0748 Bis

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PARTEA I
Miercuri, 7 octombrie 2015
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LEGI, DECRETE, HOTRRI I ALTE ACTE
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SUMAR
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Anexa la Ordinul ministrului sntii nr. 1.171/2015 pentru

aprobarea Ghidului metodologic de implementare a
Programului naional de prevenire, supraveghere i
control al tuberculozei ................................................
De
Anul 183 (XXVII) Nr. 748 bis
3122
MONITORUL OFICIAL AL ROMNIEI, PARTEA I, Nr. 748 bis/7.X.2015
ACTE ALE ORGANELOR DE SPECIALITATE

ALE ADMINISTRAIEI PUBLICE CENTRALE
MINISTERUL SNTII
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ORDIN
pentru aprobarea Ghidului metodologic de implementare
a Programului naional de prevenire, supraveghere i control
al tuberculozei*)
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Vznd Referatul de aprobare nr. N.B. 9.550/2015 al Ageniei naionale

pentru programe de sntate din cadrul Ministerului Sntii,
avnd n vedere prevederile Strategiei Naionale de Control al Tuberculozei
n Romnia 20152020, aprobat prin Hotrrea Guvernului nr. 121/2015,
n temeiul art. 7 alin. (4) din Hotrrea Guvernului nr. 144/2010 privind
organizarea i funcionarea Ministerului Sntii, cu modificrile i completrile
ulterioare,
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ministrul sntii emite urmtorul ordin:
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Art. 1. Se aprob Ghidul metodologic de implementare a Programului

naional de prevenire, supraveghere i control al tuberculozei, prevzut n anexa
care face parte integrant din prezentul ordin.
Art. 2. Anexa se poate accesa pe site-ul Ministerului Sntii, la adresa
www.ms.ro, rubrica Ghiduri clinice.
Art. 3. La data intrrii n vigoare a prezentului ordin se abrog Ordinul
ministrului sntii publice nr. 1.577/2008 pentru aprobarea Normelor metodologice
de implementare a Programului naional de control al tuberculozei, publicat n
Monitorul Oficial al Romniei, Partea I, nr. 766 din 13 noiembrie 2008.
Art. 4. Direciile de specialitate din Ministerul Sntii, direciile de
sntate public, furnizorii de servicii medicale, precum i instituiile publice care
deruleaz Programul naional de prevenire, supraveghere i control al tuberculozei
vor duce la ndeplinire prevederile prezentului ordin.
Art. 5. Prezentul ordin se public n Monitorul Oficial al Romniei,
Partea I.
p. Ministrul sntii,
Francisk Iulian Chiriac,
secretar de stat
De
Bucureti, 21 septembrie 2015.

Nr. 1.171.
*) Ordinul nr. 1.171/2015 a fost publicat n Monitorul Oficial al Romniei, Partea I, nr. 748 din
7 octombrie 2015 i este reprodus i n acest numr bis.
Anex
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Documentul de fa a fost elaborat pe baza strategiilor n domeniul controlului

tuberculozei elaborate de ECDC i OMS.
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Dei fluorochinolonele nu sunt recomandate la copii n multe ri, beneficiul tratrii
copiilor cu TB MDR cu o fluorochinolon poate depi riscurile n cele mai multe cazuri.
0RQLWRUL]DUHD WUDWDPHQWXOXL VH HIHFWXHD] OD VSWPkQL GH ODvQFHSHUHD VD OD VIkULWXO
ID]HL LQWHQVLYH L OD ILHFDUH OXQL SkQ OD WHUPLQDUH $FHDVWD WUHEXLH V FXSULQG PLQLP
HYDOXDUHDVLPSWRPHORUDDGHUHQHLODWUDWDPHQWDUHDFLLORUDGYHUVHLDJUHXWLL
0RQLWRUL]DUHDEDFWHULRORJLFODOXQLVHHIHFWXHD]SHQWUXFRSLLLFRQILUPDLSULQH[DPHQ
EDFWHULRORJLF LDU FHD UDGLRORJLF QX HVWH UHFRPDQGDW GH UXWLQ OD FRSLL GDWRULW UVSXQVXOXL
OHQWODWUDWDPHQWLQRUPDOL]ULLWDUGLYHDDVSHFWXOXLUDGLRJUDILHLWRUDFLFHVHHIHFWXHD]ODOXQL
GHWUDWDPHQWLvQDLQWHGHvQFKHLHUHDDFHVWXLD
Regimurile terapeutice recomandate la cazurile noi de tuberculoz la copii (conform
Ghid WHO: Guidance for national tuberculosis programmes on the management of
tuberculosis in children, ediia 2014) se regsesc n tabelul 7:

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VXUVFXFKLPLRVHQVLELOLWDWHHVWHFX,]RQLD]LGvQFD]GHVXUVFXFKLPLRUH]LVWHQOD+,1VH
XWLOL]HD] WUDWDPHQWXO FX 5LIDPSLFLQ LDU SHQWUX FD]XULOH FX VXUV 0'5;'5 UHJLPXULOH
XWLOL]DWHVXQWGLVFXWDELOHDetalii despre regim/doze/durat tratament sunt la capitolul referitor
la prevenia tuberculozei Orice tratament preventiv cu excepia celui cu Izoniazid trebuie
aprobat n colectivul medical al unitii!
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1. Tuberculoza la persoane infectate HIV

7UDWDPHQWXO YD IL LQVWLWXLW vQ FRODERUDUH FX PHGLFXO LQIHFLRQLVW FDUH WUDWHD] SDFLHQWXO
+,9 6H DGPLQLVWUHD] VFKHPHOH WHUDSHXWLFH VWDQGDUG UHJLPXO WHUDSHXWLF DQWLWXEHUFXORV
UHFRPDQGDWIRORVHWHUHJLPXULOHVWDQGDUGDOH3136&7FXDGPLQLVWUDUH]LOQLFSHWRDWGXUDWD
SkQODOXQL/DFRSLLLLQIHFWDL+,9GXUDWDWUDWDPHQWXOXLHVWHGHOXQL
QFD]XOvQFDUHVHDGPLQLVWUHD]DQWLUHWURYLUDOHFDUHLQWHUIHUFX5LIDPSLFLQDGDFHVWH
SRVLELOVHDPkQLQLLHUHDWUDWDPHQWXOXLDQWLUHWURYLUDOGDFQXVHYRUDVRFLDFHOHWHUDSLLQ
SUH]HQW VH SRW XWLOL]D PHGLFDPHQWH DQWLUHWURYLUDOH LQKLELWRUL GH SURWHD]H LQKLELWRUL DL
UHYHUVWUDQVFULSWD]HL QRQQXFOHR]LGLFH FDUH QX PDL SUH]LQW LQWHUDFLXQL SRWHLDOH FX
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SR]LWLYL L SRDWH IL DGPLQLVWUDW vQ GR]D GH PJNJ]L vQ ORFXO 5LIDPSLFLQHL OD
UHFRPDQGDUHDVSHFLDOLWLORUGLQUHHDXDGHEROLLQIHFLRDVH

