Showing posts with label tuberculosis. Show all posts
Showing posts with label tuberculosis. Show all posts
RNTCP – DOTS DEFINITION
Extra Pulmonary tuberculosis
TB of any organ other than the lungs, such as
the pleura (TB pleurisy), lymph nodes, intestines,
genitourinary tract, skin, joints and bones, meninges
of the brain, etc.
Pleurisy is classified as extra pulmonary TB.
A patient diagnosed with both sputum smear
positive pulmonary and extra pulmonary TB should
be classified as pulmonary TB
New
A TB patient who has never had treatment for
tuberculosis or has taken anti-tuberculosis drugs for
less than one month.
Relapse
A TB patient who was declared cured or treatment
completed by a physician, but who reports back to
the health service and is now found to be sputum
smear positive.
Transferred in
A TB patient who has been received for treatment
into a Tuberculosis Unit, after starting treatment in
another unit where s/he has been registered.
Treatment after default
A TB patient who received anti-tuberculosis
treatment for one month or more from any source
and returns to treatment after having defaulted,
i.e., not taken anti-TB drugs consecutively for two
months or more, and is found to be sputum smear
positive.
Failure
Any TB patient who is smear positive at 5 months
or more after starting treatment. Failure also
includes a patient who was treated with Category
III regimen but who becomes smear positive during
treatment.
Chronic
A TB patient who remains smear positive after
completing a re-treatment regimen.
Others
TB patients who do not fit into the above mentioned
types. Reasons for putting a patient in this type
must be specified.
Cured
Initially sputum smear-positive patient who has
completed treatment and had negative sputum
smears, on two occasions, one of which was at the
end of treatment
Treatment completed
Sputum smear-positive patient who has completed
treatment, with negative smears at the end of the
intensive phase but none at the end of treatment.
Or: Sputum smear-negative TB patient who has
received a full course of treatment and has not
become smear-positive during or at the end of
treatment.
Or: Extra-pulmonary TB patient who has received a
full course of treatment and has not become smearpositive
during or at the end of treatment.
Died
Patient who died during the course of treatment
regardless of cause
Failure
Any TB patient who is smear positive at 5 months
or more after starting treatment. Failure also
includes a patient who was treated with Category
III regimen but who becomes smear positive during
treatment.
Defaulted
A patient who has not taken anti-TB drugs for
2 months or more consecutively after starting
treatment.
Transferred out
A patient who has been transferred to another
Tuberculosis Unit/District and his/her treatment
result (outcome) is not known.
plz click this link to read
latest RNTCP guidelines for diagnosing pulmonary tb
 |
| as given in DOTS_Plus_Guidelines_Jan2010.pdf |
-ototoxicity
-nephrotoxicity
-vertigo
-electrolyte imbalance
QUINOLONES:- OFLOXACIN
-photosensitivity
-tendinopathies
-skin rash
-arthalgia
-cardiotoxicity
-diarrhoea
ETHAMBUTOL
-optic neuritis
leads to visual disturbances, colour blindness
PYRAZINAMIDE
-Arthralgia
• Hyperuricaemia
• Hepatitis
• Pruritis with or without rash
ETHIONAMIDE
-Psychiatric: hallucination and depression
• Hepatitis
• Hypothyroidism and goitre with prolonged administration
• Gynaecomastia,menstrual disturbances, impotence, acne, headache, and peripheral neuropathy
CYCLOSERINE
-CNS: dizziness, slurred speech, convulsions, headache, tremor, and insomnia
• Psychiatric: confusion, depression, altered behaviour, and suicidal tendency
• Hypersensitivity reaction
PAS
-Gastro-intestinal: anorexia, nausea, vomiting, and abdominal discomfort
• Skin rash
• Hepatic dysfunction
• Hypokalemia
• Hypothyroidism and goitre with prolonged administration
GIVEN BELOW ARE THE OLDER CHANGES, FOR LATEST CHANGES READ
*The number of specimen required for diagnosis of smear positive pulmonary TB is two,
RNTCP LATEST CHANGES
*The number of specimen required for diagnosis of smear positive pulmonary TB is two,
with one of them being a morning sputum specimen.
*earlier 3 weeks of cough was necessary, now its of only 2 weeks..
*One specimen positive out of the two is enough to declare a patient as smear positive
TB.
*RNTCP Launches Cat IV (DOTS Plus) treatment for Multi-Drug
Resistant TB {link http://www.tbcindia.org/pdfs/RNTCP%20Launches%20DOTS%20Plus%20treatment.pdf}
* Cat V is for XDR-TB.
*Switched to Category V treatment: A Category IV patient who during treatment is identified as an
“XDR-TB suspect” and who is found to have XDR-TB on testing by an NRL, who subsequently has had
their Category IV treatment stopped and RNTCP Category V treatment initiated.
Definition:-
Multi-drug resistant tuberculosis (MDR-TB) is defined as an isolate of M. tuberculosis resistant to at least isoniazid and rifampicin.
with or without other
anti-tubercular drugs based on DST results from an RNTCP accredited Culture & DST Laboratory.
All patients that are identified with MDR-TB and are to be treated with an RNTCP Category IV regimen,
Extensively drug-resistant tuberculosis (XDR-TB) is TB showing resistance to at least rifampicin, isoniazid, and any fluoroquinolone, and to at least 1of the 3 following injectable drugs used in anti-TB treatment: capreomycin, kanamycin and amikacin
• Mono-resistance: A patient whose TB is due to tubercle bacilli that are resistant in vitro to exactly one
anti-TB drug in an RNTCP accredited laboratory.
• Poly-resistance: A patient whose TB is due to tubercle bacilli that are resistant in-vitro to more than
one anti-TB drug, except not both isoniazid and rifampicin in an RNTCP accredited laboratory.
• Poly-resistance: A patient whose TB is due to tubercle bacilli that are resistant in-vitro to more than
one anti-TB drug, except not both isoniazid and rifampicin in an RNTCP accredited laboratory.
· * Drug-resistant case: A patient whose TB is due to tubercle bacilli that are resistant in vitro to at least to one anti-TB drug according to accepted laboratory methods in an RNTCP accredited laboratory.
*its available in downloadable format .
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