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Standard Treatment Guidelines (STG) and The National Essential Drug List for Tanzania (NEDLIT)
(WHO; 1997; 210 pages)
FOREWORD
ACKNOWLEDGMENTS
INTRODUCTION
Standard Treatment Guidelines (STG)
1. GASTROINTESTINAL CONDITIONS
1.1 Parasitic Diseases
1.1.1 Amoebiasis
1.1.2 Ascariasis (Round Worms)
1.1.3 Ancylostomiasis (Hookworm Disease)
1.1.4 Cestodiasis (Tapeworms)
1.1.5 Filariasis
1.1.6 Giardiasis
1.1.7 Strongyloidiasis
1.1.8 Typhoid and paratyphoid
1.1.9 Schistosomiasis
1.2 Bacillary Dysentery
1.3 Diarrhoea
1.3.1 Management of diarrhoea in children
1.3.2 Special Notes on Management
1.4 Cholera
1.4.1 Moderate Dehydration
1.4.2 Severe Dehydration
1.5 Ulcers and related conditions
1.5.1 Peptic Ulcer-General Measures
1.5.2 Oesophageal Ulcer
1.5.3 Gastric Ulcer
1.5.4 Duodenal Ulcer
1.5.5 Non-Ulcer Dyspepsia
1.5.6 Acute Gastritis
1.5.7 Gastro-Enteritis (Food Poisoning Viral)
1.5.8 Ulcerative colitis
1.6 Other gastro-intestinal problems
1.6.1 Irritable Bowel Syndrome
1.6.2 Malabsorption Syndrome
1.6.3 Tropical Sprue
1.6.4 Pernicious Anaemia
1.6.5 Chronic Pancreatitis
1.6.6 Disaccharides Deficiency
1.6.7 Peritonitis
1.6.8 Constipation
1.6.9 Haemorrhoids and other Peri-Anal Conditions
1.7 Liver Diseases Conditions
1.7.1 Liver Cirrhosis
1.7.2 Acute Liver Failure/Hepatic Encephalopathy
2. RESPIRATORY DISEASES
2.1 Acute Respiratory Infections (ARI)
2.1.1 Pneumonia
2.1.2 ARI in Children
2.1.3 Wheezing
2.1.4 Croup
2.1.5 Laryngeal Diphtheria
2.1.6 ARI in Adult
2.1.6.1 Community Acquired Infections
2.1.6.2 Hospital Acquired Infections
2.1.7 Chronic Bronchitis
2.1.8 Other Respiratory Infections
2.1.9 Asthma
2.1.9.1 Chronic Asthma in Adults
2.1.9.2 Moderate Asthma in Adults
2.1.9.3 Severe Asthma in Adults
2.1.9.4 Maintenance therapy in children
2.1.10 Cough
2.1.11 Whooping Cough
2.1.12 Allergic rhinitis
3. OBSTETRIC AND GYNAECOLOGICAL CONDITIONS AND CONTRACEPTION
3.1 Infection of the Genital Urinary Tact
3.1.1 Urinary Tract Infection During Pregnancy
3.1.2 Positive RPR or Syphilis during pregnancy
3.1.3 Vaginal Discharge During Pregnancy
3.2 Abortion
3.3 Prolonged Rupture Of Membrane (PROM)
3.4 Prophylaxis for Caesarian Section
3.5 Nausea and Vomiting in Pregnancy
3.6 Anaemia During Pregnancy
3.7 Hypertension in Pregnancy
3.7.1 Essential Hypertension
3.7.2 Pregnancy Induced hypertension (PIH)
3.7.3 Mild PIH
3.7.4 Moderate PIH
3.7.5 Severe PIH
3.7.6 Pre-Eclamptic Toxaemia (Proteinuria PIH)
3.7.7 Imminent Eclampsia
3.7.8 Eclampsia (Proteinuria PIH with Fits)
3.8 Diabetes in Pregnancy
3.9 Anaesthesia, Analgesia, Antacids
3.10 Steroids in Respiratory Distress Syndrome
3.11 Myometrial Stimulants (Oxytocics)
3.12 Uterine Stimulation After Delivery
3.13 Myometrial Relaxants (Stimulants)
3.14 Termination of Pregnancy