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2. Tuberculoza i sarcina
'DFIHPHLOHEROQDYHGH7%VXQWvQVUFLQDWHOLVHYRUDGPLQLVWUDPHGLFDPHQWHOHDQWL7%
HVHQLDOH +5=( H[FHSWkQG 6WUHSWRPLFLQD FDUH HVWH WHUDWRJHQ RWRWR[LF SHQWUX IW L HVWH
LQWHU]LV vQ WLPSXO VDUFLQLL *UDYLGD YD SULPL L PJ SLULGR[LQNJ]L Q JHQHUDO
LQVWLWXLUHDWUDWDPHQWXOXLDQWLWXEHUFXORVQXUHSUH]LQWRLQGLFDLHSHQWUXDYRUWXOWHUDSHXWLFGDUVH
LPSXQH DQDOL]D ILHFUXL FD] vQ SDUWH vQ VSHFLDO SHQWUX SULPXO WULPHVWUX GH VDUFLQ QWUXFkW
VLJXUDQDWUDWDPHQWXOXLFXPHGLFDPHQWHGHOLQLDD,,DvQVDUFLQQXHVWHVXILFLHQWFXQRVFXWvQ
IXQFLHGHYkUVWDVDUFLQLLVHSRDWHOXDvQFRQVLGHUDLHDYRUWXOWHUDSHXWLF
$OSWDUHD HVWH SHUPLV FX PDVF SHQWUX FD]XULOH SR]LWLYH PDPD QHvQWUHUXSkQG
WUDWDPHQWXODQWL7%
/HJDW GH FRQWUDFHSLD RUDO vQ 7% 5LIDPSLFLQD LQWHUDFLRQHD] FX PHGLFDLD
FRQWUDFHSWLY RUDO VF]kQG QLYHOXO GH SURWHFLH D DQWLFRQFHSLRQDOHORU VH YRU OXD vQ
FRQVLGHUDUHDOWHPHWRGHFRQWUDFHSWLYH
7UDWDPHQWXO SURILODFWLF OD QRXQVFXW YD IL OXDW vQ FRQVLGHUDUH vQ IXQFLH GH VWDWXVXO
EDFWHULRORJLF DO PDPHL L GH PRPHQWXO LQVWLWXLULL WUDWDPHQWXOXL DQWLWXEHUFXORV DO DFHVWHLD Q
FD]XO vQ FDUH PDPD DUH H[DPHQ EDFWHULRORJLF SR]LWLY OD H[DPLQDUHD PLFURVFRSLF D VSXWHL vQ
PRPHQWXO QDWHULL VDX GDF HVWH QHJDWLYDW GDU QX D vQFKHLDW WUDWDPHQWXO DQWLWXEHUFXORV VH
SRDWH OXD vQ FRQVLGHUDUH DGPLQLVWUDUHD SURILOD[LHL FX ,]RQLD]LG QRXQVFXWXOXL FX DWHQWD
PRQLWRUL]DUHDIXQFLHLKHSDWLFHDDFHVWXLDLDVRFLHUHDGHSLULGR[LQ

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3. TB i bolile hepatice
+ 5 L = DX HIHFWH KHSDWRWR[LFH 'LQWUH DFHVWHD = DUH FHD PDL PDUH DFWLYLWDWH
KHSDWRWR[LF L GH DFHHD OD EROQDYLL FX DIHFLXQL KHSDWLFH FX FLWROL] VH UHFRPDQG HYLWDUHD
DGPLQLVWUULLVDOH'DFvQWLPSXODGPLQLVWUULLWUDWDPHQWXOXLDSDUHFLWROL]DKHSDWLFFXYDORUL
DOHWUDQVDPLQD]HORUGHFHOSXLQRULPDLPDULODSDFLHQWXODVLPSWRPDWLFLGHFHOSXLQRUL
PDL PDUL OD SDFLHQWXO VLPSWRPDWLF VH vQWUHUXSH WUDWDPHQWXO SkQ OD QRUPDOL]DUHD SUREHORU
KHSDWLFH ]LOH L VH UHLD FX GR]H VF]XWH ]LOH L DSRL FX GR]D X]XDO 7HUDSLD
DQWLWXEHUFXORDV OD EROQDYXO KHSDWLF LQFOXGH +5 L DOWH FKLPLRWHUDSLFH IU KHSDWRWR[LFLWDWH
H[HPSOX6L(QDFHDVWVLWXDLHVHYDSUHOXQJLWUDWDPHQWXOSkQODOXQL
1X H[LVW FRQVHQV WHUDSHXWLF SHQWUX KHSDWLWD YLUDO DFXW 6H UHFRPDQG WHPSRUL]DUHD
WUDWDPHQWXOXLDQWL7%SkQODYLQGHFDUHDKHSDWLWHLGDUDWLWXGLQHDYDILLQGLYLGXDOL]DWvQIXQFLH
GHILHFDUHSDFLHQWVHDOHJPHGLFDPHQWHFXWR[LFLWDWHKHSDWLFUHGXV
4. TB la bolnavul cu insuficien renal
+ 5 L = VH DGPLQLVWUHD] vQ GR]H QRUPDOH 206 UHFRPDQG vQ ,5& FD VFKHP GH
WUDWDPHQWOXQL+5=XUPDWGHOXQLFX+5GUHSWFHDPDLVLJXUDOWHUQDWLY
6L(VHHOLPLQSHFDOHUHQDOPRWLYSHQWUXFDUHVHYRUIRORVLGR]HPLFLvQIXQFLHGH
FOHDUDQFHXOODFUHDWLQLQLVHYDPRQLWRUL]DIXQFLDUHQDOSHGXUDWDWUDWDPHQWXOXLFXDFHVWH
PHGLFDPHQWHQFD]XOvQFDUHHVWHQHFHVDUDGPLQLVWUDUHD6L(HOHYRUILUHFRPDQGDWHGH
RULSHVSWPkQGR]HOHILLQGUHGXVHFXRWUHLPH
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KHPRGLDOL]
5. TB la bolnavul cu diabet zaharat
'HL UHJLPXULOH VWDQGDUG SRW IL DGPLQLVWUDWH WUHEXLH UHLQXW IDSWXO F 5 L ( GLPLQX
QLYHOHOH VHULFH DOH XQRU KLSRJOLFHPLDQWH RUDOH FXP DU IL FRPSXLL VXOIRQLOXUHLFL 7LSXO GH
WUDWDPHQW DQWLGLDEHWLF YD IL VWDELOLW GH FWUH PHGLFXO VSHFLDOLVW QXWULLH L GLDEHW 'XUDWD
WUDWDPHQWXOXLDQWLWXEHUFXORVYDILSUHOXQJLWODOXQL

