TB Case Screening and Diagnosis
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Questions and Answers

How often should symptom-based screening be done for PLHIV?

  • At every visit and at the time of diagnosis (correct)
  • Only annually and at every sixth visit
  • Only at the time of diagnosis of HIV/AIDS
  • At every visit and annually

    • What is the duration of TB signs and symptoms in PLHIV?

  • Less than two weeks
  • More than four weeks
  • Any duration, not necessarily two weeks (correct)
  • Always two weeks or more

    • What is the first step in identifying presumptive TB in PLHIV?

  • Ask about previous history of treatment
  • Identify TB signs and symptoms (correct)
  • Record the patient in Form 1
  • Perform a chest X-ray

    • What is the purpose of asking about previous history of treatment and exposure to TB cases in presumptive TB?

    <p>To determine the risk for DR-TB</p> Signup and view all the answers

    What is the next step after identifying a presumptive TB case in PLHIV?

    <p>Record the patient in Form 1 and follow the diagnostic algorithm</p> Signup and view all the answers

    What is recorded on a monthly basis in Form 1?

    <p>The total number of clients who underwent chest X-ray screening</p> Signup and view all the answers

    Who should be screened for TB using symptoms and chest X-ray?

    <p>Household and close contacts of all ages of a diagnosed TB case</p> Signup and view all the answers

    What is the purpose of Fig. 2 in the context of TB screening and diagnosis?

    <p>To outline the steps for screening and diagnosis of TB in PLHIV</p> Signup and view all the answers

    What is the definition of a presumptive DR-TB case?

    <p>A TB case with a history of previous treatment and close contacts of a known DR-TB case</p> Signup and view all the answers

    What is the primary consideration for screening strategies?

    <p>All of the above</p> Signup and view all the answers

    What is the purpose of asking about the four cardinal signs/symptoms in patients consulting the health facility for other reasons?

    <p>To determine if the patient has a presumptive TB</p> Signup and view all the answers

    What is the first step in screening for pulmonary TB (PTB) in adults ≥ 15 years old?

    <p>Record the patient's demographic and contact information in a register of consults</p> Signup and view all the answers

    What is a presumptive TB?

    <p>A patient who has any of the four cardinal signs/symptoms lasting for at least two weeks</p> Signup and view all the answers

    Where can screening for TB be done?

    <p>In health facilities, in communities or congregate settings, and among health workers and TB contacts</p> Signup and view all the answers

    What is the purpose of systematic screening in health facilities?

    <p>To ensure that all patients visiting the health facility are screened for TB</p> Signup and view all the answers

    What is the purpose of asking about the cardinal signs and symptoms in Fig. 1?

    <p>To identify patients who have a presumptive TB</p> Signup and view all the answers

    What is the recommended frequency for chest X-ray screening?

    <p>Once a year</p> Signup and view all the answers

    What is the primary consideration for chest X-ray screening in resource-limited settings?

    <p>Presence of TB risk factors</p> Signup and view all the answers

    What is the requirement for pregnant women undergoing chest X-ray screening?

    <p>A written consent and abdominal protective shield</p> Signup and view all the answers

    What percentage of bacteriologically confirmed pulmonary TB cases would have been missed by screening using symptoms alone?

    <p>One-third to two-thirds</p> Signup and view all the answers

    Which of the following is NOT a TB risk factor?

    <p>Hypertension</p> Signup and view all the answers

    What should be requested for chest X-ray screening?

    <p>Posteroanterior (PA) view</p> Signup and view all the answers

    What should be brought for comparison during chest X-ray screening?

    <p>Previous chest X-rays</p> Signup and view all the answers

    What should be done if a chest X-ray is not available for high-risk patients with signs and symptoms lasting less than two weeks?

    <p>The physician may decide whether to consider the patient a presumptive TB case</p> Signup and view all the answers

    What is the recommended frequency of chest X-ray screening for adults in high-risk settings?

    <p>Annually</p> Signup and view all the answers

    What is the recommended approach for children in high-risk settings?

    <p>Symptom screening only</p> Signup and view all the answers

    What should be considered when planning chest X-ray screening in high-risk settings?

    <p>Availability of sufficient supply, including Xpert cartridges and drugs</p> Signup and view all the answers

    Why is Xpert MTB/RIF preferred over smear microscopy in ACF?

    <p>Because Xpert MTB/RIF is more sensitive than smear microscopy</p> Signup and view all the answers

    What should be done for patients with chest X-ray findings suggestive of TB?

    <p>Collect sputum for an Xpert MTB/RIF test</p> Signup and view all the answers

    What should be done for pregnant women during chest X-ray screening?

    <p>Use a protective shield and obtain written consent</p> Signup and view all the answers

    What should be asked about for patients identified as presumptive TB?

