment taken and completed within the prescribed period. | The treatment outcome possibilities for patients on TPT are completed, lost to follow-up, stopped or died as described in Table 2 .18 below. Table 2.19: Treatment outcomes Treatment completed Treatment taken and completed within the prescribed period. | ACCEPT |
587e0fa8ace24e8daf4e81b3a8e2287c | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Treatment Interruption Guidelines | Treatment is interrupted for 4 consecutive weeks or more (if on ≤ 4 months) or for two consecutive months (if on a course longer than 6 months) during the treatment period. | Treatment interrupted for 4 consecutive weeks or more (if on ≤ 4months) OR two consecutive months (if on a course longer than 6 months) during the treatment period. | ACCEPT |
e960c240b130413399f2f2a82a5c45cd | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Symptoms of Pulmonary Tuberculosis in Adults | The four common symptoms of pulmonary tuberculosis in adults used for screening are:
- Shortness of breath
- Chest pain
- Coughing up blood
- Fatigue
- Loss of appetite
Note: People with TB disease can present without symptoms. | The four common symptoms of pulmonary tuberculosis in adults used to screen, are: Other symptoms that may be present are: -Shortness of breath -Chest pain -Coughing up blood -Fatigue -Loss of appetite Note: People with TB disease can present without symptoms. | ACCEPT |
fa2b3c1ff8bd471da85bb57eeeb8c1a5 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Physical Signs of Disease Detection | Physical signs refer to abnormalities indicative of a disease that are detectable by a clinician during the examination of a patient. These signs may not be apparent to the patient. On physical examination, the signs may be non-specific, making it difficult to distinguish tuberculosis (TB) from other pulmonary diseases... | Physical signs refer to abnormalities indicative of a disease detectable by a clinician on examination of the patient. They may not be apparent to the patient. On physical examination the signs may be non-specific, making it difficult to distinguish TB from other pulmonary diseases. These may include fever (body temper... | ACCEPT |
a0239438f93445e8bb018a4e84cdbd06 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Extra-Pulmonary Tuberculosis Symptoms and Types | Extra-pulmonary TB can present with non-specific symptoms such as unintentional weight loss (more than 1.5 kg in a month), night sweats, and fever lasting more than 2 weeks. Other symptoms depend on the affected site or organ. The most common types of extra-pulmonary tuberculosis are:
- TB lymphadenitis
- Tuberculosi... | Extra-pulmonary TB can present with non-specific symptoms such as unintentional weight loss (more than 1.5 kg in a month), night sweats and fever for more than 2 weeks. Other symptoms depend on the site or organ affected. The most common types of extra-pulmonary tuberculosis are: -TB lymphadenitis -Tuberculosis pleural... | ACCEPT |
8d776cdf0cb2469182c1fc539fd2060b | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Tuberculous Meningitis: Symptoms, Risks, and Management | Tuberculous Meningitis (TBM) is a form of meningitis characterized by inflammation of the membranes (meninges) surrounding the brain or spinal cord, caused by Mycobacterium tuberculosis. Patients typically present with a gradual onset of headache, accompanied by malaise, confusion, decreased consciousness, and sometime... | Tuberculous Meningitis (TBM) is a form of meningitis characterised by inflammation of the membranes (meninges) around the brain or spinal cord and caused by Mycobacterium tuberculosis. Patients present with gradual onset of headache, accompanied by malaise, confusion, decreased consciousness, and sometimes vomiting. Pa... | ACCEPT |
2cf150cfb68743558c278eea928faf67 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | TB Lymphadenitis: Presentation and Characteristics | TB lymphadenitis is one of the most frequent presentations of extra-pulmonary TB. It involves the enlargement of peripheral lymph nodes, with cervical lymph node involvement being the most common. This condition is commonly seen in children and young adults. Lymph nodes may be firm or fluctuant, fixed, asymmetrical, di... | TB lymphadenitis is among the most frequent presentations of extra-pulmonary TB. It involves enlargement of peripheral TB lymph nodes. Cervical lymph node involvement is the most common. Commonly seen in children and young adults. Lymph nodes are firm to fluctuant, fixed, asymmetrical, discrete or matted, non-tender, a... | ACCEPT |