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6. TB la pacientul comatos
7UDWDPHQWXO VWDQGDUG WUHEXLH SUHVFULV HYLWkQGXVH DGPLQLVWUDUHD ( vQWUXFkW QX SRDWH IL
PRQLWRUL]DWDFXLWDWHDYL]XDO6HSRDWHDSHODODXUPWRDUHOHPRGDOLWLGHDGPLQLVWUDUH+L5
SRWILDGPLQLVWUDWHDPkQGRXVXEIRUPGHVLURS+56SULQSHUIX]LHLQWUDYHQRDV+L6SH
FDOHLQWUDPXVFXODULDU=WUDQVIRUPDWvQSXGUSHVRQGDQD]RJDVWULF
7. Silicotuberculoza
6HUHFRPDQGXQWUDWDPHQWFXGXUDWDPDLOXQJGHFkWFHOVWDQGDUGL]DWOXQLGDWRULW
SHQHWUULL GLILFLOH D DQWL7% OD QLYHOXO SDUHQFKLPXOXL SXOPRQDU ILEUR]DW L D IXQFLRQULL
GHIHFWXRDVHDPDFURIDJHORU
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1. Meningita TB
(WDPEXWROXO L 6WUHSWRPLFLQD DX R SHQHWUDELOLWDWH UHGXV OD QLYHOXO PHQLQJHOXL LQGHPQ
3HQHWUDELOLWDWHD DFHVWRUD HVWH DPHOLRUDW vQ FRQGLLLOH PHQLQJHOXL LQIODPDW 'LQ DFHVWH PRWLYH
DFHVWHPHGLFDPHQWHVHYRUXWLOL]DGRDUvQVLWXDLLGHQHFHVLWDWHLvQVSHFLDOvQID]DLQLLDO
D QID]DLQLLDOSHRSHULRDGGHOXQLVHUHFRPDQGDQWLWXEHUFXORDVH+5=6VDX
(QID]DGHFRQWLQXDUHVHUHFRPDQGOXQLDQWLWXEHUFXORDVH+5
E &RUWLFRL]LL VH UHFRPDQG GH UXWLQ GH OD LQLLHUHD WUDWDPHQWXOXL DQWLWXEHUFXORV VXE
IRUP GH SUHGQLVRQ PJNJ]L QHGHSLQG PJ]L SH R SHULRDG GH
VSWPkQLGXSFDUHVHUHGXFHSURJUHVLYGR]DSkQODFHOSXLQVSWPkQL
2. Pericardita TB
6HUHFRPDQGWHUDSLHVWDQGDUGL]DWVHDVRFLD]FRUWLFRWHUDSLDPJNJ]LWLPSGH
VSWPkQL FX VFGHUHD SURJUHVLY D GR]HL vQ XUPWRDUHOH VSWPkQL GXUDWD WRWDO D
FRUWLFRWHUDSLHLILLQGGHVSWPkQL
3. TB osteoarticular
7UDWDPHQWVWDQGDUGSUHOXQJLWSkQODOXQLFXSRVLELOLWDWHDDGPLQLVWUULL]LOQLFHvQID]D
GH FRQWLQXDUH$VRFLHUHD WUDWDPHQWXOXL RUWRSHGLFFKLUXUJLFDO VH IDFH OD LQGLFDLD VSHFLDOLVWXOXL
GHSURILO
4. TB ganglionar periferic
$YkQG vQ YHGHUH FDUDFWHULVWLFD PRUIRSDWRORJLF D OH]LXQLORU GLQ 7% JDQJOLRQDU FDUH
SUHVXSXQH SHQHWUDLD GLILFLO D DQWLWXEHUFXORDVHORU OD QLYHOXOPDVHORU FD]HRDVH WUDWDPHQWXO VH
SRDWHSUHOXQJLSkQODOXQLFXSRVLELOLWDWHDDGPLQLVWUULL]LOQLFHvQID]DGHFRQWLQXDUH
Empiemul TB QHFHVLWDVRFLHUHDWUDWDPHQWXOXLPHGLFDPHQWRVDQWL7%FXFHOFKLUXUJLFDO

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PDULSHFDUHOHLPSOLFLGLILFXOWLORUSURYRFDWHGHGXUDWDSUHOXQJLWFXPHGLFDPHQWHJUHXGH
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31
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GLDJQRVWLF L vQJULMLUH D FD]XULORU GH 7% SURGXV FX JHUPHQL UH]LVWHQL OD PHGLFDPHQWHOH
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WUDWDPHQW FX PHGLFDPHQWH GH OLQLD D ,,D WUHEXLH V DVLJXUH LQYHVWLJDLLOH EDFWHULRORJLFH
QHFHVDUH PRQLWRUL]ULL vQWUXQ ODERUDWRU FDUH DUH LPSOHPHQWDW VLVWHPXO GH PDQDJHPHQW DO
FDOLWLL'HDVHPHQHDXQLWLOHUHVSHFWLYHWUHEXLHVDLEDVLJXUDWHPVXULFRUHVSXQ]WRDUHGH
FRQWURODOWUDQVPLWHULLLQIHFLHL7%Se recomand ca pacienii s rmn spitalizai cel puin
pn la negativarea microscopic a sputei, de preferat pn la conversia n culturPLQLP
FXOWXULFRQVHFXWLYHQHJDWLYH
3HQWUX SDFLHQLL OD FDUH &RPLVLLOH &HQWUHORU 0'5 QX LGHQWLILF UHVXUVH WHUDSHXWLFH VH
LPSXQH OXDUHD WXWXURU PVXULORU QHFHVDUH L]ROULL FD]XULORU vQ VFRSXO OLPLWULL WUDQVPLWHULL
LQIHFLHLODGRPLFLOLXVDXvQXQLWLVSLWDOLFHWLFRUHVSXQ]WRDUH

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OD SDFLHQLLOD FDUH VXVSLFLXQHDFOLQLFL$%*VHULHVFXUW+5 VXJHUHD]FDUDFWHUXO
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LVWRULFXOXL SDFLHQWXOXL D GDWHORU GLQ DQFKHWHOH QDLRQDOH GH FKLPLRUH]LVWHQ vQDLQWHD
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1. nou-nscui din focarul TB:

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2. copii i adolesceni pn la 19 ani din focarul TB:
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3. aduli pn la 35 ani, numai la persoanele care prezint factori de risc i au TCT
pozitiv:
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5. persoanele supuse terapiei biologice imunosupresoare tip anti-TNF alfa, indiferent
de vrst, n cazul n care se poate dovedi infecia TB latent;
6. persoanele cu transplant de organe sau celule stem, indiferent de vrst, n cazul
confirmrii infeciei tuberculoase latente

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piridoxinei (vitamina B6), 5-10mg/zi la copil i 250 mg la adult.
Profilaxia dubl sau cu mai multe medicamente este, n principiu, interzis.

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Repetarea tratamentului profilactic este discutabil - doar dac exist dovada infectrii cu o
tulpin nou i se recomand infectailor HIV i copiilor contaci cu un caz nou TB cu
microscopie pozitiv.
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Cea mai eficient metod de control al transmiterii tuberculozei este reprezentat de
diagnosticul precoce i tratamentul prompt i eficient al cazurilor de tuberculoz.
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REGISTRUL DE LABORATOR
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6SHFLILFLWDWHDPVRDUFDSDFLWDWHDXQXLWHVWGHDLGHQWLILFDvQPRGFRUHFWSHUVRDQHOHFDUHQXDXERDODvQFXUVGHLQYHVWLJDUH
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7%DFWLYHGHRDUHFHSRWDSUHDUH]XOWDWHIDOVQHJDWLYHODGLQSDFLHQLFKLDULSURFHQWHPDL
PDULODLPXQRFRPSURPLL
Indicaiile clare de utilizare i interpretare a rezultatelor IGRAS, n mod special n ceea ce
privete riscul de TB activ, rmn incerte la acest moment.
6XQW QHFHVDUH VWXGLL VXSOLPHQWDUH SHQWUX D GHILQL FDSDFLWDWHD DFHVWRU WHVWH GH D SUH]LFH
GH]YROWDUHD7%SHQWUXDGHWHUPLQDUHSURGXFWLELOLWDWHDLSHQWUXDHYDOXDLPSOLFDLLOH PHGLFDOHL
HFRQRPLFHDOHXWLOL]ULLORU
QSUH]HQWHVWHGLILFLODVHUHFRPDQGDIRORVLUHDGHUXWLQDDFHVWRUWHVWHvQGLDJQRVWLFXO7%ODWHQWH
6WXGLL YLLWRDUH PDL DOHV VWXGLL SURVSHFWLYH DU IL GH PDUH LQWHUHV vQ VWDELOLUHD SHUIRUPDQHL
VLPXOWDQHD7&7LD,*5$6