    <p>Both their previous history of treatment and exposure to a TB case</p> Signup and view all the answers

    What should be done after identifying patients as presumptive TB?

    <p>Record the patient in Form 1</p> Signup and view all the answers

    What is the initial step in evaluating household contacts of diagnosed DR-TB cases?

    <p>Screen with signs and symptoms and chest X-ray</p> Signup and view all the answers

    What is the frequency of follow-up contacts for household contacts of DR-TB cases?

    <p>Every six months for two years</p> Signup and view all the answers

    What is the recommended test for DR-TB contacts without signs and symptoms or with chest X-ray findings not suggestive of TB?

    <p>Symptom screening</p> Signup and view all the answers

    What is the recommended frequency of chest X-ray for household contacts of DR-TB cases?

    <p>Every year</p> Signup and view all the answers

    What is the purpose of educating household contacts about TB signs and symptoms?

    <p>To advise them to return to the health facility if signs and symptoms develop</p> Signup and view all the answers

    What is the recommended action for household contacts with signs and symptoms or a positive chest X-ray result?

    <p>Refer to Xpert MTB/RIF testing</p> Signup and view all the answers

    What is the alternative to chest X-ray screening if it is not feasible?

    <p>Xpert MTB/RIF testing</p> Signup and view all the answers

    What is the recommended frequency of Xpert MTB/RIF testing if chest X-ray is not available?

    <p>Every year</p> Signup and view all the answers

    Study Notes

    Screening for TB

    • Household and close contacts of all ages of a diagnosed TB case should be screened for TB using symptoms and chest X-ray.

    Systematic Screening in Health Facilities

    • Systematic screening in health facilities involves screening all clients visiting the facility, regardless of the reason for consultation.
    • If the patient consults due to any of the four cardinal signs/symptoms (cough, unexplained fever, unexplained weight loss, and night sweats), follow the guidelines.
    • If the patient consults for other reasons, ask about the four cardinal signs/symptoms.
    • Steps involved in screening for pulmonary TB (PTB) in adults ≥ 15 years old:
      • Record the patient's demographic and contact information.
      • Ask about the four cardinal signs/symptoms.
      • If any of the signs/symptoms are present for at least two weeks, identify as a presumptive TB.
      • If not, offer chest X-ray screening if one has not been conducted in the past year.

    Chest X-ray Screening

    • A chest X-ray posteroanterior (PA) upright view should be requested, and previous chest X-rays should be brought for comparison.
    • Written consent should be taken from pregnant women, and an abdominal protective shield should be used.
    • If resources are limited, prioritize those with TB risk factors (e.g., contacts of TB patients, people living with HIV, elderly, diabetics, smokers, etc.).

    Risk Factors

    • TB risk factors include:
      • Contacts of TB patients
      • Those with a history of previous TB treatment
      • People living with HIV
      • Elderly (> 60 years old)
      • Diabetics
      • Smokers
      • Health-care workers
      • Urban and rural poor
      • Those with other immune-suppressive medical conditions

    Presumptive TB Case

    • If a patient has chest X-ray findings suggestive of TB, identify as a presumptive TB.
    • If a patient has TB signs and symptoms and/or a chest X-ray suggestive of TB, identify as a presumptive TB.

    Screening for PLHIV

    • Screening for PLHIV should be done at the time of diagnosis of HIV/AIDS and annually, thereafter.
    • Symptom-based screening should be done at every visit.
    • Signs and symptoms for PLHIV can be of any duration, not necessarily two weeks.

    Presumptive DR-TB Case

    • Ask about previous history of treatment and exposure to TB cases to determine the risk for DR-TB.
    • Presumptive DR-TB cases are those with previous history of TB treatment, close contacts of a known DR-TB case, or a non-converter of DS-TB regimen.

    Follow-up Contacts

    • Follow-up contacts every six months for the next two years.
    • Do symptom screening every six months and chest X-ray annually.
    • If it is not feasible to do a chest X-ray, directly do Xpert MTB/RIF test annually.

    Screening Household Contacts of DR-TB Cases

    • Evaluate all household contacts of diagnosed DR-TB cases by screening with signs and symptoms and chest X-ray.
    • Those with signs and symptoms or a positive chest X-ray result should be identified as presumptive TB.
    • Refer all household contacts identified as presumptive TB to Xpert MTB/RIF testing.
    • Follow-up contacts every six months for the next two years.

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    Related Documents

    TB Screening And Diagnosis Procedures PDF

    Description

    This quiz covers the procedures for screening household and close contacts of a diagnosed TB case, including considerations for specimen transport and laboratory capacity. Learn about the strategies for effective TB diagnosis and treatment.

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