Appendix 14. Monitoring of patients on DS-TB treatment

Vital signs, weight, etc.

X

X

X

X

X

X

X

X

At each visit

X

Adverse effects 

X

X

X

X

X

X 

X

At each visit

X

Bacteriological tests

Rapid molecular tests (b) Citation b. Rapid molecular tests:
• Xpert MTB/RIF (or Ultra) and Xpert MTB/XDR (or GenoType MTBDRsl if Xpert MTB/XDR not available).
• Repeat RMTs if microscopy or culture is positive at Month 2 or later.

X

(X)

Smear microscopy

X

X

X

X

X

Culture and pDST (c) Citation c. Culture and pDST to first- and second-line drugs:
• At baseline if RMTs are not available, to detect rifampicin and isoniazid resistance or rifampicin resistance mutations not detected by RMTs.
• At Month 2 or later, if RMTs show a new resistance.   
• At Month 4, if microscopy is still positive.

(X)

(X)

(X)

Other investigations 

Radiography (d) Citation d. Radiography:
• Chest: at baseline for children with presumed PTB, patients with non-bacteriologically confirmed PTB, suspicion of other intra-thoracic TB, then if indicated (e.g. worsening respiratory symptoms, non-response to TB treatment).
• Bone: at baseline then every 6 months for patients with bone and joint TB.

(X)

(X)

If

indicated

If indicated

Full blood count (e) Citation e. For patients on AZT or rifabutin.

(X)

(X)

(X)

If

indicated

Liver function (f) Citation f. For patients with pre-existing hepatic disease: AST and ALT (and bilirubin if AST or ALT are elevated).

(X)

(X)

(X)

(X)

(X)

(X)

(X)

If

indicated

Serum creatinine (g) Citation g. For patients with renal insufficiency.

(X)

If

indicated

HbA1c, blood glucose (h) Citation h. For all patients to detect diabetes. If diabetes is detected, monitor according to standard protocols.  

X

If

indicated

HIV, HBV, HCV (i) Citation i. For all patients, unless documented HIV, hepatitis B and C status; HIV test every 6 months in high HIV prevalence areas. 

X

 (X)

If

indicated  

CD4 and viral load (j) Citation j. For HIV-infected patients.

(X)

(X)

(X)