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EROQDYXOFX7%FRQILUPDWEDFWHULRORJLFVDXKLVWRSDWRORJLF+3
EROQDYXOFDUHQXDUHFRQILUPDUHGDUODFDUHPHGLFXOSQHXPRORJDUHVXILFLHQWHGDWHFOLQLFH
LSDUDFOLQLFHSHQWUXDGHFLGHvQFHSHUHDWUDWDPHQWXOXLDQWLWXEHUFXORV
Orice tratament antituberculos trebuie instituit numai de ctre un medic pneumolog sau cu
avizul medicului pneumolog al teritoriului de care aparine unitatea n care este instituit
tratamentul
&D]XO GH 7% HVWH GHILQLW vQ IXQFLH GH ORFDOL]DUHD EROLL FRQILUPDUHD EDFWHULRORJLF VDX
KLVWRSDWRORJLFLVWRULFXOWHUDSHXWLFLVWDWXVXO+,9
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I. LOCALIZAREA TB POATE FI:

a) SXOPRQDUGDFOH]LXQLOHVXQWvQSDUHQFKLPXOSXOPRQDUvQDUERUHOHWUDKHREURQLF
VDXvQODULQJH
Acestea sunt forme contagioase, importante din punct de vedere epidemiologic.
D H[WUDSXOPRQDUGDFOH]LXQLOHVXQWvQDOWHORFXULGHFkWFHOHGHPDLVXV
Q VLWXDLD vQ FDUH SDFLHQWXO DUH o singur localizare a bolii DFHDVWD YD IL vQVFULV OD
GLDJQRVWLFXOSULQFLSDOLYDGHWHUPLQDvQFDGUDUHDFD]XOXLvQWUXQDGLQFDWHJRULLOHGHPDLVXV
&D]XOGH7%cu dou sau mai multe localizriGLQWUHFDUHFHOSXLQXQDSXOPRQDUYDDYHDFD
GLDJQRVWLF SULQFLSDO SH FHO DO ORFDOL]ULL SXOPRQDUH LDU FD GLDJQRVWLF VHFXQGDU GLDJQRVWLFH
VHFXQGDUH SH FHO FHOH DO DOH ORFDOL]ULORU H[WUDSXOPRQDUH &D]XO VH YD vQUHJLVWUD FD 7%
SXOPRQDU
'DF QLFL XQD GLQWUH ORFDOL]UL QX HVWH SXOPRQDU VH YD FRQVLGHUD GLDJQRVWLF SULQFLSDO FHO DO
ORFDOL]ULLFHOHLPDLJUDYHLDUFHOHODOWHORFDOL]ULYRUILvQVFULVHFDGLDJQRVWLFHVHFXQGDUH&D]XOVH
YDvQUHJLVWUDFD7%H[WUDSXOPRQDU
7%diseminatGDFDUHLORFDOL]DUHSXOPRQDUVHYDFRQVLGHUDFDORFDOL]DUHSXOPRQDU6H
YD vQVFULH OD GLDJQRVWLF SULQFLSDO IRUPD DQDWRPRUDGLRORJLF SXOPRQDU LDU OD GLDJQRVWLFH
VHFXQGDUH ORFDOL]ULOH H[WUDSXOPRQDUH Q DEVHQD GHWHUPLQULL SXOPRQDUH VH YD vQUHJLVWUD FD 7%
H[WUDSXOPRQDU VH YD FRQVLGHUD GLDJQRVWLF SULQFLSDO GLDJQRVWLFXO IRUPHL FHOHL PDL JUDYH LDU
GLDJQRVWLFHVHFXQGDUHFHOHDOHFHORUODOWHGHWHUPLQUL
7% copilului YD IL FRQVLGHUDW FX ORFDOL]DUH SXOPRQDU GDF VH HYLGHQLD] OH]LXQL DOH
SDUHQFKLPXOXL SXOPRQDU DOH DUERUHOXL WUDKHREURQLF VDX DOH ODULQJHOXL GLDJQRVWLF SULQFLSDO
UHVSHFWLYFXORFDOL]DUHH[WUDSXOPRQDUGDFQXVXQWOH]LXQLvQDFHVWHVWUXFWXULGLDJQRVWLFSULQFLSDO
FHODOORFDOL]ULLXQLFHVDXFHODOORFDOL]ULLFHOHLPDLJUDYH$GHQRSDWLDWUDKHREURQLFQHvQVRLW
GH DOWH GHWHUPLQUL YD IL vQUHJLVWUDW FD GLDJQRVWLF SULQFLSDO LDU ORFDOL]DUHD VH YD FRQVLGHUD
H[WUDSXOPRQDU 'DF vQV OD XQ DVWIHO GH FD] UH]XOWDWXO H[DPHQXOXL EDFWHULRORJLF GLQ VSXW VDX
GLQWUXQ DOW SURGXV UHFROWDW HVWH SR]LWLY VH YD SUHVXSXQH H[LVWHQD ILVWXOHL WUDKHREURQLFH FKLDU
GDFDFHDVWDQXDIRVWHYLGHQLDWLDUFD]XOYDILvQUHJLVWUDWFXORFDOL]DUHSXOPRQDU
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II. CRITERIILE DE DIAGNOSTIC, CONFORM DEFINIIILOR ECDC:

&RQIRUP GHFL]LHL &RPLVLHL GLQ GH SXQHUH vQ DSOLFDUH D PRGLILFULL 'HFL]LHL
&(SHQWUXVWDELOLUHDGHILQLLLORUGHFD]vQYHGHUHDUDSRUWULLEROLORUWUDQVPLVLELOHUHHOHL
vQFRQIRUPLWDWHFX'HFL]LDQU&(D3DUODPHQWXOXL(XURSHDQLD&RQVLOLXOXLQRWLILFDWFX
QXPUXO & WH[W FX UHOHYDQ SHQWUX 6(( 8( vQ YHGHUHD GLDJQRVWLFULL
78%(5&8/2=(,(Complexul M. Tuberculosis)DXIRVWVWDELOLWHXUPWRDUHOHFULWHULL
&ULWHULLFOLQLFH
2ULFHSHUVRDQFDUHSUH]LQWXUPWRDUHOHGRXFULWHULL
D 6HPQH VLPSWRPH LVDX VHPQH UDGLRORJLFH FRPSDWLELOH FX WXEHUFXOR]D DFWLY FDUHDIHFWHD]
RULFHVHGLX

87
E 'HFL]LDFOLQLFLDQXOXLGHDWUDWDSDFLHQWXOSULQWURFXUFRPSOHWGHWHUDSLHDQWL7%sau
F &D]XO GHVFRSHULW SRVW PRUWHP SUH]HQWkQG PRGLILFUL SDWRORJLFH FRPSDUDELOH FX
WXEHUFXOR]DDFWLYLFDUHDUILQHFHVLWDWWUDWDPHQWDQWLWXEHUFXORVvQFD]XOvQFDUHSDFLHQWXO
DUILIRVWGLDJQRVWLFDWvQDLQWHGHGHFHV
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&ULWHULLGHODERUDWRU
1. Criterii pentru confirmarea cazului
&HOSXLQXQDGLQWUHXUPWRDUHOHVLWXDLL
D ,]RODUHD FRPSOH[XOXL Mycobacterium tuberculosis H[FOX]kQG 0\FREDFWHULXP ERYLV
%&*GLQWURSUREFOLQLF
E 'HSLVWDUHD GH DFLG QXFOHLF DSDULQkQG FRPSOH[XOXL Mycobacterium tuberculosis vQWUR
SUREFOLQLFLPLFURVFRSLHSR]LWLYSHQWUX%$$5
2. Criterii de laborator pentru un caz probabil
&HOSXLQXQXOGLQWUHXUPWRDUHOHWUHL
D 0LFURVFRSLHSR]LWLYSHQWUX%$$5
E 'HSLVWDUHD GH DFLG QXFOHLF DSDULQkQG FRPSOH[XOXL Mycobacterium tuberculosis vQWUR
SUREFOLQLF
F $VSHFWKLVWRORJLFGHJUDQXORPWXEHUFXORV
3. Criterii epidemiologice - neaplicabile.
&ODVLILFDUHDFD]XULORU
A. Caz posibil
2ULFHSHUVRDQFDUHvQGHSOLQHWHFULWHULLOHFOLQLFH
B. Caz probabil
2ULFH SHUVRDQ FDUH vQGHSOLQHWH FULWHULLOH FOLQLFH L FULWHULLOH GH ODERUDWRU SHQWUX XQ FD]
SUREDELO
C. Caz confirmat
2ULFHSHUVRDQFDUHvQGHSOLQHWHFULWHULLOHFOLQLFHLGHODERUDWRUSHQWUXFRQILUPDUH
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III. ISTORICUL TERAPEUTIC:

nregistrarea unui pacient se va face conform istoricului su terapeutic real.
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IV. STATUSUL HIV

a) Cazul de TB HIV- pozitiv HVWH FD]XO FX 7% FRQILUPDW EDFWHULRORJLF VDX GLDJQRVWLFDW SH
FULWHULL FOLQLFH L FDUH HVWH +,9 SR]LWLY OD WHVWDUHD HIHFWXDW FX RFD]LD GLDJQRVWLFULL 7%
VDX vQ RULFH DOW RFD]LH DQWHULRDU VWDWXVXO +,9 DQWHULRU WUHEXLH VXVLQXW GH GRFXPHQWH
PHGLFDOHFXPDUILFHOHFDUHDWHVWWHUDSLD$59
E Cazul de TB HIV- negativ HVWH FD]XO FX 7% FRQILUPDW EDFWHULRORJLF VDX GLDJQRVWLFDW SH
FULWHULLFOLQLFHLFDUHHVWH+,9QHJDWLYODWHVWDUHDHIHFWXDWFXRFD]LDGLDJQRVWLFULL7%Q
FD]XOvQFDUHODRWHVWDUHXOWHULRDUHVWHGHSLVWDW+,9SR]LWLYYDILUHFODVLILFDW

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ANUNAREA
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Orice caz de TB (confirmat bacteriologic / HP, sau la care medicul pneumolog decide
nceperea tratamentului antituberculos) va fi anunat de ctre medicul care a diagnosticat cazul
sau care a iniiat tratamentul n 48 de ore, prin fia de anunare, dispensarului de
pneumoftiziologie (DPF) pe teritoriul cruia bolnavul are adresa stabil (locuiete n fapt,
conform declaraiei sale), indiferent de adresa sa legal (nscris n documentele de identitate).
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3HQWUX D IXUQL]D '3) WRDWH LQIRUPDLLOH GH FDUH DFHVWD DUH QHYRLH SHQWUX vQUHJLVWUDUHD L
GHFODUDUHD FD]XOXL FD L SHQWUX GHFODQDUHD DQFKHWHL HSLGHPLRORJLFH vQ ILD GH DQXQDUH VH YRU
FRPSOHWDWRDWHUXEULFLOHFkWPDLFRUHFW
'3)YDYHULILFDSULQSHUVRQDOXOSURSULXVDXSULQPHGLFXOGHIDPLOLHGDFSDFLHQWXOORFXLHWHvQ
IDSWODDGUHVDvQVFULVvQILDGHDQXQDUH
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NREGISTRAREA I DECLARAREA

'DFEROQDYXOORFXLHWHODDGUHVDGDWYDILvQUHJLVWUDWvQ5HJLVWUXOGH7%DO'3)LvQED]DGH
GDWH HOHFWURQLF GXS R SUHDODELO YHULILFDUH vQ ED]D GH GDWH QDLRQDO SHQWUX D VH HYLWD GXEOD
UDSRUWDUHDatele nscrise vor corespunde episodului de mbolnvire care estenregistrat.
'DFVHFRQVWDWFSDFLHQWXOQXORFXLHWHODDGUHVDvQVFULVvQILDGHDQXQDUHDFHDVWDYDIL
UHWXUQDWXQLWLLFDUHDWULPLVRFXPHQLXQHD3DFLHQWXOQXORFXLHWHODDGUHVDLQGLFDW
QVLWXDLDvQFDUHSDFLHQWXODIRVWH[WHUQDWLQXVHPDLSUH]LQWOD'3)FDUHDSULPLWDQXQDUHD
DFHVWDYDvQUHJLVWUDLYDGHFODUDFD]XOYDIDFHLQYHVWLJDLLSHQWUXJVLUHDOXLLGDFQXvOYDJVL
vQWUXQ LQWHUYDO GH OXQL GH OD vQUHJLVWUDUH vO YD HYDOXD 3LHUGXW 'DF EROQDYXO DSDUH vQ DFHVW
LQWHUYDO OD '3) ILH YD FRQWLQXD WUDWDPHQWXO GDF YD ORFXL vQ FRQWLQXDUH OD DGUHVD OD FDUH D IRVW
vQUHJLVWUDWILHVHYDRSHUDWUDQVIHUXOODXQDOW'3)vQWHULWRULXOFUXLDGHFODUFVDPXWDW
7RDWHFD]XULOHGH7%YRUILvQUHJLVWUDWHvQRUGLQHDFURQRORJLFDDSDULLHLORUDWkWvQ5HJLVWUXOGH
7%DO'3)FkWLvQED]DGHGDWHHOHFWURQLFLQGLIHUHQWGDFVXQWFD]XULQRLUHWUDWDPHQWHSHQWUX
GLYHUVHVLWXDLLVDXWUDQVIHUXULGLQDOWH'3)


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,QLLHUHWHUDSLHELRORJLF

+,1PJNJFGR]DPD[LPDPJ]LULWPGHDGPLQLVWUDUH]LOQLF
,VWRULF PHGLFDO vQWUHEDL GDF H[LVW 7% vQ DQWHFHGHQWH FRQWDFW 7% UHFHQW WUDWDPHQW FXUHQW LPXQRPRGXODWRU FRUWLFRVWHURL]L VDX
LPXQRVXSUHVRULVWRULFGHGURJXULLYGHWHQLH+,9DFHVWHDFRQGXFODXQULVFFUHVFXWSHQWUX,7%/VDXUHDFWLYDUH7%
4)7vQFD]XOvQFDUHVXFFHGH7&7VHUHFRPDQGDVHHIHFWXDvQ]LXDvQWHUSUHWULLWHVWXOXLVDXODFHOPXOW]LOHGHODLQWHUSUHWDUHSHQWUXD
QXILLQIOXHQDWHUH]XOWDWHOHSRVLELOUH]XOWDWHIDOVSR]LWLYH
/XDL vQ FRQVLGHUDUH LQLLHUHD WHUDSLHL ELRORJLFH OD OXQL GXS vQFHSHUHD WUDWDPHQWXOXL ,7%/ GDF HVWH SRVLELO DPkQDUHD SkQ FH
WUDWDPHQWXO,7%/HVWHFRPSOHW
QFD]GH7%DFWLYWHUDSLDELRORJLFVHSRDWHLQLLDUHLQLLDGXSILQDOL]DUHDWUDWDPHQWXOXL7%LHYDOXDUHDILQDO


2. Reevaluri pacieni n terapie biologic sau cu transplant de organe
sau de celule stem
3DFLHQLvQWHUDSLHELRORJLFVDXWUDQVSODQWDL
5HHYDOXUL
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Au efectuat tratament
pentru TB activ:

ODOXQLGHODLQLHUHD
WHUDSLHLELRORJLFH
DQDPQH]
H[DPHQFOLQLF
EDFWHULRORJLF
UDGLRORJLF
LDSRLDQXDO
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Nu au efectuat tratament
pentru ITBL /TB activ:

ODOXQLGHODLQLHUHD
WHUDSLHLELRORJLFH
DQDPQH]
H[DPHQFOLQLF
UDGLRORJLF

ODOXQLGHWHUDSLH
ELRORJLF
FRQIRUP
DOJRULWPXOXLGHOD
LQLLHUHDWHUDSLHL
ELRORJLFH
LDSRLDQXDO
in
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Au efectuat tratament
pentru ITBL:

ODILQDOXOWUDWDPHQWXOXL
,7%/SULQ
H[DPHQFOLQLF
UDGLRORJLF

ODXQDQGH]LOHGHOD
LQLLHUHDWUDWDPHQWXOXL
ELRORJLFGDFDFHVWDVH
LQLLD]GXSWHUPLQDUHD
WUDWDPHQWXOXL,7%/SULQ
H[DPHQFOLQLF
UDGLRORJLF
LDSRLDQXDO
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3. De cte ori se consider c este necesar se poate solicita din partea medicului dermatolog,
reumatolog, pneumolog sau chiar de pacient consult de specialitate.
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NOT:
Pacienii care au efectuat n antecedente tratament pentu boal TB sunt evaluai periodic
(clinic, bacteriologic i radiologic) i nu primesc tratament pentru ITBL.
La pacienii care au mai efectuat un tratament anterior pentru ITBL sau tuberculoz activ, se
va analiza n mod individual oportunitatea unui alt tratament al ITBL.
QFT nu se repet dac este negativ,GHRDUHFHQXVHFXQRDWHIHUHDVWUDDQHUJLFFDOD7&7GH
VSWPkQL QHFXQRVFkQGXVH DVWIHO PRPHQWXO YLUDMXOXL L LPSOLFLW DO LQWHUYDOXOXL GH WLPS RSWLP
SHQWXDILUHSHWDW
QFT nu se recomand ca test de evaluare a tratamentului ITBLGHRDUHFHUH]XOWDWXOFHOXLGHDO
GRLOHDWHVWSRDWHVFUHH]HFRQIX]LLSRDWHILWRWSR]LWLYGDUPDLUHGXVvQLQWHQVLWDWHLPDLPXOWGHFkW
DWkW RGDW FX FUHWHUHD LPXQRGHSUHVLHL LQGXV GH WHUDSLD ELRORJLF FUHWH L ULVFXO DSDULLHL
UH]XOWDWHORUQHGHWHUPLQDWHVDXIDOVQHJDWLYH

111
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5JUDILHWRUDFHFX

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127Dac la reevaluarea de 6 luni este normal reevaluare anual, ct timp persist

sursa (cazul index TB MDR/XDR)

*Supravegherea clinic/paraclinc se adreseaz contacilor TB MDR/XDR la care nu s-a instiuit
tratament profilactic!

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FIA PENTRU TRATAMENTUL PROFILACTIC

(CHIMIOPROFILAXIE)
111
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ANEXA 29
114
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3$57,&8/$5(
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, 7HPH GH ED] GH GLVFXWDW OD SULPD vQWkOQLUH FX SDFLHQWXO GXS VWDELOLUHD
GLDJQRVWLFXOGH7%
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7%LWUDWDPHQWXOVX/DSULPDvQWkOQLUHFXXQSDFLHQWGLDJQRVWLFDWFX7%WUHEXLHGLVFXWDWH
XUPWRDUHOHWHPH
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7%HVWHFXUDELOvQOXQLGHWUDWDPHQWFRUHFWLFRPSOHW
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6LPSWRPH
0RGDOLWLGHSUHYHQLUHDWUDQVPLWHULLLJLHQDWXVHLYHQWLODLHDGHFYDWVSDLLORU
QHFHVLWDWHDL]ROULLvQVSLWDO
,PSRUWDQD FRODERUULL OD FRQWUROXO FRQWDFLORU IDPLOLDOL GH FROHFWLYLWDWH GH
DQWXUDM
%RDO LQFOXV vQ SURJUDPHOH GH VQWDWH DOH 06 VSLWDOL]DUH LQYHVWLJDLL L
WUDWDPHQWHJUDWXLWH

,,7HPHGHED]FDUHWUHEXLHVXEOLQLDWHSHSDUFXUVXOWUDWDPHQWXOXL
(GXFDUHDSDFLHQWXOXLHVWHXQSURFHVFRQWLQXXGHDOXQJXOWHUDSLHL'XSvQWkOQLUHDLQLLDO
FXDFHVWDPHVDMHOHHGXFDLRQDOHWUHEXLHWUDQVPLVHFRQWLQXXLvQWULWH8UPWRDUHOHWHPHVXQW
FRQVLGHUDWHFDILLQGUHOHYDQWH
7LSXOLFXORDUHDPHGLFDPHQWHORUVROXLLORULQMHFWDELOH
&DQWLWDWHDLIUHFYHQDDGPLQLVWUULL
(IHFWHOHVHFXQGDUH
7UDWDPHQWXOGHFRQWLQXDUH
)UHFYHQD L LPSRUWDQD H[DPHQHORU GH VSXW L VHPQLILFDLD UH]XOWDWHORU
DFHVWRUD
&RQVHFLQHOH OXULL QXPDL XQXLD GLQWUH PHGLFDPHQWH VDX DOH RSULULL
WUDWDPHQWXOXL
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,,,&HHVWHGHVSXVVDXGHIFXWDWXQFLFkQG
3DFLHQWXOVHVLPWHPDLELQHLYUHDVvQWUHUXSWUDWDPHQWXO
7UHEXLH H[SOLFDW F VLPSWRPHOH VH SRW DPHOLRUD VHQVLELO vQ ID]D LQLLDO D WUDWDPHQWXOXL
SULPHOH VSWPkQL7RWXL GDF SDFLHQWXO QX FRQWLQX WUDWDPHQWXO vQ XUPWRDUHOH OXQL
XQLLEDFLOLWXEHUFXORLSRWVXSUDYLHXLLQGXFkQGUHFGHUHDLGH]YROWDUHDGHPLFURRUJDQLVPH
UH]LVWHQWHODPHGLFDLH&KLDUGDFSDFLHQWXOVHVLPWHPDLELQHHVWHLPSRUWDQWVLFRQWLQXH
WUDWDPHQWXO
8QSDFLHQWQRXYUHDVLLDPHGLFDLDDFDVIUVXSUDYHJKHUH
3XQHL vQWUHEUL SHQWUX D GHWHUPLQD FDX]HOH DFHVWHL GHFL]LL ([SOLFDL F PDMRULWDWHD
SDFLHQLORUQRXGLDJQRVWLFDLVXQWVSLWDOL]DLvQWLPSXOID]HLLQWHQVLYHDWUDWDPHQWXOXLSHQWUXD
SXWHDILPRQLWRUL]DLFXDWHQLH

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QWLPSXOID]HLGHFRQWLQXDUHGDFHVWHGLILFLOYHQLUHDODGLVSHQVDUvQWUHEDLGDFH[LVW
VSULMLQGLQSDUWHDIDPLOLHLIDGHWUDWDPHQW([SOLFDLFH[LVWRSROLWLFIHUPvQDLQVLVWDFD
WUDWDPHQWXOVILHPRQLWRUL]DWGLUHFW
3DFLHQWXO D OLSVLW GH OD WUDWDPHQW ]LOH vQ WLPSXO ID]HL GH FRQWLQXDUH D
RPLVGRXSUL]HGLQWUDWDPHQW
$IODL PRWLYHOH QFHUFDL V UH]ROYDL SUREOHPHOH $PLQWLLL DWkW SDFLHQWXOXL FkW L
DSDULQWRULORUSULQLORU GHVSUH QHFHVLWDWHD GH D OXD WRDWH GR]HOH SH GXUDWD WUDWDPHQWXOXL
5HFXSHUDLSUL]DSLHUGXW
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([SOLFDL QHFHVLWDWHD H[DPHQXOXL 6SXQHL DWkW SDFLHQWXOXL FkW L DSDULQWRULORUSULQLORU
FHVWHLPSRUWDQWVILPVLJXULFWUDWDPHQWXOSURJUHVHD]IDYRUDELO
0DPD FRSLOXOXL VSXQH F VRXO HL FDUH WXHWH QX DUH WLPS SHQWUX
LQYHVWLJDUHD7%
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SHQWUXHOVILHWHVWDWGHRDUHFHLDUSXWHDLQIHFWDLSHDOLLVDXDUSXWHDRUHLQIHFWDSHPDP
VDXSHFRSLO2IHULLYVOYL]LWDLSHVRVDXDUDQMDLFXXQFROHJVOYL]LWH]HLVLH[SOLFH
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2IHULLYVYRUELLFXIDPLOLDGHVSUH7%/LQLWLLIDPLOLDFRSLOXOQXHVWHFRQWDJLRVHO
ILLQGvQWUDWDPHQW([SOLFDLPRGXOGHWUDQVPLWHUHLPRGDOLWLOHGHSUHYHQLUHDOH7%
3DFLHQWXOVHVLPWHUXGLQFDX]DWUDWDPHQWXOXLLYUHDVvORSUHDVF
6WDELOLLGDFVLPSWRPHOHSDFLHQWXOXLVXQWFDX]DWHGHPHGLFDLDDQWL7%LGDFUHSUH]LQW
HIHFWHDGYHUVHPLQRUHVDXPDMRUHDOHDFHVWHLD'DFVXQWHIHFWHPDMRUHRSULLWUDWDPHQWXOL
WULPLWHL SDFLHQWXO OD '3) 'DF VXQW HIHFWH PLQRUH DMXWDLO DVWIHO vQFkW VL FRQWLQXH
WUDWDPHQWXO([SOLFDLSULQLORULPSRUWDQDWUDWDPHQWXOXLFRUHFW
3DFLHQWXOQXDUHPLMORDFHGHWUDQVSRUWSHQWUXDYHQLODGLVSHQVDU
$IODLPRWLYHOHQFHUFDLVFRQOXFUDLFXSDFLHQWXOSULQLLvQJVLUHDXQRUVROXLL&HUHL
VSULMLQXODXWRULWLORUORFDOHSHQWUXDUH]ROYDSUREOHPD