3.15 Drugs in Pregnancy and Lactation
3.16 Pelvic Inflammatory Diseases
3.17 Hormonal Contraceptives
3.17.1 Check List Questions
3.17.2 Oral Contraceptives
3.17.3 Drugs Reducing Effect of Oral Contraceptives
3.17.4 Drugs made less Effective by Oral Contraceptives
3.17.5 Post Coital Contraception (“morning-after pill”)
3.17.6 Long Term Hormonal Contraceptives
3.17.7 Implant Contraceptive
3.18 Antepartum Haemorrhage (APH)
3.19 Dysmenorrhoea
3.20 Infertility
4. CARDIOVASCULAR DISEASES
4.1 Infections
4.1.1 Prophylaxis of Bacterial Endocarditis
4.1.2 Dental and upper Respiratory Tract Procedure
4.1.3 Parenteral Regimen Required for Genital-Urinary Procedures
4.1.4 Patient with Prosthetic Valve
4.2 Rheumatic Heart Disease
4.2.1 Rheumatic Fever
4.2.2 Antibiotics Prophylaxis after Rheumatic Fever
4.3 Treatment of Acute Arthritis and Carditis
4.4 Hypertension
4.4.1 Mild Hypertension
4.4.2 Moderate/Severe Hypertension
4.5 Cardiac failure
4.5.1 Mild to Moderate and Severe Cardiac Failure
4.5.2 Acute Pulmonary Oedema
4.5.3 Resistant cardiac failure
4.6 Angina Pectoris
4.6.1 Stable Angina/Infrequent Attacks
4.6.2 Frequent Attacks
4.7 Myocardial Infarction (Ml)
4.7.1 General Measures
4.7.2 Left Ventricular (Pump) Failure
4.7.3 Arrhythmias
4.7.4 Tachycardia
4.7.5 Rehabilitation
4.7.6 Prevention of Re-infarction
5. MALARIA
5.1 General Guidelines
5.2 Uncomplicated Malaria, Chloroquine Sensitive
5.3 Uncomplicated Malaria, Chloroquine resistant
5.4 Malaria due to vivax/ovale
5.5 Complicated Malaria
5.5.1 General measure
6. SKIN DISEASES
6.1 Bacterial Phyzogenic Skin Infections
6.1.1 Impetigo
6.1.2 Folliculitis
6.1.3 Furunculosis
6.1.4 Erysipelas
6.1.5 Acute Cellulitis
6.1.6 Acne
6.1.7 Paranychia
6.2 SKIN FUNGAL INFECTIONS
6.2.1 Dermatophytosis (Ringworm)
6.2.2 Tinea Corporis (Body Ringworm)
6.2.3 Tinea Capitis (Scalp Ringworm)
6.2.4 Tinea Versicolor (Pityrias Versicolor)
6.2.5 Tinea Pedis (Athlete's Foot)
6.3 OTHER FUNGAL DISEASES
6.3.1 Candidiasis
6.3.2 Deep Fungal Infections
6.4 Scabies
6.5 Herpes Simplex
6.6 Herpes Zoster (Shingles)
6.7 Chicken Pox
6.8 OTHER SKIN DISEASES
6.8.1 Allergic Contact Dermatitis
6.8.2 Eczema
6.8.3 Urticaria
6.8.4 Psoriasis
6.8.5 Pellagra
6.8.6 Depigmented Skin
6.8.7 Brucellosis (Undulant Fever)
6.8.8 Lichen Planus
7. SEXUALLY TRANSMITTED INFECTIONS / DISEASES (STD)
7.1 General Guidelines
7.2 Reasoning Behind STD Drug Treatment Regimens
7.3 Gonorrhoea
7.4 Chancroid
7.5 Epididymo-Orchitis
7.6 Chlamydia Infections
7.7 Syphilis
7.8 Genital Warts
7.9 Trichomoniasis
7.10 The Syndrome Treatment of STD
7.10.1 In Men
7.10.2 In Women
8. DENTAL AND ORAL CONDITIONS
8.1 Dental Infections
8.1.1 Periapical Abscess
8.1.2 Infected (Dry) Socket
8.1.3 Periodontal Conditions
8.1.4 Oral/Mucosal Ulcerations
8.1.5 Infections of the Oral cavity
8.1.6 Pericoronitis
8.1.7 Ludwig's Angina