bca9783ebfd14325bbb4777c051f4c19 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Meningitis Assessment Techniques | Patient lies in a supine position. Flex one of the patient's legs at the hip and knee while the patient is lying on their back, then slowly extend the leg at the knee. A positive test is indicated when there is resistance to knee extension or pain in the lower back due to stretching of the meninges. Another demonstrabl... | Patient lies in supine position. Flex one of the patient's legs at hip, and knee with the patient lying on back, and then slowly extend the leg at the knee/straighten the knee. Positive test elicited when: -there is resistance to knee extension or pain in the lower back, from stretching of the meninges. Another physica... | ACCEPT |
fda390c413de409e9d00c9930659fb96 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Miliary Tuberculosis: Symptoms and Patient Demographics | Miliary TB is more commonly seen in infants, children under 4 years old, and immunocompromised individuals. Symptoms of miliary tuberculosis can be vague, with patients presenting general deterioration in health. Disseminated TB usually develops insidiously, with systemic symptoms such as fever, weakness, weight loss, ... | Miliary TB is seen more commonly in infants, children less than 4 years old, and in immunocompromised people. Symptoms of miliary tuberculosis can be vague and the patient presenting with general deterioration in health. Disseminated TB usually develops insidiously with systemic symptoms such as fever, weakness, weight... | ACCEPT |
d564efe5206c4670a4df1f483420f1e1 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Tuberculous Pleural Effusion: Symptoms and Clinical Presentation | Tuberculous (TB) pleural effusion is a build-up of fluid in the space between the lining of the lung and the lung tissue (pleural space) following infection with tuberculosis. Presentation is often acute, with symptoms including non-productive cough, chest pain, shortness of breath, and high temperature. The patient ma... | Tuberculous (TB) pleural effusion is a build-up of fluid in the space between the lining of the lung and the lung tissue (pleural space) after infection with tuberculosis. Presentation is often acute with non-productive cough, chest pain, shortness of breath and high temperature. The patient may have pleuritic pain (sh... | ACCEPT |
9c5fdd9bdba34a9aa822c68c4cc65e97 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Miliary Tuberculosis and Its Complications | Miliary TB is a potentially life-threatening type of tuberculosis that occurs when a large number of bacteria travel through the bloodstream and spread throughout the body. Tuberculosis of the bones most commonly affects the vertebral column. Both children and adults can develop neurological symptoms and progressive pa... | Miliary TB is a potentially life-threatening type of TB that occurs when a large number of the bacteria travel through the bloodstream and spread throughout the body. TB of the bones most commonly affects the vertebral column. Children and adults can develop neurological symptoms and progressive paralysis. Back pain, s... | ACCEPT |
6fb708d46d8d4e21b1c1ebeb24b211e3 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Management of Extrapulmonary Tuberculosis and HIV Testing Protocols | - Proper history taking, observation, and physical assessment must be conducted to identify the site of disease.
- HIV testing must be offered to all patients with a previous negative or unknown HIV status.
- Emergency care must be provided for very sick patients at the PHC level prior to referral to the hospital.
-... | -Proper history taking, observation and physical assessment must be conducted to identify the site of disease. -HIV testing must be offered to all patients with a previous negative or unknown HIV status. -Emergency care must be provided for very sick patients at PHC level prior to referral to hospital. Treatment for EP... | ACCEPT |
42caa6be425a4dc1a5907b5d37c95ede | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Tuberculosis Testing and Specimen Handling Procedures | - Provide an opportunity for asking questions.
- Wrap the session by summarizing the clinical presentation for the different types of TB.
Laboratory request form and specimen plastic bag:
- Complete the laboratory request form. Ensure all information is filled out; if any information is missing from the patient fol... | -Provide opportunity for asking questions -Wrap the session by summarising the clinical presentation for the different types of TB. Laboratory request form and specimen plastic bag o Complete the laboratory request form. Ensure all information is completed, if there is any missing information in patient folder verify w... | ACCEPT |
260a7dc88fad4197bf81481ef48f9eac | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Sputum Collection Education for Patients | Aim of the role play:
- Practice educating patients on the importance of proper sputum collection.