,93DFLHQWXOFX7%0'5
FHHVWH7%0'5
HGXFDLDLVXSRUWXOSVLKRORJLFDOSDFLHQWXOXL
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OLQLDD,,D
LPSRUWDQDSUHOHYULLVSXWHLOXQDU
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WUDWDPHQWXO
9 3DFLHQWXO FX 7% L +,9 LPSRUWDQD HIHFWXULL XQXL WUDWDPHQW FRUHFW L FRPSOHW
WXEHUFXOR]DILLQGRERDOFXUDELOvQOXQL

115
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352*5$08/8,
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,,QGLFDWRULGHHYDOXDUHDL3136&7
1. indicatori fizici:
QXPUXOSHUVRDQHORUH[DPLQDWHSHQWUXGHSLVWDUHDFD]XULORUGHLQIHFLHvPEROQYLUHGH
WXEHUFXOR] VXVSHFL VLPSWRPDWLFL FRQWDFL JUXSXUL FX ULVF FUHVFXW
SHUVRDQH
QXPU GH SHUVRDQH H[DPLQDWH FURUD OL VDX HIHFWXDW H[DPHQH UDGLRORJLFH
SHUVRDQH
QXPU GH SHUVRDQH H[DPLQDWH FURUD OL VDX HIHFWXDW H[DPHQH EDFWHULRORJLFH E.
SHUVRDQH
QXPU GH SHUVRDQH OD FDUH VD HIHFWXDW WHVW FXWDQDW OD WXEHUFXOLQ 7&7
SHUVRDQH
QXPUGHSHUVRDQHODFDUHVDHIHFWXDWWHVW,*5$4XDQWLIHURQ7%SHUVRDQH
QXPUXOGHSHUVRDQHODFDUHVDLQLLDWFKLPLRSURILOD[LD
QXPUXO SHUVRDQHORU LQIHFWDWH FX 7%'6 OD FDUH VD DGPLQLVWUDW WUDWDPHQW
SURILODFWLFSHUVRDQH
QXPU SHUVRDQH LQIHFWDWH FX 7%0;'5 OD FDUH VD DGPLQLVWUDW WUDWDPHQW
SURILODFWLFSHUVRDQH
QXPU DQFKHWH HSLGHPLRORJLFH HIHFWXDWH FD]XUL QRL L UHWUDWDPHQWH
QRWLILFDWH
QXPU EROQDYL 7% PRQLWRUL]DL SULQ H[DPHQH UDGLRORJLFH EROQDYL VH
HIHFWXHD]H[DPLQULUDGLRORJLFHEROQDY7%'6LH[DPLQULUDGLRORJLFHEROQDY
7%0;'5
QXPU EROQDYL 7% FURUD OL VDX HIHFWXDW H[ EDFWHULRORJLFHE.EROQDYLVH
HIHFXHD] H[DPLQUL EDFWHULRORJLFH E.EROQDY 7%'6 L H[DPLQUL
EDFWHULRORJLFHE.EROQDY7%0;'5
QXPUEROQDYL7%WUDWDL
QXPUEROQDYL7%WUDWDLDQ
QXPUEROQDYLFX7%0;'5vQID]DLQWHQVLYWUDWDLDQ
QXPUEROQDYLFX7%0;'5vQID]DGHFRQWLQXDUHWUDWDLDQ
2.indicatori de eficien:
FRVWPHGLXHVWLPDWH[DPHQUDGLRORJLFOHL
FRVW PHGLX HVWLPDW H[DPHQ EDFWHULRORJLF E. OHL PLFURVFRSLH L FXOWXU
FRQYHQLRQDO
FRVWPHGLXHVWLPDWDQWLELRJUDPVHULD,OHL
FRVWPHGLXHVWLPDWDQWLELRJUDPVHULHOXQJOHL
FRVWPHGLXHVWLPDWWUDWDPHQWFKLPLRSURILODFWLFSHUVRDQHLQIHFWDWHFX7%'6
OHLOXQ
FRVW PHGLX HVWLPDW WUDWDPHQW FKLPLRSURILODFWLF SHUVRDQH LQIHFWDWH FX 7%
0'5;'5OHLOXQ
FRVWPHGLXHVWLPDWWHVWFXWDQDWODWXEHUFXOLQ7&7OHL
FRVWPHGLXHVWLPDWWHVW,*5$4XDQWLIHURQ7%OHL
FRVWPHGLXHVWLPDWDQFKHWHSLGHPLRORJLFOHL
FRVWPHGLXHVWLPDWEROQDY7%WUDWDWDQOHLWHUDSLHVWDQGDUG
FRVWPHGLXHVWLPDWEROQDY7%WUDWDWDQOHL(675
FRVWPHGLXHVWLPDWEROQDY7%WUDWDWDQOHLUHJLP,,LQGLYLGXDOL]DW
FRVWPHGLXHVWLPDWEROQDYFX7%0;'5vQID]DLQWHQVLYWUDWDWOHL
FRVWPHGLXSDFLHQWFX7%0;'5vQID]DGHFRQWLQXDUHWUDWDWOHL

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3. indicatori de rezultat:
SURFHQWXO FD]XULORU QRL GH WXEHUFXOR] FX DQFKHW HSLGHPLRORJLF GLQ WRWDOXO
FD]XULORUQRLvQUHJLVWUDWH
SURFHQWXO SHUVRDQHORU FX FKLPLRSURILOD[LH GLQ FHOH FX LQGLFDLH SHQWUX
FKLPLRSURILOD[LH
SURFHQWXO WXWXURU FD]XULOH QRL GH 7% FRQILUPDWH EDFWHULRORJLF SOXV GLDJQRVWLFDWH
FOLQLFYLQGHFDWHVDXWUDWDPHQWFRPSOHWGLQWRDWHFD]XULOHQRL7%vQUHJLVWUDWH
SURFHQWXO WXWXURU FD]XULOH OD UHWUDWDPHQW GH 7% FRQILUPDWH EDFWHULRORJLF SOXV
GLDJQRVWLFDWH FOLQLF YLQGHFDWH VDX WUDWDPHQW FRPSOHW GLQ WRDWH FD]XULOH QRL 7%
vQUHJLVWUDWH

