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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.
- aBPNS is a clinical examination for detecting peripheral neuropathy and grading the severity of symptoms (Appendix 16).
- bFor children under 5 years, a specialized equipment and consultation are required.