NATIONAL TUBERCULOSIS AND LEPROSY PROGRAMME
Indonesia's TB Guidelines
Training for staff working at DR-TB management centres.
Training modules
“Continuum of HIV services refers to a comprehensive package of HIV prevention, diagnostic, treatment, care and support services provided for people at risk of HIV infection or living with HIV and their families”
August, 2018
Tuberculosis (TB) is among the top ten most common causes of death globally and as a single infectious disease it top among infectious diseases. Furthermore, it is noted as the top causes of death among people infected with the human immunodeficiency virus (HIV). Despite recent decreases in the numb...er of notified cases, Namibia still has a high TB burden and is included among the top 30 high-burden TB countries by the World Health Organisation (WHO). In the 2018 Global TB Report, the estimated incidence rate of TB in Namibia was 423/100,000. The same report estimated that 60 people per 100,000 populations died of TB in Namibia, which is a concern, for a disease that is curable and preventable.
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Zambia has completed the implementation of the National TB Strategic Plan (2017-2021) that set in motion the TB elimination agenda in Zambia through coordinated and accelerated TB response. During this period, the National TB and Leprosy Programme (NTLP) registered tremendous success.
The NTLP is ...poised to attain the ambitious goal pronounced by the government of eliminating TB by 2030, in line with the Sustainable Development Goals (SDGs) and the World Health Organization End TB Strategy. The programme exponentially increased TB notifications from as low as 35,922 people with TB in 2018 to 40,726 in 2020 and in 2021 the TB notifications rose to 50,825 (a 25% increase against 2020 performance). The NTLP also registered incredible success in sustaining high TB Preventive Treatment (TPT) initiations among persons living with HIV and a high TB treatment success rate among drug-susceptible TB cases. New and relapse TB notifications in children below 15 years increased by 43%, from 2,724 in 2020 to 3,890 in 2021. TB notifications ratio between children aged 0-4 and 5-14 was 0.9, an improvement from what we achieved in 2018 (the ratio was 0.7). The proportion of TB patients who are HIV positive continued to decrease, reaching 34% in 2021 from 39% in 2020. Sustained increases in TB notifications, treatment success rate, and TPT initiations have resulted in a rapid decrease in the TB incidence rate that reached 307 per 100,000 population in 2021 against a rate of 391 in 2015.
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El propósito de esta guía es brindar orientaciones clínicas actualizadas en TB/VIH con énfasis en aspectos de diagnóstico, incluidas nuevas técnicas, así como de tratamiento vigente, sin perder de vista un enfoque de salud pública. Al recopilar y consolidar en una sola guía las últimas rec...omendaciones de la Organización Mundial de la Salud en el tema, se busca elaborar un documento de referencia y consulta frecuente, que unifique y estandarice el manejo de la coinfección TB/VIH de manera integral en establecimientos de salud con base en el principio de “dos enfermedades, un solo paciente”. También busca sustentar la actualización de normas y guías nacionales sobre la coinfeccion y complementar el trabajo coordinado que debe existir entre los programas de prevencion y control de TB y VIH a todo nivel en el marco las doce actividades de colaboración TB/VIH recomendadas internacionalmente.
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The purpose of this guide is to provide updated clinical guidance on TB/HIV, with an emphasis on diagnostic aspects—including new techniques—as well as current treatment, while maintaining a public health approach. By compiling and consolidating the latest World Health Organization recommendatio...ns on the subject into a single guide, the aim is to create a reference and consultation document that is frequently used, and that unifies and standardizes the comprehensive management of TB/HIV co-infection in healthcare facilities based on the principle of “two diseases, one patient.” It also seeks to support the updating of national standards and guidelines on co-infection and to complement the coordinated work that must exist between TB and HIV prevention and control programs at all levels, within the framework of the twelve internationally recommended TB/HIV collaborative activities.
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Addressing TB comorbidities and risk factors is central to the World Health Organization (WHO) End TB Strategy. These guidelines consolidate the latest WHO recommendations on TB and key comorbidities. The guidelines are a living document and will include dedicated sections for each key TB comorbidit...y or health-related risk factor. The first edition focused on HIV-associated TB, updating the WHO policy on collaborative TB/HIV activities. This second edition expands on the previous edition and consolidates new and existing recommendations on interventions to address undernutrition in people with TB, to provide food assistance to households of people with TB in food-insecure settings, and to screen for TB among those who are undernourished or food insecure.
HIV and undernutrition are leading health-related drivers of TB globally, both negatively impacting on TB treatment outcomes. TB remains the top cause of death among people with HIV, and nearly half of people with TB are undernourished, which in turn increases their risk of early mortality.
These guidelines are intended for use by ministries of health, particularly TB programmes and departments addressing related health conditions and risk factors, by implementing partners, technical and funding agencies, civil society, affected communities, clinicians, and by public health practitioners.
The guidelines are complemented by an operational handbook, that provides practical advice on how to implement the recommendations at the scale needed to achieve national and global impact.
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This report was developed by the WHO TB Vaccine Accelerator Finance and Access working group, co-led by WHO, Gavi and the Government of South Africa. It sets out the working group’s shared vision for equitable access to novel TB vaccines and will advance a shared understanding of the current lands...cape and its possible evolution in the future. It identifies six urgently needed solutions to accelerate access and financing and highlights the roles of different stakeholders to support the implementation of these solutions.
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The WHO South-East Asia (SEA) Region bears a high burden of tuberculosis (TB) and MDR-TB. In 2015, the Region accounted for nearly 200 000 or 35% of the global estimated new RR/MDR-TB cases eligible for treatment. Extensively drug-resistant TB (XDRTB) has also been reported from s...ix countries of the SEA Region. MDR-TB could potentially replace drug-susceptible TB, and constitutes a threat to global public health security. The South- East Asia Regional Response Framework for DR-TB 2017–2021 complements the Ending TB in the South-East Asia Region: Regional Strategic Plan 2016–2020” and outlines key strategies for reducing morbidity, mortality and transmission of DR-TB.
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In order to maintain daily operations and patient care services, health care facilities need to develop an Emergency Water Supply Plan (EWSP) to prepare for, respond to, and recover from a total or partial interruption of the facilities’ normal water supply. Water supply interruption can be caused... by several types of events such as natural disaster, a failure of the community water system, construction damage or even an act of terrorism.
The planning guide provides a four step process for the development of an EWSP:
1. Assemble the appropriate EWSP Team and the necessary background documents for your facility;
2. Understand your water usage by performing a water use audit;
3. Analyze your emergency water supply alternatives; and
4. Develop and exercise your EWSP
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The latest update (28 January 2021) includes the following addition and revision:
biosafety aspects for working with antigen-detecting rapid diagnostic test;
handling new variants of SARS-CoV-2 in the laboratory;
updated assay decontamination before disposal;
personal protectiv...e equipment (PPE) for specimen collection;
addressing chemical hazards and their safe disposal; and
the fourth edition of the WHO Laboratory Biosafety Manual (LBM4) is now available and the terminology in this guidance was aligned with the LBM4.
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