8.1.8 Dental Abscess
8.2 Post Extraction Bleeding
8.3 Tooth Sensitivities
8.4 Dental Caries
8.5 Aphthous Ulcerations
8.5.1 Minor aphthous ulcers
8.5.2 Major aphthous ulcers
8.6 Edentulousness
8.7 Malocclusions
8.8 Traumatic Injuries to Teeth in Children
8.9 Tumours of the Oral Cavity
8.9.1 Benign Odontogenic Tumours
8.9.2 Malignant Odontogenic Tumours
8.9.3 Soft Tissue and Bone Tumours (Non-Odontogenic)
8.9.4 Lymphomas
8.10 Shedding of Primary (Milk) Teeth
8.11 Eruption of Teeth
9. GENITO-URINARY DISEASES: KIDNEY CONDITIONS
9.1 Glomerulonephritis
9.2 Pyelonephritis
9.3 Nephrotic Syndrome
10. EAR, NOSE AND THROAT CONDITIONS
10.1 Otitis (External and Media)
10.1.1 Otitis External
10.1.2 Otitis Media
10.2 Acute Rhinitis and Sinusitis
10.3 Pharyngotonsillitis
10.4 Laryngitis
10.5 Acute Epiglotitis (AE)
11. EYE CONDITIONS
11.1 Prevention/Management
11.2 Red Eye
11.3 Corneal Abrasion
11.4 Penetrating Injury
11.5 Chemical Burns
11.6 Conjunctivitis
11.6.1 Conjunctivitis of the Newborn
11.7 Unilateral
11.8 Trachoma
11.9 Xerophthalmia/Vitamin A Deficiency
12. TUBERCULOSIS AND LEPROSY
12.1 Tuberculosis
12.1.1 Control of Tuberculosis
12.1.2 Case Management
12.1.3 Treatment Categories
12.1.3.1 Treatment Guidelines Catagory I
12.1.3.2 Treatment guidelines Category II
12.1.4 New Cases Other Than Smear Positive (PT)
12.1.5 Chronic Cases
12.2 Leprosy
12.2.1 General Information about Leprosy
12.2.1.1 When Leprosy Should be Suspected
12.2.1.2 Diagnosis of Leprosy
12.2.2 Classification of Leprosy
12.2.2.1 Tuberculoid Leprosy
12.2.2.2 Borderline Leprosy
12.2.2.3 Borderline Tuberculoid (BT) Leprosy
12.2.2.4 Borderline Lepromatous (BL) Leprosy
12.2.2.5 Lepromatous (LL) leprosy
12.3 Treatment of Leprosy
12.3.1 Categories of Patients
12.3.2 Where the Patient should be Treated
12.3.3 Duration of Treatment
12.3.4 Procedures During and After Treatment
12.3.5 Responsibilities During Treatment
12.4 Prevention of Disabilities and rehabilitation
12.5 Signs and Treatment of Severe Reversal Reaction (RR)
12.5.1 Signs and Treatment of severe Erythema Nodosum Leprosum (ENL) Reaction
12.5.2 Treatment of Mild reaction
12.5.3 Precautions with Prednisolone
12.6 Responsibilities
12.7 How to Look After Ulcers
12.8 Surveillance of Patients After Release from MDT
12.9 Referral Criteria of Leprosy Patients
13. MUSCULOSKELETAL CONDITIONS AND JOINT DISEASES
13.1 Infections
13.1.1 Osteomyelitis
13.1.2 Tropical Pyomyositis
13.2 Inflammatory Conditions
13.2.1 General Guidelines
13.2.2 Rheumatoid Arthritis
13.2.3 Gout
13.2.4 Osteoarthritis
14. METABOLIC AND ENDOCRINE SYSTEM CONDITIONS
14.1 Diabetes Mellitus
14.2 Thyroid Diseases
14.2.1 Hyperthyroidism
14.2.2 Hypothyroidism
15. CENTRAL NERVOUS SYSTEM DISEASE CONDITIONS
15.1 Infections
15.1.1 Meningitis
15.1.2 Other CNS Infections
15.1.3 Tetanus
