General Management of Tuberculosis

Tuberculosis (TB) is a chronic airborne infectious disease caused by Mycobacterium tuberculosis. It is transmitted from one person to another through airborne droplets released when an infected person coughs, sneezes, or sings.

Clinical Presentation

Patients with tuberculosis may present with one or more of the following symptoms:

Cough lasting more than two weeks, or of any duration in people living with HIV (PLHIV)
Fever
Excessive night sweats
Weight loss
Haemoptysis (blood-stained sputum)

Depending on the site of infection, patients may also present with swollen lymph nodes, ascites, difficulty breathing, chest pain, swollen joints, or other organ-specific symptoms.

Investigations

The recommended investigations for tuberculosis include:

Sputum smear microscopy
Rapid molecular testing such as GeneXpert
Culture and drug susceptibility testing for diagnosing drug-resistant TB and surveillance
Chest X-ray to assist in diagnosis or triage of presumptive TB patients

Important Notes

Conduct HIV Provider-Initiated Testing and Counselling (PITC) for all TB patients.
Conduct Provider-Initiated TB Screening (PITS) for all health facility outpatients and inpatients.
For detailed diagnosis and investigation, refer to the Manual for the Management of Tuberculosis and Leprosy in Tanzania.

Pharmacological Treatment

Tuberculosis treatment consists of two phases.

Initial (Intensive) Phase

Rifampicin + Isoniazid + Pyrazinamide + Ethambutol (RHZE) for 2 months in both new and retreatment cases.

Continuation Phase

Rifampicin + Isoniazid (RH) for 4 months in new and retreatment cases.
Rifampicin + Isoniazid (RH) for 10 months in severe forms of tuberculosis such as TB meningitis, miliary TB, and spinal TB.

Recommended Adult Daily Dosage (Fixed-Dose Combination)

Body Weight	Initial Phase (RHZE 150/75/400/275 mg)	Continuation Phase (RH 150/75 mg)
21–30 kg	2 tablets	2 tablets
31–50 kg	3 tablets	3 tablets
51–74 kg	4 tablets	4 tablets
≥75 kg	5 tablets	5 tablets

Recommended Paediatric Daily Dosage

For infants weighing less than 2 kg, consult a paediatric specialist, District TB and Leprosy Coordinator (DTLC), or Regional TB and Leprosy Coordinator (RTLC).

Weight	RHZ 75/50/150 mg	Ethambutol 100 mg	RH 75/50 mg
2–2.9 kg	Consult specialist	Consult specialist	Consult specialist
3–3.9 kg	1 tablet	—	1 tablet
4–7.9 kg	1 tablet	1 tablet	1 tablet
8–11.9 kg	2 tablets	2 tablets	2 tablets
12–15.9 kg	3 tablets	3 tablets	3 tablets
16–24.9 kg	4 tablets	4 tablets	4 tablets
≥25 kg	Use adult fixed-dose combination dosage	Use adult regimen	Use adult regimen

Administration of Anti-Tuberculosis Medicines

Oral anti-tuberculosis medicines should be swallowed under direct observation by a health worker or a designated treatment supporter.
Medicines should preferably be taken on an empty stomach.
Fixed-dose combination (FDC) formulations are recommended whenever available to improve adherence and reduce pill burden.

Imeandikwa:

Ijumaa, 26 Juni 2026, 10:29:44 GMT +3

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