Determination of disease classification and type of tuberculosis patients need a "case definition" which includes issues, namely:
one. Location or sick organs: lungs, or an additional lung.
two. Bacteriology (result of sputum by microscopic examination): AFB smear positive or negative; AFB = Acid Resistant Basil.
two. The severity of disease: mild or extreme.
two. History of earlier TB treatment: new or have been treated.
one. Determining the appropriate treatment alloys,
two. Registration of cases correctly,
two. Choose priority of treatment of smear positive tuberculosis,
two. Cohort analysis of treatment outcomes.
Benefits and purpose determines the classification and type are:
Some terms in the definition of case:
one. Cases of TB: TB patients who had microscopically proven or diagnosed by a doctor.
two. TB cases sure (sure): patients with positive cultures for Mycobacterium tuberculosis or no culture facilities, at least two of two specimens of sputum smear positive SPS results.
one. Avoid inadequate treatment (undertreatment) thus stopping the emergence of resistance,
two. Avoiding unnecessary treatment (overtreatment), thus increasing the consumption of resources is more cost effective (cost effective).
two. Reduce side effects.
Alloy suitability and dosage of treatment with diagnostic section is necessary to:
a. Classification based on the organ affected:
one) Pulmonary Tuberculosis
two) extra-pulmonary tuberculosis
Pulmonary tuberculosis is tuberculosis that assaults the tissue (parenchymal) lung, excluding the pleura (lining of the lungs) and the glands at the hilum.
Tuberculosis affecting organs other than lungs, eg pleura, the lining of the brain, lining of the heart (pericardium), lymfe glands, bones, joints, skin, intestine, kidney, urinary tract, genitals, and others.
b. Classification based on the results of microscopic examination of sputum, ie on tuberculosis:
* At least two of two specimens of sputum smear positive SPS results.
* specimen of sputum smear results positive SPS and chest chest radiograph showed a picture of tuberculosis.
* specimen SPS sputum smear results are positive and culture-positive TB germs.
* or more specimens of sputum positive results after two sputum specimens SPS on earlier examination results are negative smear and there is no improvement after administration of non-TB antibiotics.
one) smear-positive pulmonary tuberculosis
two) smear negative pulmonary tuberculosis
Cases that do not meet the definition of smear positive pulmonary TB. Diagnostic criteria of smear negative pulmonary tuberculosis ought to include:
c. Classification by severity of disease
* At least specimens of sputum smear results are negative SPS.
* Photograph shows a picture of abnormal thoracic tuberculosis.
* No improvement after administration of non-TB antibiotics.
* Specified (thought about) by the doctor to be given treatment.
two). Extra-pulmonary tuberculosis were divided based on the severity of the disease, namely:
one). Smear negative pulmonary tuberculosis positive chest radiograph
Divided according to severity of disease, namely the type of heavy and light. Extreme form when the picture of chest radiograph showed extensive lung destroy description (eg the technique "far advanced"), and / or the patient's general condition worse.
Note:
* Additional pulmonary TB light, for example: TB lymph nodes, pleuritis eksudativa unilateral, bone (excluding backbone), joints, and adrenal glands.
* Extra-pulmonary tuberculosis weight, for example: meningitis, out military, pericarditis, peritonitis, pleuritis eksudativa bilateral, spinal tuberculosis, intestinal TB, TB and genital urinary tract.
d. Classification based on history of earlier treatment
* When a patient of pulmonary tuberculosis also have extra-pulmonary TB, then for purposes of recording, the patient must be recorded as pulmonary TB patients.
* If a patient with extra-pulmonary tuberculosis in several organs, it is recorded as extra-pulmonary tuberculosis in the most extreme organ disease.
Classification based on earlier treatment history is divided in to several types of patients, namely:
one) New Case
Are patients who have not been treated with OAT or have ever swallow OAT is less than month (two weeks).
two) The case of relapse (Relapse)
two) Case after breaking treatment (Default)
Is a tuberculosis patient who historicallyin the past had received tuberculosis treatment and has been declared cured or complete treatment, was diagnosed again with smear positive (smear or culture).
two) Case after failure (Failure)
Were patients who had medical treatment and finish treatment two months or more with smear positive.
two) The case of transfer (Transfer In)
Are patients who stay sputum examination results positive or became positive again in the fifth month or more in the coursework of treatment.
6) Other cases
Is a patient who was transferred from the UPK has another TB register to continue treatment.
Note:
Smear negative pulmonary TB and additional pulmonary TB, can also experience a relapse, failure, default or become chronic cases. Although rare, it must be proven by pathological, bacteriological (culture), radiology, and specialist medical considerations.
Are all cases that do not meet the above requirements. In this group include chronic cases, ie patients with sputum smear examination results are still positive after completion of treatment replicates.
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