15.1.4 Rabies
15.2 Vascular Headaches
15.3 Anxiety Neurosis
15.4 Depressive Psychosis
15.5 Epilepsies
15.5.1 Status Epilepticus
15.5.2 Serial Epilepsy
15.6 Schizophrenia
15.7 Alcohol Dependence Syndrome
15.8 Substance Abuse
16. OTHER DISEASE CONDITIONS
16.1 Leishmaniasis
16.2 Trypanosomiasis
16.3 Anthrax
16.4 Mastitis (Breast Abscess)
17. VIRAL INFECTIONS
17.1 Measles
17.2 Poliomyelitis
17.3 Viral Hepatitis
17.4 HIV
18. ALLERGIC REACTIONS
18.1 Anaphylaxis (Acute Hypersensitivity)
19. NUTRITIONAL AND HAEMATOLOGIC CONDITIONS
HAEMATOLOGICAL DISEASE CONDITIONS
19.1 Anaemia
19.2 Sickle Cell Anaemia
19.3 Q6PD deficiency
19.4 Bleeding Disorders
19.4.1 Hereditary Bleeding Disorders
19.4.2 Haemophilia A (Factor VIII deficiency)
19.4.3 Haemophilia B (Factor IX deficiency)
19.5 Von Willebrand Disease (VWD)
19.6 Acquired Bleeding Disorders/Platelet Disorders
19.7 Haemorrhagic Disease of the Newborn
19.8 Anticoagulation
NUTRITIONAL DISEASE CONDITIONS
19.1 Avitaminosis
19.1.1 Vitamin A Deficiency
19.1.2 Vitamin D Deficiency
19.3 Nicotinic Acid Deficiency (Pellagra)
19.1.4 Thiamine Deficiency (Beriberi)
19.1.5 Riboflavin Deficiency
19.1.6 Pyridoxine Deficiency
19.1.7 Ascorbic Acid Deficiency
19.1.8 Vitamin K Deficiency
20. MALIGNANT DISEASE CONDITIONS
20.1 Hepatoma
20.2 Cancer of the Cervix
20.3 Cancer of the Breast
20.4 Kaposi's Sarcoma
20.5 Leukemia
20.6 Burkitt's Tumour
21. INJURIES AND TRAUMA
BITES
21.1 Animal Bites
21.2 Insect Bites
21.3 Snake Bites
BURNS
22. FOREIGN BODIES
23. PAIN
24. POISONING
25. NORMAL LABORATORY VALUES
NATIONAL ESSENTIAL DRUG LIST
1. ANAESTHETICS
2. MUSCLE RELAXANTS AND CHOLINESTERASE INHIBITORS
3. ANALGESICS, ANTIPYRETICS
4. ANTIMIGRAINE DRUGS
5. ANTI-ALLERGICS AND DRUGS USED IN ANAPHYLAXIS AND SHOCK
6. ANTIDOTES
7. ANTIEPILEPTICS AND ANTICONVULSANTS
8. ANTI-INFECTIVE DRUGS
9. ANTINEOPLASTIC DRUGS AND IMMUNOSUPPRESSIVE DRUGS
10. ANTI-PARKINSONISM DRUGS
11. DRUGS AFFECTING THE BLOOD
12. PLASMA SUBSTITUTES, BLOOD PRODUCTS
13. CARDIOVASCULAR DRUGS
14. DERMATOLOGICAL DRUGS
15. DIURETICS
16. GASTROINTESTINAL DRUGS
17. HORMONES, ANTIDIABETIC AGENTS, ENDOCRINE DRUGS, CONTRACEPTIVES
18. DIAGNOSTIC AGENTS
19. IMMUNOLOGICALS
20. OPHTHALMOLOGICAL PREPARATIONS
21. DRUGS USED IN EAR, NOSE AND THROAT (ENT)
22. OXYTOCICS & ANTI-OXYTOCICS
23. PSYCHOTHERAPEUTIC DRUGS
24. RESPIRATORY TRACT DRUGS
25. SOLUTION, CORRECTING WATER ELECTROLYTE AND ACID BASE DISTURBANCES
26. DISINFECTANTS and ANTISEPTICS
27. VITAMINS & MINERALS
28. DENTAL DRUGS/SUPPLIES
29. VILLAGE HEALTH POSTS
30. ESSENTIAL LABORATORY DIAGNOSTIC REAGENT
ABBREVIATIONS AND SYMBOLS
Standard Treatment Guidelines (STG) and The National Essential Drug List for Tanzania (NEDLIT)
THE UNITED REPUBLIC OF TANZANIA
MINISTRY OF HEALTH
April 1997
Second Edition
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