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Disease prevention, early detection and effective management.

7.1 General Management of Tuberculosis

Table of Contents

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

NOTEConduct 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
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