CTE #2: MATRIX OF COMMUNICABLE DISEASES

By: Joanna Mae T. Molaga – BSN 2B

Disease and
Mode of
Causative Diagnostic Test Signs and Symptoms Treatment and Prevention
Transmission
Agent
 Chest X-ray (CXR) examination A. For patients 15 years old and above, a presumptive TB has any of
complement bacteriologic testing in the following: Fixed dose combination are the kind
making a diagnosis Cough of at least 2 weeks duration with or without of drugs used as anti-TB regimen.
 Direct sputum smear microscopy 1.) Significant and unintentional weight loss 2.) Fever 3.) Bloody Usually composed of :
- recommended for case finding sputum 4.) Chest/back pains not related to any musculoskeletal disorder 1.) Isoniazd (H)
 Airborne/ among adults and children who can 5.) Easy fatigability 6.) Night sweats 7.) Shortness of breath. 2.) Rifampacin (R)
spread through expectorate since its simple, B. For patients below 15 years old, a presumptive PTB has at least three 3.) Pyrazinamide (Z)
the suspended economical provides definite (3) of the following clinical criteria: 4.) Ethambutol (E)
air particles diagnosis and can be put up even 1.) coughing/wheezing ≥ 2 weeks 5.) Sterptomycin (S)
from one in remote areas. 2.) unexplained fever ≥ 2 weeks after common causes s/a malaria or Note: Treatment varies depending on
person to  TB culture and drug pneumonia have been excluded,
which category treatment the patient
Tuberculosis another when susceptibility test 3.) Loss of weight 4. ) Failure to respond to 2 weeks of antibiotic
belongs. Also, drug dosage varies with
an individual – using solid or liquid media to therapy for lower respiratory tract infections 5.) loss of normal
respect to age (child and adults ) and
cough, sneeze, ascertain TB resistant energy 6.) Failure to regain previous state of health 2 weeks
after a viral infection body weight
speaks, and  PPD test or Mantoux test
sing Presumptive extra pulmonary TB may have the following symptoms:
- basic screening tool for TB infection Preventive measures:
among children using purifi ed 1.) Neck stiffness 2.) Gibbus 3.) Non-painful enlarged cervical
lymphadenopathy 4.) Pleural Effusion 5.)Pericardial effusion 1. Vaccination
protein derivative (PPD) tuberculin
solution 6.) Distended abdomen 7.) Non painful enlarged joint
8.) Sign of tuberculin hypersensitivity
 Xpert MTB/RIF assay- is a rapid
test that detects Mycobacterium
tuberculosis and rifampicin
resistance.
Department of Health. (2014). National TB control program
Manual of procedures fifth edition. Retrieved from http://www.ntp.doh.gov.ph/downloads/NTP_MOP_5th_Edition.pdf
 1. Tourniquet Test 1. During Febrile For individuals that may be sent
- helpful in the early febrile phase in differentiating dengue from other illnesses Phase home:
 Vector - performed by inflating the BP cuff to a point in a midway between systolic and - Fever, headache, body - adequate bed rest
Transmission - diastolic for 5 minutes. If petechiae ≥ 20 per 2.5 cm square, then it is considered as malaise, mylagia, - adequate fluid intake
through the positive. arthralgia, retro- - Paracetamol, 4 gram maximum
bite of Aedes 2. Virus isolation orbital pain, anorexia, perday in adults and accordingly in
aegypti and - useful only at the early phase thus, blood should be collected before day 5 of illness nausea, vomiting, children
Aedes - have poor yield compare to molecular test due to viability of the virus and quality of diarrhea, flushes skin,
albopictus samples rash ( petechial, For severe cases IV fluid therapy
mosquitos 3. Polymerase Chain Reaction Hermanns sign) is the mainstay treatment for
- Useful in the early phase, shows sensitivity of 100% in the first 5 days and reduced to Defervescence occurs on dengue shock and continuous
70% after 5 days and has ability to determine dengue serotypes
day 3-7 of illness wherein assessment is a must
4. Detection of antigens temperature drops Prevention and Control
- High concentrations of E/M antigen and NS1 glycoprotein the form of immune
between 37.5 Celsius to
complexes could be detected in patients with both primary and secondary dengue
38 Celsius or less and Follow 4-S against Dengue
infections up to nine days after the onset of illness.
remains within the the - Search and Destroy breeding
Dengue 5. Serological Test
5.1 Dengue IgM Test and Indirect IgG ELISA test range. sites
-Dengue IgM Test should be taken as soon as the disease is suspected , if dengue IgM is still 2. During Critical - Secure self protection
negative after day 7 with negative dengue IgG tested at less 7 days, then dengue IgG is Phase - Seek early consultation
recommended for diagnostic confirmation - Abdominal pain or - Support indoor and outdoor
5.2 Haemagglutination Inhibition Test tenderness, persistent fogging/spraying to prevent
- used only for research purposes to differentiate primary and secondary dengue infections vomiting, clinical outbreak
since it is labour extensive. signs of fluid
- is based on the ability of dengue antigens to agglutinate red blood cells (RBC) of ganders or accumulation,
trypsinized human O RBC. mucosal bleeding,
6. Haematological tests lethargy, liver
- A drop of the platelet count below 100 000 per µL is a constant feature of dengue enlargement, increase
haemorrhagic fever
in hematocrit and
- Thrombocytopaenia is usuallyobserved in the period between day 3 and day 8 following
the onset of illness and increase in haematocrit of 20% or more decreasing platelet
compared with convalescent values, is suggestive of hypovolaemia due to vascular
permeability and plasma leakage

