You are on page 1of 11

Presumptive TB

Presumptive TB*
Adult Cough of at least 2 weeks
:
with/ without fever, chills,
night sweats, back/ chest
pain, fatigue, loss of
appetite, weight loss,
hemoptysis, dyspnea.
Child
:

(<15 y/o) w/ any 3 out 6


symptoms, cough of any
duration in a high risk
individual or close contact of
a TB source.

Chest X-ray suggestive of


Tuberculosis
Imaging studies, fluid/tissue
aspirate suggestive of extraMTB Detected,
RIF NOT
pulmonary
TB

Resistant / Sensitive

DSSM
Smear (+)
History of Previous
Treatment ?

(Relapse, TALF, TAF, PTOU)

No

Yes
Refer to PMDT for
Evaluation

(Xpert MTB/RIF, Culture DST)

New, Bacteriologically
Confirmed, TB

MTB Detected,
RIF- RESISTANT
Refer to PMDT Services
for Management

Category I Treatment
Retreatment,
Bacteriologically
Confirmed, TB

Category II Treatment
SRDR (Cat IV)

Smear (-)
X-ray findings
suggestive of TB?

Yes

No

History of Previous
Treatment ?

(Relapse, TALF, TAF, PTOU)

New, Clinically
Diagnosed, TB

Category I Treatment

Yes

No

Refer to PMDT for


Evaluation

(Xpert MTB/RIF, Culture DST)

MTB Detected, RIF NOT


Resistant / Sensitive
MTB NOT Detected

MTB Detected,
RIF- RESISTANT
Refer to PMDT Services
for Management

Further Clinical
Evaluation/ Refer to
specialist

Category II Treatment

Yes

No

Yes

No

Refer to PMDT Services


for Management

Category I Treatment
Retreatment, Clinically
Diagnosed, TB
Symptomatic &
Typically ill?

Refer to PMDT for


Evaluation

(Xpert MTB/RIF, Culture DST)

MTB Detected, RIF NOT


Resistant / Sensitive
MTB NOT Detected

SRDR (Cat IV)

Age < 15 y.o.


DSSM not done

X-ray findings
suggestive of TB?

Yes

No

Access to Xpert?

Yes

No

MTB Detected,
RIF- RESISTANT

Further Clinical
Evaluation, 3/6 Criteria

Category II Treatment

Yes

No

Yes

No

Refer to PMDT Services


for Management

Category I Treatment
Retreatment, Clinically
Diagnosed, TB
Symptomatic &
Typically ill?

SRDR (Cat IV)

History of Previous
Treatment ?

(Relapse, TALF, TAF, PTOU)

Age < 15 y.o.


DSSM not done

X-ray findings
suggestive of TB?

Yes

No

Access to Xpert?
Not TB, investigate
once Symptoms recur

Yes

No

MTB Detected,
RIF- RESISTANT

Yes

er to PMDT for
Evaluation

MTB/RIF, Culture DST)

Ye

No

MTB Detected, RIF NOT


Resistant / Sensitive

Retreatment,
Bacteriologically
Confirmed, TB

Category II Treatment

New, Bacteriologically
Confirmed, TB

Category I Treatment

History of
Treatm

(Relapse, TAL

No
New, Clinically
Diagnosed, TB

Category I Treatment

related problem,
diately inform staff if you have
ve cough.
de Information and ask staff
eve your record.
is no need for priority
.
will be directed on a
ated waiting area prior to
g the DOTS consultation room.
will be provided with masks,
napkin for your
ng/pulmonary toileting needs,
riate waste receptacles are
placed for your disposal.
will be instructed by staff on
ou can do while waiting for
rn, Please observe proper
tory etiquette, wear your

long? And other symptoms.


3.Obtain & retrieve patients ITR.

4.Assure all DOTS patient shall be first


priority on consultation to minimize exp
expedient time spent
5.Instruct and assist patient to the desi
separate waiting area and make patien
comfortable. Keep windows open to ens
ventilation.
6. Hand out masks and tissue packs to
instruct on the proper use of the mask
not to remove them.

7.Educate patient on the proper Respira


etiquette and instruct them how to prop
disposed their soiled items and to perfo
handwashing. Instruct them not to roam

er Personal protective
cough / symptoms
tent.

masks / PPEs and instruct on proper cough


etiquette.

our turn in the


aiting area before
the DOTS room.

16. Direct the patient to the waiting Area whil


waiting for her turn to be called.

will the inform you of


prognosis and will
your next step:

Smear Result OR/


e Smear Result with
/suggestive of TB

e Smear Result without

17. Inform the patient of the result and the


outcome/ prognosis based on NTP algorithm.
Provide privacy & confidentiality.
a) Immediately provide treatment package (Ca
II) and start DOTS. Counsel the patient regard
the disease, prevention and treatment regime
Advise on Nutrition, rest, and interventions to
manage adverse reactions.
b) Reassess and evaluate patients current
condition, if patient still manifest symptoms,
he/she may be subjected to have an X-ray or

Smear (+)
New Presumptive Drug Susceptible TB
(Children with Presumptive TB,
Presumptive EPTB, PLHIV with sign/
symptom of TB)

TB
(Signs &
CX

Xpert MTB/RIF Test

MTB Detected
Rifampicin

Presumptive
TB
Sputum
Collection Area

Provi

Sup

h
s

ks,

EC
s

Direct to DOTS
Waiting Area
(Outdoor)

Submit
TB Microscopy
Laboratory

Advise
result
turn a

uban magkasakit

Sampungan
Sampung
ang baba ug
anUbo
ilong kung
ug mag

Hatsing.
Gamit ang Tissue,
panyo o labakara

OR

ilabay sa saktong

Gamit ang kewlyo or


buktonan sa sienna,
DILI sa kamot.