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close this bookNational Guidelines for the Clinical Management of HIV/AIDS - Tanzania (NACP; 2005; 131 pages)
View the documentLIST OF ABBREVIATIONS
View the documentACKNOWLEDGEMENTS
View the documentFOREWORD
Open this folder and view contentsCHAPTER 1: INTRODUCTION
Open this folder and view contentsCHAPTER 2: ORGANIZATION OF HIV/AIDS CARE AND TREATMENT
Open this folder and view contentsCHAPTER 3: HIV/AIDS PREVENTION
Open this folder and view contentsCHAPTER 4: PROTECTIVE MEASURES AGAINST HIV TRANSMISSION
Open this folder and view contentsCHAPTER 5: LABORATORY TESTS IN HIV/AIDS
Open this folder and view contentsCHAPTER 6: HIV/AIDS AND PREGNANCY
Open this folder and view contentsCHAPTER 7: PEDIATRIC HIV/AIDS AND RELATED CONDITIONS
Open this folder and view contentsCHAPTER 8: COMMUNITY AND HOME BASED CARE FOR PEOPLE LIVING WITH HIV/AIDS (PLHA)
Open this folder and view contentsCHAPTER 9: COUNSELLING RELATED TO HIV-TESTING AND TREATMENT ADHERENCE
close this folderCHAPTER 10: MANAGEMENT OF COMMON SYMPTOMS AND OPPORTUNISTIC INFECTIONS IN HIV/AIDS
View the document10.1 Introduction
Open this folder and view contents10.2 Clinical features commonly encountered in patients with HIV/AIDS
Open this folder and view contents10.3 Prophylactic treatment of common opportunistic infections in HIV/AIDS
close this folder10.4 Treatment of Opportunistic Infections:
View the document10.4.1 Viral infections
View the document10.4.2 Bacterial infections
View the document10.4.3 Fungal infections
View the document10.4.4 Protozoa
Open this folder and view contentsCHAPTER 11: MANAGEMENT OF MENTAL HEALTH PROBLEMS IN HIV/AIDS
Open this folder and view contentsCHAPTER 12: MANAGEMENT OF HIV INFECTED PATIENTS USING ANTIRETROVIRAL DRUGS
Open this folder and view contentsCHAPTER 13: ARV THERAPY IN INFANTS AND CHILDREN
Open this folder and view contentsCHAPTER 14: USE OF ARVS IN SPECIAL CIRCUMSTANCES
Open this folder and view contentsCHAPTER 15: HIV/AIDS AND NUTRITION
Open this folder and view contentsCHAPTER 16: MANAGEMENT OF ANTIRETROVIRAL MEDICINES
Open this folder and view contentsCHAPTER 17: CERTIFICATION OF HEALTHCARE FACILITIES AS CARE AND TREATMENT SITES
 

10.4.4 Protozoa

Toxoplasma encephalitis

Clinical features

Focal paralysis or motor weakness depending on area affected

Neuro-psychiatric manifestation corresponding to the affected area in the brain

Altered mental status (forgetfulness etc.)

Diagnosis

Predominantly based on clinical findings after exclusion of other common causes of neurological deficit. If available, a CT scan is very useful for confirmation.

Treatment

Acute infection:

Tabs Sulphadiazine 1 gm 6hourly + Tabs Pyrimethamine 100mg loading dose then 50mg/day + Tabs Folinic acid 10mg/day for 6 weeks.

After six weeks of treatment

Prophylaxis therapy:

Tabs Sulphadiazine 500mg 6hourly + Tabs Pyrimethamine 25-50mg/day + Tabs Folinic acid 10mg/day.

For those allergic to sulphur:

Replace Tab Sulphadiazine with capsule Clindamycin 450mg 6 hourly.

Discontinue maintenance therapy when CD4 count>200 cells/ml for 6 months, initial therapy completed and patient is asymptomatic

Primary prophylaxis therapy for toxoplasmosis

Tabs Trimethoprim - Sulphamethoxazole (TMP-SMX) 160/800mg orally/day.

For those allergic to sulphur, give Tab Dapsone 50mg/day + Tab Pyrimethamine 50mg per week + Tab Folinic Acid 10 mg 3 times a week.

Intestinal protozoa

For intestinal protozoa which is a common cause of diarrhoea and difficult to diagnose, the recommended treatment: Tabs Albendazole 800mg BD for one week.

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