Guidance for national tuberculosis programmes on the management of tuberculosis in children
Annex 2
TB
case and treatment
outcome definitions Case
and outcome definitions
This section describes the recently revised definitions of TB cases, their classification and the treatment outcome categories (1). Presumptive TB refers to a patient who presents with symptoms or signs suggestive of TB (previously known as a TB suspect). Bacteriologically confirmed or clinically diagnosed cases of TB (Box A2.1) are also classified according to: -
anatomical site of disease;
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history of previous treatment;
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drug resistance;
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HIV status.
Box A2.1 TB case definitions 路
A bacteriologically confirmed TB case is one from whom a biological specimen is positive by smear microscopy, culture or WHO-approved rapid diagnostics (such as Xpert MTB/RIF). All such cases should be notified, regardless of whether TB treatment has started.
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A clinically diagnosed TB case is one who does not fulfil the criteria for bacteriological confirmation but who has been diagnosed with active TB by a clinician or other medical practitioner who has decided to give the patient a full course of TB treatment. This definition includes cases diagnosed on the basis of X-ray abnormalities or suggestive histology and extrapulmonary cases without laboratory confirmation. Clinically diagnosed cases subsequently found to be bacteriologically positive (before or after starting treatment) should be reclassified as bacteriologically confirmed.
Classification based on anatomical site of disease Pulmonary TB (PTB) refers to any bacteriologically confirmed or clinically diagnosed case of TB involving the lung parenchyma or the tracheobronchial tree. Miliary TB is classified as PTB because there are lesions in the lungs. Tuberculous intrathoracic lymphadenopathy (mediastinal and/or hilar) or tuberculous pleural effusion, without radiographic abnormalities in the lungs, constitutes a case of extrapulmonary TB. A patient with both pulmonary and extrapulmonary TB should be classified as a case of PTB.
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