2012_12 management of mdr-tb in children a field guide_0

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Management of MultidrugResistant Tuberculosis in Children: A Field Guide WŚŽƚŽ :ƵƐƟŶ /ĚĞ &ŝƌƐƚ ĚŝƟŽŶ EŽǀĞŵďĞƌ ϮϬϭϮ dŚŝƐ ŚĂŶĚŬ ŝƐ ŵĂĚĞ ƉŽƐƐŝďůĞ ďLJ ƚŚĞ ƐƵƉƉŽƌƚ ŽĨ ƚŚĞ ŵĞƌŝĐĂŶ ƉĞŽƉůĞ ƚŚƌŽƵŐŚ ƚŚĞ hŶŝƚĞĚ ^ƚĂƚĞƐ ŐĞŶĐLJ ĨŽƌ /ŶƚĞƌŶĂƟŽŶĂů ĞǀĞůŽƉŵĞŶƚ ;h^/Ϳ dŚĞ ĐŽŶƚĞŶƚƐ ŽĨ ƚŚŝƐ ƌĞƉŽƌƚ ĂƌĞ ƚŚĞ ƐŽůĞ ƌĞƐƉŽŶƐŝďŝůŝƚLJ ŽĨ d Z // ĂŶĚ dŚĞ ^ĞŶƟŶĞů WƌŽũĞĐƚ ŽŶ WĞĚŝĂƚƌŝĐ ƌƵŐͲ ZĞƐŝƐƚĂŶƚ dƵďĞƌĐƵůŽƐŝƐ ĂŶĚ ĚŽ ŶŽƚ ŶĞĐĞƐƐĂƌŝůLJ ƌĞŇĞĐƚ ƚŚĞ ǀŝĞǁƐ ŽĨ h^/ Žƌ ƚŚĞ hŶŝƚĞĚ ^ƚĂƚĞƐ 'ŽǀĞƌŶŵĞŶƚ

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Page 1: 2012_12 Management of MDR-TB in Children a Field Guide_0

Management of Multidrug-­Resistant Tuberculosis in Children: A Field Guide

Page 2: 2012_12 Management of MDR-TB in Children a Field Guide_0
Page 3: 2012_12 Management of MDR-TB in Children a Field Guide_0

Management of Multidrug-­Resistant Tuberculosis in Children: A Field Guide

Page 4: 2012_12 Management of MDR-TB in Children a Field Guide_0
Page 5: 2012_12 Management of MDR-TB in Children a Field Guide_0

Acknowledgements

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Table of Contents

Introduction 2

Section 1: Diagnosis 45

812

Section 2: Regimen Design 141417

Section 3: Monitoring 232324262830

Section 4: Infection Control 333334

Selected References 36

Appendices 38424446

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2 Introduction

Introduction

et  al.

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Mangement of Drug-­Resistant Tuberculosis in Children 3

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4 Diagnosis of DR-­TB in Children

Recognition and Initial Management of a Child with Suspected

MDR-­TB

Section 1: Diagnosis of MDR-­TB in Children

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Mangement of Drug-­Resistant Tuberculosis in Children 5

Algorithm for Suspected MDR-­TB in a Child

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6 Diagnosis of DR-­TB in Children

Case Examples: Suspected MDR-­TB in a Child

 

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Mangement of Drug-­Resistant Tuberculosis in Children 7

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8 Diagnosis of DR-­TB in Children

Diagnostic Specimen Management

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Mangement of Drug-­Resistant Tuberculosis in Children 9

Mycobacterium  tuberculosisM.  tuberculosis

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10 Diagnosis of DR-­TB in Children

minim

um

Types of Specimens

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Mangement of Drug-­Resistant Tuberculosis in Children 11

minim

um

First  

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12 Diagnosis of DR-­TB in Children

Management Algorithm for Child Contacts of MDR-­TB Cases

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Mangement of Drug-­Resistant Tuberculosis in Children 13

Case Example: Contact

th

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14 Regimen Design

Principles of Regimen Design: Pediatric Considerations

et  al.

Section 2: Regimen Design

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Mangement of Drug-­Resistant Tuberculosis in Children 15

Case Examples: Regimen Design

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16 Regimen Design

M.  tuberculosis

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Mangement of Drug-­Resistant Tuberculosis in Children 17

Dosing of Second-­Line Antituberculous Agents For Pediatrics

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18 Regimen Design

Weight-­Based Dosing in Children

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Mangement of Drug-­Resistant Tuberculosis in Children 19

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20 Regimen Design

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Mangement of Drug-­Resistant Tuberculosis in Children 21

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22 Regimen Design

hours

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Mangement of Drug-­Resistant Tuberculosis in Children 23

Section 3: Monitoring

1 3 4 5 6 9 15 18

A proposed monitoring schedule

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24 Monitoring

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Mangement of Drug-­Resistant Tuberculosis in Children 25

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26 Monitoring

Co-­Morbid Conditions

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Mangement of Drug-­Resistant Tuberculosis in Children 27

and or

Algorithm for Management of Children on Treatment for MDR-­

TB and HIV

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28 Monitoring

Adherence

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Mangement of Drug-­Resistant Tuberculosis in Children 29

Case Examples: Adherence

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30 Monitoring

Nutritional Monitoring for Children with MDR-­TB

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Mangement of Drug-­Resistant Tuberculosis in Children 31

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32 Monitoring

TB

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Mangement of Drug-­Resistant Tuberculosis in Children 33

Facility-­Based Infection Control

Section 4: Infection Control

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34 Infection Control

Case Example: Infection control

Community-­Based Infection Control

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Mangement of Drug-­Resistant Tuberculosis in Children 35

Case Example: Infection Control

Page 42: 2012_12 Management of MDR-TB in Children a Field Guide_0

36 References

Selected References

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Mangement of Drug-­Resistant Tuberculosis in Children 37

]

]

]

]

]

]

]

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38 Appendices

Appendix A: Sample Intake Form

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Mangement of Drug-­Resistant Tuberculosis in Children 39

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40 Appendices

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Mangement of Drug-­Resistant Tuberculosis in Children 41

Y Y Y Y P

Y Y Y Y P

Y Y Y Y P

Y Y Y Y P

o  or  

C

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42 Appendices

Appendix B: Medications Used to Treat

MDR-­TB

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Mangement of Drug-­Resistant Tuberculosis in Children 43

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44 Appendices

Appendix C: Contact Management Form for

Children Exposed to MDR-­TB

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Mangement of Drug-­Resistant Tuberculosis in Children 45

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46 Appendices

Appendix D: Protocols for Specimen

Collection

Gastric Aspiration

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Mangement of Drug-­Resistant Tuberculosis in Children 47

Sputum Induction

General:

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48 Appendices

Management  of  materials

Management  of  the  environment

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Mangement of Drug-­Resistant Tuberculosis in Children 49

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50 Appendices

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Mangement of Drug-­Resistant Tuberculosis in Children 51

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