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.
[Link] & retrieve patients ITR.
[Link] all DOTS patient shall be first
priority on consultation to minimize exp
expedient time spent
[Link] 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.
[Link] 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.
