m Communicable diseases

E \ational Tuberculosis Control Program Ȃ key

policies
Case finding Ȃ direct Sputum Microscopy and X-ray
examination of TB symptomatics who are negative
after 2 or more sputum exams
Treatment Ȃ shall be given free and on an
ambulatory basis, except those with acute
complications and emergencies
Direct Observed Treatment Short Course Ȃ
comprehensive strategy to detect and cure TB
patients.
m Category 1- new TB patients whose sputum is
positive; seriously ill patients with severe forms
of smear-negative PTB with extensive
parenchymal involvement (moderately- or far-
advanced) and extra-pulmonary TB (meningitis,
pleurisy, etc.)
m Category 2-previously-treated patients with
relapses or failures.
m Category 3 Ȃ new TB patients whose sputum is
smear-negative for 3 times and chest x-ray result
of PTB minimal
m new TB patients whose sputum is
positive; seriously ill patients with
severe forms of smear-negative
PTB with extensive parenchymal
involvement (moderately- or far-
advanced) and extra-pulmonary TB
(meningitis, pleurisy, etc.)
÷ntensive Phase (given daily for the first 2 months)-
Rifampicin + ÷sioniazid + pyrazinamide +
ethambutol.
÷f sputum result becomes negative after 2 months,
maintenance phase starts. But if sputum is still
positive in 2 months, all drugs are discontinued from
2-3 days and a sputum specimen is examined for
culture and drug sensitivity. The patient resumes
taking the 4 drugs for another month and then
another smear exam is done at the end of the 3rd
month.
Maintenance Phase (after 3rd month, regardless of the
result of the sputum exam)-÷\ + rifampicin daily
m Category 2-previously-treated patients with
relapses or failures.
÷ntensive Phase (daily for 3 months, month 1,2 &
3)-÷sioniazid+ rifampicin+ pyrazinamide+
ethambutol+ streptomycin for the first 2 months
Streptomycin+ rifampicin pyrazinamide+
ethambutol on the 3rd month. ÷f sputum is still
positive after 3 months, the intensive phase is
continued for 1 more month and then another
sputum exam is done. ÷f still positive after 4
months, intensive phase is continued for the
next 5 months.
Maintenance Phase (daily for 5 months, month
4,5,6,7,& 8)-÷sionazid+ rifampicin+ ethambutol
m Category 3 Ȃ new TB patients whose
sputum is smear-negative for 3 times and
chest x-ray result of PTB minimal

m ÷ntensive Phase (daily for 2 months) Ȃ

÷sioniazid + rifampicin + pyrazinamide

m Maintenance Phase (daily for the next 2

months) - ÷sioniazid + rifampicin
m Stop TB ; Do it with DOTS
E dvocacy is a planned and continuous
effort to inform people about issue and
instigate change. dvocacy usually takes
place over an extended period of time and
includes a variety of strategies to
communicate a specific message.

E TB is the number one infectious killer in

the world.
E One TB suspect can infect another 10
healthy persons
m 9eprosy Control Program
E P O Classification Ȃ basis of multi-drug therapy
~ Paucibacillary/PB Ȃ non-infectious types. 6-9
months of treatment.
~ Multibacillary/MB Ȃ infectious types. 24-30 months
of treatment.
E Multi-drug therapy Ȃ use of 2 or more drugs renders
patients non-infectious a week after starting
treatment
~ Patients w/ single skin lesion and a negative slit skin
smear are treated w/ a single dose of ROM regimen
~ For PB leprosy cases- Rifampicin+Dapsone on Day 1
then Dapsone from Day 2-28. 6 blister packs taken
monthly within a max. period of 9 mos.
E ll patients who have complied w/ MDT are considered
cured and no longer regarded as a case of leprosy, even if
some sequelae of leprosy remain.
E Responsibilities of the nurse
~ Prevention Ȃ health education, healthful living through
proper nutrition, adequate rest, sleep and good personal
hygiene;
~ Casefinding
~ Management and treatment Ȃ prevention of secondary
injuries, handling of utensils; special shoes w/ padded
soles; importance of sustained therapy, correct dosage,
effects of drugs and the need for medical check-up from
time to time; mental & emotional support
~ Rehabilitation-makes patients capable, active and self-
respecting member of society.
m Control of Schistosomiasis Ȃ a tropical disease
caused by a blood fluke, Schistosoma 

; transmitted by a tiny snail 

  
E Preventive measures Ȃ health education
regarding mode of transmission and methods
of protection; proper disposal of feces and
urine; improvement of irrigation and
agriculture practices
E Control of patient, contacts and the
immediate environment
E Specific treatment- Praziquantel Ȃ drug of
choice
m ¸
 

  
  

 
E Filariasis- a chronic prasitic infection caused by
a nematode, Puchereria Ê  Moung and
adult worms live in the lymphatic vessels and
nodes, while the micro filariae are in the blood;
transmitted through bites from an infected
female mosquito, edes
 
that bites at
night.
~ Treatment: Diethylcarbamazine citrate or etrazan
~ Elephantiasis and ydrocoele are handled through
surgery, prevention and supportive care
Malaria Ȃ infection caused by the bite of the
female 

mosquito,
E Chemoprophylaxis Ȃ Chloroquine taken at weekly
intervals, starting from 1-2 weeks before entering the
endemic area.
E nti-malarial drugs Ȃ sulfadoxine, quiinine sulfate,
tetracycline, quinidine
E ÷nsecticide treatment of mosquito nets, house
spraying, stream seeding and clearing, sustainable
preventive and vector control meas

Dengue -fever
4 oǯclock habit
m Programs on Measles.
Chickenpox, Mumps,
Diphtheria, Pertusis, Tetanus Ȃ
focused on health information
campaigns and intensive
immunization of children in
barangays.
m ¸ 
 


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~ ©ood personal hygiene
~ Use of footwear
~ Pashing fruits and vegetables well
~ Use of sanitary toilets
~ Sanitary disposal of garbage
~ Boiling drinking water at least 2-3 min. from
boiling point or chlorination
m¸ 
 




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m  .# 
m Mgt. of Rabies

m Pash wound with soap and water, betadine or alcohol

may be applied
m ÷f dog is healthy observe for 14 days. ÷f nothing
happens- no need for ttt.÷f it dies or shows rabies, kill
then bring head for lab. Exam & consult doctor.
m ctive immunization Ȃ body develops b against rabies
up to 3 yrs.
m Passive ÷ Ȃ giving b to persons with head and neck
bites, multiple single deep bites, contamination of
mucous membranes or thin covering of the eyes, lips or
mouth to provide immediate protection
m RPO Ȃ immunization of pets at 3 mos. of age and yearly
thereafter
m Prevention and Control on ST÷s
µ ©onorrhea, Syphilis, ÷
/÷DS,
Trichomoniasis,Chlamydia, ep B ( the
most serious type Ǯcause of severe cx. Eg.
Massive liver damage and
hepatocarcinoma
µ 4 Cǯs in the Syndromic Mgt
µ 1. Compliance
µ 2. Counseling/ Education
µ 3. Contact tracing to treat partner
µ 4. Condom use
µ ep B vaccination
µ Universal precautions
µ Safe sex