3.3 Other investigations

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    In addition to TB diagnosis 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 drugs

    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 thionamides

    Audiometry (b) Citation b. For children under 5 years, a specialized equipment and consultation are required.

    Patients on aminoglycosides

    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 aminoglycosides

    Serum electrolytes (potassium)

    Patients on aminoglycosides

    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 thionamides 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.