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This manual provides a pocket-sized guide to the clinical management of tuberculosis, particularly in patients suffering from co-infection with HIV. Designed for use by busy clinicians, the manual aims to promote the best possible diagnosis and treatment in low-income countries where the prevalence of TB and HIV infection is high, case loads are heavy, and laboratory support may be limited. With these needs in mind, the manual combines the latest scientific knowledge about these diseases with authoritative advice based on extensive field experience in several of the hardest hit countries.
Throughout the manual, tables, flow charts, lists of do's and don'ts, and numerous practical tips are used to facilitate quick reference and correct decisions. Information ranges from advice on how to distinguish TB from other HIV-related pulmonary diseases, through a coloured score chart to aid the diagnosis of TB in children, to the simple reminder that in sub-Saharan Africa, anyone with TB is in a high risk group for HIV. Though primarily addressed to clinicians working at district hospitals in sub-Saharan Africa, the manual is also suitable for use in areas of Asia and South America where the problem of TB and HIV co-infection poses a growing clinical challenge.
The manual has twelve concise chapters presented in a convenient spiral-bound format. Background information is provided in the first chapters, which summarize basic facts about TB, HIV, and HIV-related TB, and outline a framework for effective TB control. Diagnosis is covered in four chapters, which set out detailed principles and procedures for the diagnosis of TB in adults and in children, and for the diagnosis of HIV infection in adults and in children with TB. Chapter seven presents standardized TB case definitions, by site of disease, result of sputum smear, and by previous treatment, and explains how these case definitions allow categorization of patients for treatment purposes.
Extensive treatment guidelines are presented in chapters devoted to the treatment of TB patients, management of the side effects of specific anti-TB drugs, and the management of other HIV-related diseases in TB patients. The manual concludes with a discussion of the importance of coordinated care in different settings, followed by advice on the prevention of TB in HIV-infected individuals.
"... a most useful review to those new to the problems and a handy reference for the experienced clinician when faced with some particular difficulty... I congratulate WHO on deciding to produce this valuable book and the authors on the imaginative and practical way they have presented the problems and their management..."
- Sir John Crofton, Professor Emeritus of Respiratory Diseases and Tuberculosis, University of Edinburgh, Scotland
TB/HIV: A Clinical Manual
A.D. Harries and D. Maher, with contributions from M.C. Raviglione, P. Chaulet, P.P. Nunn and E. van Praag , 1996, 135 pages, WHO/TB/96.200; Order no 1930088, Sw.fr. 12.-/US $ 10.80; in developing countries: Sw.fr. 8.40
TB/HIV - A Clinical Manual
http://www.who.int/gtb/publications/tb_hiv/index.htm
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