World Health Organization (WHO) & Special Programme for Research and Training in Tropical Diseases.(2009). Dengue guidelines for diagnosis, treatment, prevention and control. Retrieved from
https://www.who.int/tdr/publications/documents/dengue-diagnosis.pdf
Department of Health. (2012). Philippine Health Advisory. Retrieved from http://www.doh.gov.ph/sites/default/files/publications/PhilippineHealthAdvisories2012.compressed.pdf
Department of Health. (2012). Administrative Order 2012-0006 Revised Dengue Clinical Case Management Guidelines 2011. http://www.chd11.doh.gov.ph/webfiles/pdf/resu/ao2012_0006.pdf
Ministry of Health Malaysia & Academy of . (2010) Management of Dengue Infection in Adults. Retrieved from https://www.moh.gov.my/moh/attachments/5502.pdf

Leprosy Transmission of leprosy is Since published studies shows insufficient 1. Skin symptoms The same 3-drug regimen
poorly understood, accuracy for diagnosis of leprosy and are  Discolored flat patches of skin, may be numb and look of rifampicin, dapsone and
although it is thought to be not commercially available, leprosy is faded (lighter than the skin around) clofazimine may be used for all
 through inhalation of diagnosed by finding at least one of the  Nodules on the skin leprosy patients, with a duration
droplets containing the following cardinal signs:  Thick, stiff or dry skin of treatment of 6 months for PB
causative agent,  Painless ulcers on the soles of feet leprosy and of 12 months for MB
Mycobacterium leprae (M. (1) definite loss of sensation in a pale  Painless swelling or lumps on the face or earlobes
leprae) (hypopigmented) or reddish skin patch; leprosy.
 Loss of eyebrows or eyelashes
(2) thickened or enlarged peripheral nerve, 2. Symptoms caused by damage to the nerves are:
Prolonged, close contact with loss of sensation and/or weakness of  Numbness of affected areas For prevention of leprosy,
with someone with the muscles supplied by that nerve;  Muscle weakness or paralysis
untreated leprosy over (3) presence of acid-fast bacilli in a slit-skin  Enlarged nerves (especially those around the elbow and
many months is needed to smear. 1. Early Prevention and
knee and in the sides of the neck) Diagnosis
catch the disease (4) histopathological diagnosis over a  Eye problems that may lead to blindness
biopsy 2. Use of antibiotics
3. Symptoms caused by the disease in the mucous (chemoprophylaxis)
membranes are: 3. Immunoprophylaxis
For multibacillary leprosy, slit-skin smears  stuffy nose
is being utilized to ascertain its occurrence
 Nosebleeds
.
4 . Signs of advanced leprosy
 crippling of hands and feet
 Shortening of toes and fingers due to reabsorption
 Chronic non-healing ulcers on the bottoms of the feet
 Blindness
 Loss of eyebrows
 Nose disfigurement
World Health organization. ( 2017). Guidelines for the diagnosis, treatment and prevention of leprosy. Retrieved from tps://apps.who.int/iris/bitstream/handle/10665/274127/9789290226383-
eng.pdf?ua=1
Center for Disease Control and Prevention.(2017). Hansen’s disease. Retrieved from https://www.cdc.gov/leprosy/index.html
 Laboratory tests can be done to confirm rabies in Signs and symptoms vary on Once symptoms occur immunizations and
 Direct contact humans: clinical stage. treatment of immunoglobulins is not
through bite and non bite 1. Fluorescent Antibody Testing (FA) For the prodromal stage: effective to patient with rabies anymore.
exposures such as licking - gold standard for rabies diagnosis - non-specific Thus, preventive measure should be
and scratches from -It is a rapid and sensitive test based on microscopic manifestations, which considered.
animals with rabies virus examination under ultraviolet light using tissue samples include fever, sore
 inhalation of from brainstem, thalamus, cerebellum and the throat, anorexia, 4 R’s in Animal Rabies Risk Assessment:
aerosolized virus hippocampus (Ammon’s horn) are recommended for nausea, vomiting, 1. Recognizing,
increased sensitivity of the test.
 human-to-human generalized body - Recognize risk factors
cases were through malaise, headache, 2. Recording
2. Polymerase Chain Reaction (PCR) abdominal pain and - Pertinent information such as nature,
corneal as well as through
- technique can confirm dFA results and can detect paresthesia pain. place, time , site, condition of animal etc
liver, kidney and other
rabies virus in saliva and skin biopsy samples. For the acute neurologic stage: should be recorded so that health team
Rabies organ transplants
3. Serology - hyperactivity, members will have basis for risk
- more useful to ascertain the immune status of hypersalivation, assessment and categorization
immunized animals and humans disorientation, and 3. Reporting
- used to evaluate the immunogenicity of human and hallucination, bizarre - Within 24 hours of suspected
animal rabies vaccines. behavior interspersed case report it immediately for proper
4. Histological Findings with lucid intervals, documentation and coordination with
-indication of rabies such as occurrence of Negri bodies seizures, nuchal rigidity appropriate staff who may do further care.
is ascertained using histological examination. or paralysis may last by 4. Referral
2-7 days - Refer to higher facilities so that
During life, rabies can be diagnosed through - may also include bite wounds will be managed and
examinations of biological fluids such as saliva, spinal hydrophobia and prompt interventions will be done to
fluid tears and etc. However this method has low aerophobia for the avoid complications
accuracy. furious type
Department of Health. (2019). National rabies prevention and control program manual of procedures. Retrieved from doh.gov.ph/sites/default/files/publications/Rabies
%20Manual_MOP_2019%20nov28.pdf
Malaria Vector Transmission - 1. Microscopy Symptoms are usually non 1.) Artemether-Lumefantrine (AL) combination
through the female  "gold standard" for specific, it comprise: - the first line medicine in the treatment of confirmed
Anopheles mosquitoes, diagnosing malaria - Headache, fatigue, uncomplicated and severe Plasmodium falciparum malaria
which bite mainly between 2. Rapid Diagnostic Test Kits abdominal discomfort, and 2.) Quinine (QN) in combination with either tetracycline or
dusk and dawn.  Utilized in inaccessible coastal muscle and joint aches doxycycline or clindamycin (QN+T/D/C x 7 days)
or island areas where there is - In children, restlessness, - second-line treatment if AL is not available and patient is
no microscopy center and poor feeding, and cough whether conscious or unconscious
trained microscopist , and - In severe cases, coma 3. Artesunate (AS) suppository
areas where there is metabolic acidosis, severe - can be introduced if patient is unconscious and there is
outbreaks. anemia, gypoglycemia, acute inadequate capacity to manage the case due to scarcity of
Both Microscopy and Rapid renal failure, and acute resources or facilities
Diagnostic Test Kits are used to pulmonary edema . 4. ACT can be used for all Plasmodium species and mixed
ascertain if there is presence of infections
 malarial parasites in collected blood 5. All anti-malarial drugs will be selected based on pre-
samples. qualifications by WHO or Good Manufacturing Procedures (GMP)
certifications
Preventive measure
- Apply insect repellent to exposed skin. ...
-Wear long-sleeved clothing and long pants if you are outdoors at night.
-Use a mosquito net over the bed if your bedroom is not air-conditioned
or screened. ...
-Spray an insecticide or repellent on clothing, as mosquitoes may bite
through thin clothing.
-avoid places with prevalence of disease

