National Tuberculosis Management Guidelines
[Pages:152]2019
National Tuberculosis Management Guidelines
END TB
Government of Nepal Ministry of Health and Population Department of Health Services
National Tuberculosis Centre
Thimi, Bhaktapur
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NATIONAL TUBERCULOSIS MANAGEMENT GUIDELINES 2019
TABLE OF CONTENTS
1. INTRODUCTION AND INFORMATION ON THE NATIONAL TB PROGRAM
1
2. BACKGROUND ON TUBERCULOSIS BURDEN
9
3. GENERAL INFORMATION ABOUT TUBERCULOSIS
11
4. TUBERCULOSIS CLASSIFICATION AND DEFINITIONS
15
5. TUBERCULOSIS CASE DETECTION AND DIAGNOSIS
18
6. TREATMENT OF TUBERCULOSIS
33
7. DIAGNOSIS AND TREATMENT OF TUBERCULOSIS IN CHILDREN
52
8. DRUG RESISTANT /MDR TB MANAGEMENT
75
9. TB INFECTION CONTROL
78
10. TUBERCULOSIS AND HIV
83
11. TUBERCULOSIS AND TOBACCO
89
12. TUBERCULOSIS AND DIABETES
95
13. MANAGEMENT ASPECTS OF TB CONTROL PROGRAM
99
14 MONITORING AND EVALUATION FOR TB CONTROL PROGRAM
101
ANNEXURES
Annex 1a: Procedure for obtaining clinical samples for bacteriological examination 108 Annex 1b: Job Aid for gastric aspiration 112 Annex 2: Recommended treatment regimens and dosages use of fixed dosed
combined (FDC) drugs 113 Annex 3a: Guidance for dosing of INH preventive therapy 114 Annex 3b: Recommended Anti -TB drug dosages 114 Annex 4: Flow chart for management of bacteriologically confirmed cases 115 Annex 5: Triple-layer packaging 116 Annex 6: Recording and reporting forms 117
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NATIONAL TUBERCULOSIS MANAGEMENT GUIDELINES 2019
NATIONAL TUBERCULOSIS MANAGEMENT GUIDELINES 2019
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ACKNOWLEDGEMENT
The National TB Centre director (Dr. Sagar Rajbhandari) expresses my sincere gratitude to all the authors and reviewers of this guideline particularly to the World Health Organization and all the others who contributed in coming up with this comprehensive National Tuberculosis (TB) Management Guideline 2019
1. Dr. Bhim Singh Tinkari, Previous NTC Director 2. Dr. Ashesh Dhungana, Chief Consultant Chest Physician, NTC 3. Dr. Sharad Kumar Sharma, Chief SMEAR section, NTC 4. Mr. Anil Thapa, Previous Chief SMEAR section, NTC 5. Dr. Naveen Prakash Shah, Consultant Chest Physician, NTC 6. Mr. Gokarna Raj Ghimire, Laboratory In-charge, NTC 7. Mr. Pushpa Raj Joshi, Statistical officer, NTC 8. Ms. Basundhara Sharma, Senior Public Health Officer, NTC 9. Ms. Meera Hada, Medical Technologist, NTC 10. Prof. Dr. Brajendra Srivastav, NAINS College of Medicine 11. Dr. Suvesh Kumar Shrestha, Technical Specialist-TB, SCI 12. Dr. Ashish Shrestha, National Consultant-TB, WHO 13. Dr. Pramod Raj Bhattarai, Damien Foundation 14. Dr. Bhawana Shrestha, Project Manager, NATA/GENETUP 15. Dr. Praveen Sanker, Laboratory Consultant, SCI-FIND 16. Mr. Rajendra Basnet, SCI/NTC 17. Mr. Ratna Bahadur Bhattarai, Monitoring and Evaluation Specialist- SCI/NTC 18. Mr. Gokul Mishra, Liaison Officer, NTC/LSTM 19. Mr. Bhagawan Maharjan, Microbiologist, GENETUP 20. Mr. Nilaramba Adhikari, SCI/NTC 21. Mr. Lok Raj Joshi, SCI/NTC 22. Mr. Naval Kishor Shrestha, SCI/NTC 23. Mr. Chitra Jung Shahi, DTLO, NTC 24. Mr. Krishna Adhikari, Lab Technician Officer, NTC 25. Ms. Kamala Devi Wagle, Public Health Nurse Officer, NTC 26. Ms. Tara Sharma, NTC 27. Ms. Anju Basnet, NTC 28. Mr. Gopi Prasad Rupakheti, Kharidar/Supervisor, NTC 29. Dr. Lungten Z. Wangchuk, Scientist, Team -Lead, CDS, WHO, Nepal
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