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Improving the Diagnosis and Treatment of Smear- Negative Pulmonary and Extrapulmonary Tuberculosis Among Adults and Adolescents: Recommendations for HIV-Prevalent and Resource-Constrained Settings.

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Geneva, WHO, 2006

This book gives technical guidelines on improving diagnosis and treatment of smear-negative pulomonary and extrapulmonary tuberculosis. This document is intended for those dealing with tuberculosis and HIV at all levels in HIV-prevalent and resource-constrained settings. It is intended to assist development of national policies to improve the diagnosis and management of smear-negative pulmonary and extrapulmonary tuberculosis. The recommendations and algorithm/s are designed for use by national tuberculosis and HIV/AIDS control programmes and service providers. HIV-prevalent settings are defined as countries, subnational administration units (e.g. districts, counties) or selected facilities (e.g. referral hospitals,drug rehabilitation centres) where the adult HIV prevalence rate among pregnant women is ≥1% or HIV prevalence among tuberculosis patients is ≥5%. In those countries where national HIV prevalence is below 1%, national tuberculosis and HIV control authorities should identify and define HIV-prevalent settings (subnational administrative units or facilities) based on the epidemiology of he HIV epidemic and the magnitude of HIV-associated tuberculosis, and develop appropriate guidance for the implementation of these recommendations. The recommendations and revised algorithms are intended for immediate implementation in sub-Saharan Africa and other HIV-prevalent settings, as defined by national tuberculosis and HIV control authorities, to guide the expedited diagnosis and management of tuberculosis.