- Provide clear instructions to patients on the sputum collection procedure. | Aim of the role play: -Role play to practice educating patients on the importance of proper sputum collection -To practice how to provide clear instructions to patients on the sputum collection procedure | ACCEPT |
b8c6a67b9930404188d8e398fa2f8094 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Role-Playing in Clinical Communication and Sputum Specimen Collection Techniques | Facilitator notes:
- Instruct participants to work in groups of three: a patient, a clinician, and an observer.
- The observer will provide feedback on the interaction between the patient and clinician.
- Participants will switch roles until everyone in the group has played each role.
- Allow 10 minutes for the rol... | Facilitator notes: -Instruct participants to work in groups of three -a patient, clinician and an observer -The observer will observe and provide feedback on the interaction between the patient and clinician -The participants will switch roles until everyone in the group has played each role. -Allow 10 minutes for the ... | ACCEPT |
38069b59e08245b2a90d7765617f15fc | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Sputum Collection via Nasogastric Tube in Children | A tube is inserted into the stomach through the patient's nose to obtain swallowed sputum. This procedure is used to collect sputum in children who do not cough it up. It must be performed early in the morning before eating. Patients may need to be hospitalized, and it is an uncomfortable procedure. | A tube is inserted into the stomach through the patients nose to obtain swallowed sputum. Used to obtain sputum in children who do not cough up sputum. Must be done early in the morning before eating. Patients may need to be hospitalised. It is an uncomfortable procedure for the patient. | ACCEPT |
11f56a33f86c4c2eaaa71721103ae8f7 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Bronchoscopy for Sputum and Tissue Collection | A scope is passed through the mouth or nose to the affected part of the lung to obtain sputum or lung tissue. This procedure is used to collect sputum when the patient cannot cough and gastric aspirate cannot be performed. It is an invasive procedure that requires special equipment and must be conducted in a hospital b... | A scope is passed through the mouth or nose to the disease part of the lung to obtain sputum or lung tissue. Used to obtain sputum when the patient cannot cough and gastric. aspirate cannot be done. Invasive procedure. Requires special equipment. Must be done in a hospital by a specialist. Requires anaesthesia. | ACCEPT |
9a10b72de5d04533a22da73ed4c7f944 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Automated Nucleic Acid Amplification Tests for Tuberculosis Diagnosis | Three TB NAAT assays have been approved by the National TB Programme as first-line tests for the investigation of TB in clinical specimens. They are:
- Xpert MTB/RIF Ultra
- BD MAX MDR-TB
- cobas MTB and cobas MTB-RIF/INH assays
All three assays are automated TB testing platforms. Automated means that most steps invo... | Three TB NAAT assays that have been approved by the National TB Programme as first-line (front-line) tests for the investigation of TB in clinical specimens. They are: o Xpert MTB/RIF Ultra, o BD MAX MDR-TB and o cobas MTB and cobas MTB-RIF/INH assays. All three assays are automated TB testing platforms. o Automated me... | ACCEPT |
f2ed5c5178c9419ab5ff2ecbd2c0fd01 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Aspirate Analysis for MTB Detection and Resistance Testing | Aspirates:
- Tissue biopsies
- Fluids (joint, pleural, ascitic, peritoneal, pus collection)
- Cerebrospinal fluid (CSF)
Strengths and weaknesses:
- Specific for the MTB complex
- Short Turnaround Time (TAT)
- Detects MTB and RIF resistance (high sensitivity for RIF resistance)