Department of Health. (2009). Administrative order 2009-0001: Revised Policy and Guidelines on the Diagnosis and Treatment for Malaria. Retrieved from
https://www.actmalaria.net/newsroom/viewtopic.php?f=19&t=13
World Health Organization. (2015). Guidelines for the treatment of Malaria: third edition. Retrieved from https://www.who.int/docs/default-source/documents/publications/gmp/guidelines-for-
the-treatment-of-malaria-eng.pdf

A. Direct Detection Method Mild leptospirosis symptoms include: As soon as the illness is diagnosed
1. Culture and isolation Fever antibiotic therapy should
-Gold standard but time consuming and labour intensive immediately start regardless of the
Mylagia
Direct Contact with - uses dark field microscopy to identify serovar but is phase.
urine of infected insensitive Headache
animals or contact 2. Polymerase Chain Reaction Conjunctival suffusion For mild leptospirosis, the drug of
with contaminated - can confirm disease diagnosis early especially during the first Abdominal pain choice is doxycycline & amoxicillin
environment such as week of illness but is not generally utilized due to its cost and azithromycin dehydrate are
Diarrhea
water, oil, plants or limiting nature and need for trained personnel alternative medicines.
rodent bites B. Indirect Detection Method For moderate-severe leptospirosis,
1. Microagglutination Test Severe leptospirosis symptoms the drug of choice remains to be
Leptospirosis - Highly sensitive but time consuming and hazardous since it include: penicillin G. Other alternative drigs
include live antigen. Jaundice are parenteral ampicillin, 3rd
- Four fold rise of titer from acute to convalescent confirms Oliguria generation cephalosporin (cefotaxime,
the diagnosis Renal Failure ceftriaxone), and parenteral
2. Specific IgM Rapid Diagnostic Test azithromycin dehydrate.
- serologic test to detect quickly leptospira genus-specific Pulmonary hemorrhage
Preventive measures
IgM antibodies in human sera Thrombocytopenia 1.) avoidance of high-risk exposure
3. Nonspecific Rapid Diagnostic Test Altered sensorium, meningitis 2.) use personal protective equipment
-detects Leptospira antibody through agglutination if avoidance of high risk exposure is
reaction and is used as screening test but not sensitive and not possible
should be confirmed using micro agglutination test 3.) Pre exposure antibiotic
prophylaxis
Philippine Society for Microbiology and Infectious Diseases. (2010). CPG for Leptospirosis 2010. Retrieved from https://www.psmid.org/cpg-leptospirosis-2010/
Transmitted through Rapid diagnostic test HIV doesn’t have definite symptoms. Since HIV have no cure, following preventive measures and avoiding risk
the exchange of a Its symptoms vary depending on the factors is a must so that an individual will not acquire such disease.
-an in vitro
variety of body fluids stage of infection. In addition, a retroviral therapy consists of 3 or more medicines
immunochromatographic or
from infected people, combinations fight HIV. It can also be used to prolong life and strengthen
immunofiltration diagnostic test
such as blood, breast immune system
for detecting HIV-1 and -2 As infection progressively weakens
milk, semen and Preventive measure include:
HIV antibodies and/or HIV p24 the immune system, individuals will
vaginal secretions. 1. Avoid risky sexual behaviours
antigen. develop certain influenza like
HIV can also be 2. Taking pre-exposure prophylaxis (PrEP) and post-exposure
transmitted from a symptoms and eventually illnesses prophylaxis (PEP)
