REFERRING MDR TB SUSPECTS

What is MDR TB?

Multidrug-resistant TB (MDRTB): is active TB involving Mycobacterium tuberculosis organism that are resistant to at least Isoniazid and Rifampicin.

How to Identify MDR TB suspect?

Previously Treated Cases 1.Failure cases of Category I and II New or Previously Treated Cases 1.Symptomatic contact of confirmed or suspected DR-TB 2. Confirmed case of HIV with symptoms of TB

2. Other/Chronic TB cases 3. Non-converter of Category II

How to Identify MDR TB suspect?

RETREATMENT CASES 1. Failure cases of DOTS Category I and II

a patient who remains (or becomes) sputum smearpositive on the 5th month or later of DOTS Category I or Category II treatment patients who have failed more than two DOTS treatment Patients who were given non-DOTS treatment Other (+) and Other (-)

2. Other/Chronic TB cases

How to Identify MDR TB suspect?

RETREATMENT CASES 3. Non-converter of Category II

a patient who remains smear-positive at the end of the third month of DOTS Category II treatment

4. Relapse Cases of Category I and II

a patient who has been declared cured or treatment completed, and is diagnosed with bacteriologically (smear or culture) positive TB

How to Identify MDR TB suspect?

RETREATMENT CASES 5. Return After Default

a patient who returns to treatment with positive bacteriology (smear or culture) following interruption of treatment for two months or more

How to Identify MDR TB suspect?

NEW OR RETREATMENT CASES 1. Symptomatic contact of a confirmed or suspected drug-resistant patient

A contact refers to a household contact who is a person who normally sleeps in the same dwelling unit as the drug-resistant index case for at least three months and has a common arrangement for preparation and consumption of food This patient has a higher risk of contracting the drug-resistant strain of the index case.

How to Identify MDR TB suspect?

NEW OR RETREATMENT CASES 2. Confirmed case of HIV with symptoms of TB

PLWH who has pulmonary or extra-pulmonary TB symptoms or has chest x-ray findings suggestive of TB HIV infection by itself is not a risk factor specifically for MDR-TB, but for TB, in general. However, since HIVinfected patients with MDR-TB have high mortality, early diagnosis through culture and DST are recommended

How to Refer MDR TB Suspect?

Smear (+) Re-treatment Case

Treatment Center Screening : TB Culture and DST, Smear, PE & Medical Hx

NTP Treatment cards PMDT Referral form-fully

How to Refer MDR TB Suspect?

Smear (-) Re-treatment Case
Acknowledgement form from Treatment centre

Chest Xray TB Diagnostic Committee Recommendation for Treatment NTP Treatment card Fully Accomplished MDR TB Referral Form

DOTS Facility OR Standardize d Treatment at the Treatment Center

Treatment Center : TB Screening Culture and DST, Smear, PE & Medical Hx

Date of referral

Ensure COMPLETENESS and CORRECTNESS of information

Suspects complete name and demographic info Referring units complete information

Identify reason for referring DR-TB suspect (High Risk Group)

Detailed history of suspects previous anti-TB treatment (if any)

Acknowledgmen t form for initial diagnosis

referring unit will receive Acknowledgment Form from the TC

Plan and recommendation for the patient

Patients referred will be

Provided of free screening and assessment (PE and Medical History Free Laboratory and Diagnostic Test (DST, Culture) Free medicine for the whole duration of treatment

PMDT Treatment Centers:

Lung Center of the Philippines Kabalikat sa Kalusugan (KASAKA) PTSI-Tayuman San Lazaro Hospital Dr. Jose N. Rodriguez Memorial Hospital (DJNRMH-TALA)

Thank you