Diagnosis
Sputum
Each patient should have direct smear microscopy (DSM) on 3 sputum specimens for diagnosis. DSM should be repeated at the end of the intensive phase to confirm sputum conversion.
Sputum of TB patients MUST be sent or taken to the TB Reference Laboratory when:
• sputum conversion to negative has not taken place
• there is concern that the patient has developed drug resistance
• culture and sensitivities are required
Chest X-rays
This have to be done upon:
• admission for diagnosis
• completion of outpatient treatment
NOTE To reduce the rate of exposure of the patients, any other films can be taken only where specifically indicated. An X-ray at the end of the intensive phase is not likely to provide any additional benefit. |
Tuberculin Testing
Use Mantoux test only
Tuberculin, dried (PPD) 1:1000 intradermal 0.1 ml 5 TU.
Examine after 48-72 hours.
Positive Mantoux Test
Adults |
Indulation > 10 mm |
Children |
Indulation > 6 mm |
These results may indicate:
• active infection (especially when strongly positive)
• previous infection or
• previous BCG
NOTE Absence of a response does not exclude TB because individuals with HIV may not have sufficient immunity for a positive Mantoux Test despite active TB |
