MODULE C
Exercise C: Written Exercise Giving supervised treatment Individual work on written exercise The purpose of this exercise is to document supervised treatment in the Category IV Treatment Cards of patients receiving MDR-TB treatment. In this exercise you will practice recording treatment on a Category IV Treatment Card for Mr. Ambrosio Amador. Fold out the Category IV Treatment Card for Mr. Amador provided to you. 1. Write your three letter initials on the days that you supervised treatment. Write your three letter initials: __ __ __ 2. Use the information provided below to update the patient’s Category IV Treatment Card. •
For Treatment Site staff a. Update Mr Amador’s Category IV Treatment Card using the information provided in boxes. b. Update page 3 of his treatment card starting on the date of patient endorsement to your facility. Assume that you are a staff of Jasmine Health Center providing supervised treatment to the patient.
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For Treatment Center staff Update Mr. Amador’s Category IV Treatment Card, pages 1-4, using all the information below. Ambrosio submitted baseline specimens on May 14 and 15, 2008. The DSSM results were 1+ and 2+. Baseline CXR done on May 14, 2008 showed progression of the bilateral infiltrates and increase in the right upper lung cavity.
Ambrosio began his treatment on Monday, May 19, 2008. He came and received directly observed treatment on the following days: May 19, 20, 21, 22, 23, 24. Ambrosio complained about dizziness for a week which seemed manageable and he continued with his treatment. May 25 was Sunday. He received directly observed treatment on May 26, 27, 28, 29, 30, 31. June 1 was Sunday. He received directly observed treatment on June 2, 2008. He did not come on June 3, 4, and 5. The TC staff found out from his cousin through phone call that he had transferred to the house of another relative, also in Manila because of a family conflict. The TC staff coordinated with the nearest DOTS facility, Jasmine Health Center for default follow-up. Early in the morning on June 6, the Jasmine Health Center worker visited the patient’s home and found that Ambrosio had been sick and complaining of severe nausea and dizziness. The health worker was able to convince Ambrosio to report at the Treatment Center that same day. On June 6, because of his severe symptoms, the TC physician gave ancillary medicines and revised the regimen, replaced prothionamide with PASER 4 grams/sachet, 2 sachets per day, with a plan to present it to the Consilium. Ambrosio received supervised treatment, took PASER instead of prothionamide along with the other drugs. The TC physician emphasized to Ambrosio the importance of not missing treatment and Ambrosio promised to continue taking his drugs. He also expressed willingness to be decentralized to Jasmine Health Center. * For Treatment Site staff, update page 2 of the Category IV Treatment Card.
82 Treat MDR-TB Patients