mother to her child such as tuberculosis, meningitis, and 3. Abstinence, use of condoms
during pregnancy and severe bacterial infections.
delivery.
Center for Disease Control and Prevention. HIV Basic .Retrieved from https://www.cdc.gov/hiv/basics/index.html
Possible modes of 1. Molecular tests (PCR)
transmission for 2. Antibody test such as Symptoms are influenza-like and Center for disease control recommends that patients with SARS receive the
SARS-CoV-2, including ELISA (Enzyme Linked include fever, malaise, myalgia, same treatment that would be used for a patient with any serious
contact, droplet, ImmunoSorbant Assay) and headache, diarrhoea, and shivering community-acquired atypical pneumonia since efficacy of antiviral
airborne, fomite, (Immunofluorescence (rigors). No individual symptom or medicines are being tested up until now
SARS
fecal-oral, Assay) cluster of symptoms has proved to be
bloodborne, mother- specific for a diagnosis of SARS Preventive Measure
to-child, and animal- FREQUENT HAND WASHING.
to-human Isolation of probable cases
transmission.
World Health Organizations.(2003). Frequently asked questions on Severe Acute Respiratory Syndrome (SARS).Retrieved from https://www.who.int/csr/sars/sarsfaq/en/
Department of Health and Human Services & Center for Disease Control and Prevention. (2004) Clinical Guidance on the Identification and Evaluation of Possible SARS-CoV Disease among Persons
Presenting with Community-Acquired Illness. Retrieved from https://www.cdc.gov/sars/clinical/guidance.pdf
Likely spreads from 1. Serology Tests Severe acute respiratory illness Antiviral treatments and vaccine are still not available.
an infected person’s - Detects presence of with symptoms of: Preventive Measures
respiratory antibodies to MERS-CoV  • fever • cough • shortness of breath -Wash your hands often with soap and water for 20 seconds
secretions, such as 2. Molecular Tests -Cover your nose and mouth with a tissue when you cough or sneeze
MERS-CoV through coughing and - Used to detect Viral RNA in - Avoid touching eyes nose and mouth with unwashed hands
close contact with clinical samples
infected individual - Clean and disinfect frequently touched surfaces and
objects, such as doorknobs
Center for Disease Control andPrevention.[ Factsheet]. Information about Middle East Respiratory Syndrome (MERS). Retrieved from
https://www.cdc.gov/coronavirus/mers/downloads/factsheet-mers_en.pdf
COVID19 1. Serology Tests Clinical signs and symptoms: Antiviral treatments and vaccine are still not available.
- Detects presence fever. Preventive Measures
 of antibodies to MERS- dry cough. -Wash your hands often with soap and water for 20 seconds
CoV  tiredness. -Cover your nose and mouth with a tissue when you cough or sneeze
aches and pains. - Avoid touching eyes nose and mouth with unwashed hands
2. Molecular Tests
Direct contact with sore throat. - Clean and disinfect frequently touched surfaces and
Used to detect Viral RNA
respiratory droplets in clinical samples diarrhoea. objects, such as doorknobs
from a carrier conjunctivitis. -AVOID crowded places
-Stay at home if there is no necessary appointments
headache.
-Always wear a mask and face shield and sanitize properly in public places
loss of taste or smell.
a rash on skin, or discolouration of fingers
or toes.

Serious symptoms:

difficulty breathing or shortness of breath.

World Health Organization. (2020). Coronavirus. Retrieved from https://www.who.int/health-topics/coronavirus#tab=tab_3