,,,QGLFDWRULHSLGHPLRPHWULFL
(YDOXDUHD HQGHPLHL GH 7% L D LPSDFWXOXL DSOLFULL 3URJUDPXOXL OD WRDWH QLYHOHOH '3)
MXGHHDQ VDX OD QLYHO QDLRQDO VH IDFH SULQ SUHOXFUDUHD GDWHORU WRWDO FD]XUL QRLUHFLGLYH SH
FRKRUWH GHEROQDYLFXDMXWRUXOXUPWRULORULQGLFDWRUL
Incidena global a TB
[
ar
ii
,QGLFDWRUXO VH SRDWH FDOFXOD L VHSDUDW SHQWUX FD]XUL QRL L UHFLGLYH incidena cazurilor
noi, UHVSHFWLYa recidivelor
rm

FRKRUW XQJUXSGHSDFLHQLvQUHJLVWUDLLGHFODUDLvQWURSHULRDGGHWLPSGDWWULPHVWUXDQFDUHXUPHD]DILHYDOXDLSHED]DXQRU
FULWHULLSUHVWDELOLWH
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'DFVHFDOFXOHD]incidena pe sexe, grupe de vrst, medii HWFQXPLWRUXOWUHEXLHVILH

HJDO FX QXPUXO GH ORFXLWRUL GLQ WHULWRULXO UHVSHFWLY GH DFHODL VH[ JUXS GH YkUVW VDX GLQ
PHGLXOSHQWUXFDUHVHFDOFXOHD]LQFLGHQD
Incidena cazurilor noi pulmonare pozitive la microscopie
QUFD]XULQRLFX7%SXOPSR]LWLYDODPLFURVFRSLH
=

QUORFXLWRULGLQWHULWRULXOUHVSHFWLYODLXOLHDDQXOXLUHVSHFWLY

$FHDVWLQFLGHQVHSRDWHFDOFXODLVSHFLILFSHVH[HLJUXSHGHYkUVWH
Incidena TB la copii
QUFD]XUL7%ODFRSLL DQL
=

QUFRSLL DQLGLQWHULWRULXOUHVSHFWLYODLXOLHDDQXOXLUHVSHFWLY

,QFLGHQD VH SRDWH UHFDOFXOD OD VIkULWXO DQXOXL XUPWRU H[FOX]kQG GLQ QXPUXO GH FD]XUL
QXPUXOGHLQILUPDLGLQFDWHJRULDUHVSHFWLYGHEROQDYL
1UFD]XUL PHQLQJLWD 7%
=

QU

FD]XUL

7%

OD

FRSLL
,QGLFHPHQLQJLWLFODFRSLL
Mortalitatea
QUGHFHVHSULQ7%


3UHYDOHQDSHULRGLF

QUEROQDYLDIODLvQHYLGHQvQSHULRDGDDQDOL]DW
[
=
QUORFXLWRULGLQWHULWRULXOUHVSHFWLY

3UHYDOHQDLQVWDQWDQHH
QUEROQDYLDIODWLLQWUDWDPHQWODXQPRPHQWGDW
=


=

117
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,,,,QGLFDWRULGHPRQLWRUL]DUHDL3136&7SULYLQGGLDJQRVWLFXO
QUFD]XULFX7%SXOPRQDUD0 +

QUFD]XULLQUHJLVWUDWHFX7%SXOPRQDUD
QUFD]XULFX7%SXOPRQDUD & +

QUFD]XULLQUHJLVWUD WHFX7%SXOPRQDUD
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Rata de depistare a cazurilor TB noi pulmonare microscopic pozitive din cazurile

suspecte examinate
=
QUFD]XULQRL SXOPRQDUHSR]LWLYHODPLFURVFRSLHGHSLVWDWH[
QUFD]XULVXVSHFWHH[DPLQDWH
3URFHQWXO FD]XULORU GHSLVWDWH FX 7% WUHEXLH V ILH PDL PDUH GH GLQ FD]XULOH VXVSHFWH
H[DPLQDWH
Rata de depistare a cazurilor TB din numrul estimat de astfel de cazuri existente n
teritoriu indicator calculat de OMS i apare n Raportul anual global de control al
tuberculozei
= QUFD]XUL7%GHSLVWDWH[
QUHVWLPDWFD]XUL7%H[LVWHQWHvQWHULWRULX
,QGLFDWRUXO LOXVWUHD] FRPSRQHQWD XQXL SURJUDP GH FRQWURO DO 7% GH GHSLVWDUH D FD]XULORU
9DORDUHDVDHGHGRULWVILHPDLPDUHGH
Rata de confirmare bacteriologic a cazurilor pulmonare:
in
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,QGLFDWRUXOVHSRDWHFDOFXODJOREDOSHQWUXWRDWHFD]XULOHFX7%SXOPRQDUvQUHJLVWUDWHVDX
VHSDUDWSHQWUXFD]XULQRLLUHFLGLYHUDWDGHFRQILUPDUHDFD]XULORUSXOPRQDUHQRLUHVSHFWLYD
UHFLGLYHORUSXOPRQDUHSULQPLFURVFRSLHVDXSULQFXOWXU
us
iv
QFHQWUHOHvQFDUHGLDJQRVWLFXOEDFWHULRORJLFHVWHFRUHVSXQ]WRUSURSRULDFD]XULORUSR]LWLYH
vQPLFURVFRSLHUDSRUWDWODWRDWHFD]XULOHSXOPRQDUHHVWHSHVWH
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Proporia cazurilor noi pulmonare pozitive la microscopie din toate cazurile noi
pulmonare i extrapulmonare
QUFD]XULQRLSXOPRQDUH0
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Monitorul Oficial R.A., Str. Parcului nr. 65, sectorul 1, Bucureti; C.I.F. RO427282,

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Tiparul: Monitorul Oficial R.A.

Monitorul Oficial alRomniei, Partea I, nr. 748 bis/7.X.2015 conine 122 de pagini.
Preul: 61 lei
Acest numr al Monitorului Oficial al Romniei a fost tiprit n afara abonamentului.
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0748 Bis

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Miercuri, 7 octombrie 2015

LEGI, DECRETE, HOTRRI I ALTE ACTE

Anexa la Ordinul ministrului sntii nr. 1.171/2015 pentru

Anul 183 (XXVII) Nr. 748 bis

MONITORUL OFICIAL AL ROMNIEI, PARTEA I, Nr. 748 bis/7.X.2015

ACTE ALE ORGANELOR DE SPECIALITATE

Vznd Referatul de aprobare nr. N.B. 9.550/2015 al Ageniei naionale

ministrul sntii emite urmtorul ordin:

Art. 1. Se aprob Ghidul metodologic de implementare a Programului

Bucureti, 21 septembrie 2015.

MONITORUL OFICIAL AL ROMNIEI, PARTEA I, Nr. 748 bis/7.X.2015

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MONITORUL OFICIAL AL ROMNIEI, PARTEA I, Nr. 748 bis/7.X.2015

MONITORUL OFICIAL AL ROMNIEI, PARTEA I, Nr. 748 bis/7.X.2015

MONITORUL OFICIAL AL ROMNIEI, PARTEA I, Nr. 748 bis/7.X.2015

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MONITORUL OFICIAL AL ROMNIEI, PARTEA I, Nr. 748 bis/7.X.2015

MONITORUL OFICIAL AL ROMNIEI, PARTEA I, Nr. 748 bis/7.X.2015

MONITORUL OFICIAL AL ROMNIEI, PARTEA I, Nr. 748 bis/7.X.2015

MONITORUL OFICIAL AL ROMNIEI, PARTEA I, Nr. 748 bis/7.X.2015

MONITORUL OFICIAL AL ROMNIEI, PARTEA I, Nr. 748 bis/7.X.2015

MONITORUL OFICIAL AL ROMNIEI, PARTEA I, Nr. 748 bis/7.X.2015

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