Tuberculosis is chronic airborne infectious disease caused by Mycobacterium tuberculosis.
Diagnosis criteria
- Cough of more than two weeks
- Fever
- Excessive night sweats
- Haemoptysis (sputum mixed with blood stains)
- Loss of weight
- Others includes swelling of lymph nodes, ascites, difficulty in breathing, swelling of joints etc., depending on the site of the disease
Investigations
- Sputum- smears microscopy or sputum for Gene –Expert.
- Culture and sensitivity; this is done to DR presumptive patients and DST surveillance
- Chest X-rays: done when smear negative and still suspect TB
NOTE. Conduct HIV provider initiated testing and counseling for all TB patients
For detailed diagnosis and investigation of tuberculosis, refer to Tanzania National TB & leprosy guidelines.
Pharmacological Treatment
TB treatment is divided into two phases:
- Initial /intensive phase, which consists of:
A: RHZE for 2 months for new case
AND
A: SRHZE for 2 months then A: RHZE 1month for re-treatment case. - Continuation phase, which consists of:
A: RH for 4 months for new patient
AND
A: RHE 5 months for re-treatment case.
Table 7.1 Recommended daily doses of first-line anti-TB drugs for adults and children
New/Retreatments | Initial Phase | Continuation Phase |
New | Rifampicin + Isoniazid + Pyrazinamide and Ethambutol in fixed dose (RHZE) for 2 months | Rifampicin + Isoniazid (RH) for 4 months |
Retreatments | Streptomycin+ Rifampicin + Isoniazid + Pyrazinamide and Ethambutol for 2months then
RHZE for 1months |
Rifampicin + Isoniazid+ Ethambutol (RHE) for 5 months. |
Table 7.2 Daily dosage of anti-TB drugs (FDCs) in new adult patients
Body weight | Number of tablets in initial phase: 2 months (R150/H75/Z400/E275) mg | Number of tablets in continuation phase: 4 months (R150/H75) mg |
21–30 kg | 2 | 2 |
31–50 kg | 3 | 3 |
51–74 kg | 4 | 4 |
≥75 kg | 5 | 5 |
Table 7.3 Daily dosages of anti-TB Drugs (FDCs) in new paediatric patients
Duration | Drug | Weight Bands (Number of Tablets) | ||||
4-7kg | 8-
11kg |
12-
15kg |
16-24 kg | 25 kg+ | ||
2 months of
intensive phase, daily observed treatment
|
(RHZ)
[75/50/150]
(E) [100] |
1
1 |
2
2 |
3
3 |
4
4 |
Go to adult dosages and preparations |
4 months of continuation phase,
daily observed treatment |
(RH)
[75/50]
|
1 | 2 | 3 | 4 |
Note:
- The oral drugs should preferably be given on an empty stomach in a fixed dose combination
- The oral drugs must be swallowed under observation from health facility staff or treatment supporter of his/her choice at home