positive

In new patients, if the specimen obtained at the end of month 3 is smear-positive,
sputum culture and drug susceptibility testing (DST) should be performed.

In new patients, if the specimen obtained at the end of the intensive phase
(month 2) is smear-positive, sputum smear microscopy should be obtained at
the end of the third month.

For smear-positive pulmonary TB patients treated with first-line drugs, sputum
smear microscopy may be performed at completion of the intensive phase of
treatment.

It is recommended that TB patients who are living with HIV should receive at least
the same duration of TB treatment as HIV-negative TB patients.

New patients with pulmonary TB should receive a regimen containing 6 months
of rifampicin: 2HRZE/4HR.

Well-designed, maintained and operated fans (mixed-mode ventilation) can help to obtain adequate dilution when natural
ventilation alone cannot provide sufficient ventilation rates.
In some settings, mechanical ventilation (with or without climate control) will be needed. This may be the case, for example,
where natural or mixed-mode ventilation systems cannot be implemented effectively, or where such systems are inadequate given local conditions (e.g. building structure, climate, regulations, culture, cost and outdoor air quality).

In existing healthcare facilities that have natural ventilation, when possible, effective ventilation should be achieved by
proper operation and maintenance on a regular schedule. Simple natural ventilation may be optimized by maximizing the
size of the opening of windows and locating them on opposing walls.

Adequate ventilation in healthcare facilities is essential for preventing transmission of airborne infections, and is strongly
recommended for controlling spread of TB. The choice of ventilation system will be based on assessment of the facility and
informed by local programmatic, climatic and socioeconomic conditions (refer to guideline for Controls 10a and 10b). Any ventilation system
must be monitored and maintained on a regular schedule. Adequate resources (budget and staffing) for maintenance are
critical.

To minimize the spread of droplet nuclei, any coughing patient with a respiratory infection – in particular, patients with or
suspected of having TB – should be educated in cough etiquette and respiratory hygiene; that is, in the need to cover their
nose and mouth when sneezing and/or coughing (see rest of the recommendation p. 12 of the guideline).

It is also crucial to separate infectious patients after triage. The specific criteria (e.g. smear and culture status) for separating
patients will depend on the local settings and patient population. In particular, patients living with HIV or with strong clinical