The recommendations in these guidelines promote the use of simple, non-invasive diagnostic tests to assess the stage of liver disease and eligibility for treatment; prioritize treatment for those with most advanced liver disease and at greatest risk of mortality; and recommend the preferred use of n...ucleos(t)ide analogues with a high barrier to drug resistance (tenofovir and entecavir, and entecavir in children aged 2–11 years) for first- and second-line treatment. Recommendations for the treatment of HBV/HIV-coinfected persons are based on the WHO 2013 Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection, which will be updated in 2015.
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The National Tuberculosis Programme (NTP) of Rwanda (known as TB & ORD Division/IHDPC/RBC) is preparing to write their next National Strategic Plan and for this reason Rwanda was selected as a country to received technical assistance (TA) to conduct an assessment of their surveillance system using t...he surveillance checklist as input for the new strategy. This TA was provided under the USAID TBCARE I Core project on Monitoring and Evaluation, Operational Research and Surveillance (C7.08) developed a surveillance checklist with the objectives to assess a national surveillance system’s ability to accurately measure TB cases and deaths and to identify gaps in national surveillance systems that need to be addressed in order to improve TB surveillance.
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A regional consultation report and draft transition framework
Specific measures are being taken within the National Tuberculosis Control Programme (NTP) to address the MDR TB problem through appropriate management of patients and strategies to prevent the propagation and dissemination of MDR TB.
The term "Programmatic Management of Drug Resistant TB" (PMD...T) refers to programme based MDR TB diagnosis, management and treatment. This guideline promotes full integration of basic TB control and PMDT activities under the NTP, so that patients with TB are evaluated for drug resistance and are placed on the appropriate treatment regimen and properly managed from the outset of treatment, or as early as possible. The guidelines also integrate the identification and treatment of more severe forms of drug resistance, such as extensively drug resistant TB (XDR TB).
At the end, the guideline introduces new standards for registering, monitoring and reporting outcomes of multidrug resistant TB cases.
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Guidelines for Primary, Secondary and Tertiary Level Care
Following the encouraging initial results of the pilot project, the Ministry of Health is committed to increasing access to MDR-TB diagnosis, treatment and care. An expansion plan for the programmatic management of drug-resistant TB has been developed and forms part of the Five Year National Strateg...ic Plan for TB Control, 2011-2015. The long-term goals of the MDR-TB expansion plan are threefold:
1. Diagnosis of MDR-TB in all groups of patients at risk for MDR-TB
2. Diagnosis of MDR-TB in all HIV-infected TB patients
3. MDR-TB treatment for all patients diagnosed with MDR-TB under WHO-endorsed treatment protocols
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"This document has been developed for outpatient oncology
facilities to serve as a model for a basic infection
control and prevention plan. It contains policies
and procedures tailored to these settings to meet minimal
expectations of patient protections as described
in the CDC Guide to Infecti...on Prevention in Outpatient
Settings."
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NATIONAL TUBERCULOSIS AND LEPROSY PROGRAMME