MODULE B
Answers to self-assessment questions 1. The following groups are considered high risk for MDR-TB and should be referred for testing at a Treatment Center Retreatment cases 1. Failure - Category I failure - Category II failure (chronic TB case) 2. Relapse of category I or II 3. Return after default 4. “Other” type of patients: a) Non-DOTS patients b) “Other –positive” c) “Other-negative” 5. Non-converters of category II New or retreatment cases 6. Symptomatic contacts of a drug-resistant case 7. HIV-positive patients who have pulmonary or extra-pulmonary TB symptoms or have chest x-ray findings suggestive of TB 2. Two samples are needed. They are collected as follows: • First sample (spot sputum specimen): on Day 1 at the Treatment Center. • Second sample (early morning sputum specimen): on Day 2 at the MDR-TB suspect’s home, first thing after waking. 3. The MDR-TB Screening Form is an individual form for each MDR-TB suspect that holds a large amount of background information about the patient. The TB Symptomatics Masterlist is a record of all TB suspects, including TB and MDR-TB suspects seen at the MDR-TB Treatment Center. 4. Screening Code, date of screening, complete name and address, age, date of birth, and sex, no. of previous TB treatment, source of referral (site or doctor), site where last treated for TB, registration group, risk factors, symptoms, chest x-ray results (if available) 5. Smear, Culture and DST – Clinically deteriorating patients may need to be started on treatment urgently before the DST results are available or they will be at risk of dying. These patients should be identified by the physician, and their cases presented to the Consilium immediately. 6. If an MDR-TB suspect’s DST results show resistance to H, R and E, the Consiliumex should be completed to present the case to the Consilium in order to make a decision about treatment. 7. Inform the patient clearly and in a sensitive way. It is important to inform the MDR-TB suspect as soon as possible about drug resistance and the next steps that will be taken to start treatment. 8. The physician must present the case to the Consilium immediately. Either the culture needs to be repeated or empiric treatment needs to be started.
Detect Cases of MDR-TB
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