- Reduced sensitivity in smear-ne... | aspirates -Tissue biopsies -Fluids (joint, pleural, ascitic, peritoneal, pus collection) -Cerebrospinal fluid (CSF) Strengths and weaknesses • It is specific for the MTB complex • Short Turnaround Time (TAT) • Detects MTB and RIF Resistance (High sensitivity for RIF Resistance) • Reduced sensitivity in smear negative c... | ACCEPT |
6f398f35e1a8415f8413500e98a156c2 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | BD MAX™ MDR-TB Assay: A Rapid Diagnostic for Tuberculosis Resistance Testing | The BD MAX™ MDR-TB assay is a PCR-based molecular diagnostic test that can simultaneously detect the bacteria that cause tuberculosis (TB) and determine whether the bacterial strain is sensitive or resistant to two important first-line drugs, rifampicin and isoniazid (INH), in a single test. This is crucial for decidin... | The BD MAX TM MDR-TB assay is a PCR-based molecular diagnostic test that can simultaneously detect the bacteria that cause tuberculosis (TB) and determine whether the bacterial strain detected is sensitive or resistant to two important first-line drugs, rifampicin and isoniazid (INH), in a single test. This is importan... | ACCEPT |
73e9c4c975bd421f87f46c07cf1a1761 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Acquisition of TB-NAATs for Mycobacterium tuberculosis Detection and Resistance Testing | The NHLS has acquired two TB-NAATs from Roche Molecular Systems: the cobas MTB and the cobas MTB-RIF/INH assay. The cobas MTB detects the presence of Mycobacterium tuberculosis (MTB) in clinical samples. The cobas MTB-RIF/INH assay detects resistance to rifampicin or isoniazid. Samples that test positive with cobas MTB... | The NHLS has acquired two TB-NAATs from Roche Molecular Systems, the cobas MTB and the cobas MTB-RIF/ INH assay. Cobas MTB detects the presence of MTB in clinical samples. The cobas MTB-RIF/INH assay detects resistance to rifampicin or isoniazid. Samples that are positive with cobas MTB are then tested for resistance t... | ACCEPT |
8cf1be4d03734c92baead2de559214e0 | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Laboratory Testing and Result Communication | Role of the Laboratory:
- The laboratory will test the specimen.
- Communicate results back to the facility.
- Inform patients of their results via SMS notification.
- This should be done within 48 hours. | Role of the laboratory • The laboratory will test the specimen, and • Communicate results back to the facility • Inform patients of their results -SMS notification • This should be within 48 hours | ACCEPT |
060b33bf066f41ffb5e3db2244cac75d | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | TB NAAT Result Interpretations | There are seven possible TB NAAT results, reported as follows:
1. MTB Detected, Rifampicin Unsuccessful ; Xpert MTB/RIF and BD MAX MDR-TB and Cobas MTB &
Cobas MTB-RIF/INH all YES
2. MTB Detected, Rifampicin Susceptible ;Xpert MTB/RIF and BD MAX MDR-TB and Cobas MTB &
Cobas MTB-RIF/INH all YES
3. MTB Detected, Rifampi... | There are seven (7) possible TB NAAT results, and they are reported as follows: MTB/RIF BD MAX MDR-TB Cobas MTB & Cobas MTB-RIF/ INH MTB Detected, Rifampicin Unsuccessful Yes Yes Yes MTB Detected, Rifampicin Susceptible Yes Yes Yes MTB Detected, Rifampicin Susceptible & Isoniazid Resistant No Yes Yes MTB Detected, Rifa... | ACCEPT |
b9674fb936604bdfbd44dcfee841f05e | DEP_HEALTH_TB_TRAINING_GUIDELINE_2024.pdf | Tuberculosis Diagnosis and Treatment Guidelines | MTB complex detected. MTB was isolated from the specimen. The patient has bacteriologically confirmed TB and should be treated. The clinician should initiate the patient on appropriate TB treatment. Treatment will be guided by rifampicin and isoniazid resistance status.
Results of tests to determine susceptibility or ... | MTB complex detected • MTB was isolated from the specimen • The patient has bacteriologically confirmed TB and should be treated. • The clinician should initiate the patient on appropriate TB treatment • Appropriate treatment will be guided by rifampicin and isoniazid resistant status Meaning Action by the clinician Re... | ACCEPT |
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