In addition to TB diagnostic tests, the following investigations should be performed at baseline and during treatment. The purpose is to identify common comorbidities, contra-indications, as well as adverse effects of TB drugs.
Table 3.10 – Other investigations in TB treatment
Tests |
Indications |
---|---|
Electrocardiogram (ECG) |
Patients on QT-prolonging drug(s) |
Brief peripheral neuropathy screen (BPNS) (a) Citation a. BPNS is a clinical examination for detecting peripheral neuropathy and grading the severity of symptoms (Appendix 16). |
Patients on linezolid |
Visual function tests |
Patients on MDR/RR-TB treatment including ethambutol, linezolid or a thionamide |
Audiometry (b) Citation b. For children under 5 years, a specialized equipment and consultation are required. |
Patients on aminoglycoside |
Full blood count |
Patients on linezolid (or rifabutin) |
Liver function tests Aspartate aminotransferase (AST) Alanine aminotransferase (ALT) |
Patients with pre-existing hepatic disease Patients on MDR/RR-TB treatment |
Creatinine Serum creatinine Creatinine clearance |
Patients with pre-existing renal disease Patients on aminoglycoside |
Serum electrolytes (potassium) |
Patients on aminoglycoside |
Glycated haemoglobin (HbA1c), or Blood glucose level (fasting or random) |
All patients |
HIV, hepatitis B and C testing |
Patients with undocumented HIV, hepatitis B and C status |
CD4 count and viral load |
Patients with TB/HIV coinfection |
Thyroid stimulating hormone (TSH) |
Patients on thionamide or PAS |
Pregnancy test |
Patients of childbearing age with MDR/RR-TB |
For more information, see Chapter 9, Chapter 10 and Chapter 11.
- (a)BPNS is a clinical examination for detecting peripheral neuropathy and grading the severity of symptoms (Appendix 16).
- (b)For children under 5 years, a specialized equipment and consultation are required.