National Standard Treatment Guidelines for the Primary Level, 2013

255 Pages·2013·1.34 MB·English

Islamic Republic of Afghanistan
Ministry of Public Health
General Directorate of Pharmaceutical Affairs
National Standard
Treatment Guidelines
for the Primary Level
may 2013
CoNteNtS
Foreword ..................................................ix
Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi
Acknowledgments .......................................xiii
How to Use This Guideline ..............................xix
Acronyms and Abbreviations ...........................xxii
Glossary ................................................. xxv
Chapter 1. Dental and Oral Conditions ................ 41
Chapter 2. Digestive System Conditions ...............46
2.1. Diarrhea and Dehydration ........................... 46
2.1.1. Acute Diarrhea, without Blood, in Children
Younger Than 5 Years ................................ 46
2.1.2. Acute Diarrhea, without Blood, in Children
Older Than 5 Years and in Adults .....................53
2.1.3. Persistent Diarrhea, without Blood,
in Children Younger Than 5 Years ................... 54
2.1.4. Persistent Diarrhea in Children Older Than
5 Years and in Adults ..................................56
2.1.5. Dysentery .........................................56
2.1.5.1. Dysentery, Bacillary. . . . . . . . . . . . . . . . . . . . . . . . .56
Copyright ©2013 Ministry of Public Health,
General Directorate of Pharmaceutical Affairs 2.1.5.2. Dysentery, Amebic ..........................58
2.1.6. Giardiasis .........................................59
This publication is made possible by the generous support of the American
2.1.7. Cholera ........................................... 60
people through the U.S. Agency for International Development (USAID),
under the terms of cooperative agreement number 306-A-00-11-00532-00. 2.2. Peptic Ulcer Disease ................................. 62
The contents are the responsibility of Ministry of Public Health of the Islamic
Chapter 3. Respiratory System Conditions ............65
Republic of Afghanistan with the technical support of Management Sciences
for Health and the World Health Organization Eastern Mediterranean 3.1. Asthma ................................................65
Regional Office and do not reflect necessarily the views of USAID or the 3.1.1. Asthma in Children ...............................65
United States Government.
3.1.2. Asthma in Adults ................................ 68
About SPS 3.2. Common Cold and Flu ................................71
The Strengthening Pharmaceutical Systems (SPS) Program strives to build 3.3. Pneumonia in Children and Adults ...................73
capacity within developing countries to effectively manage all aspects of
3.3.1. Pneumonia in Children Younger Than 5 Years ...74
pharmaceutical systems and services. SPS focuses on improving governance
in the pharmaceutical sector, strengthening pharmaceutical management 3.3.2. Pneumonia in Children Older Than 5 Years
systems and financing mechanisms, containing antimicrobial resistance, and and in Adults ..........................................78
enhancing access to the most efficacious, safe and cost-effective medicines
3.4. Chronic Obstructive Pulmonary Disease .............81
and appropriate use of medicines.
NAtIoNAl StANDARD tReAtMeNt GuIDelINeS foR tHe PRIMAR y level iii
C ontents C ontents
Chapter 4. Ear, Nose, and Throat Conditions ..........84 9.5. Abortion (Vaginal Bleeding in Early Pregnancy) ... 156
4.1. Otitis Externa ........................................ 84 9.6. Ectopic Pregnancy .................................. 163
4.2. Acute Otitis Media ....................................87 9.7. Preterm Labor .......................................164
4.2.1. Acute Otitis Media in Children Younger 9.8. Delivery and Postpartum Care ......................166
Than 5 Years ......................................... 88 9.9. Postpartum Hemorrhage ........................... 172
4.2.2. Acute Otitis Media in Children Older Than 5 Years 9.10. Newborn Care ..................................... 176
and in Adults ......................................... 90 9.11. Cracked Nipples during Breastfeeding ............184
4.3. Chronic Otitis Media .................................91 9.12. Mastitis and Breast Abscess ....................... 187
4.4. Acute Sinusitis ....................................... 92 9.12.1. Mastitis ........................................ 187
4.5. Sore Throat .......................................... 94 9.12.2. Breast Abscess ................................188
4.5.1. Viral Pharyngitis ................................. 94 9.13. Dysmenorrhea .....................................189
4.5.2. Bacterial Tonsillitis ..............................96 9.14. Abnormal Vaginal Bleeding .........................191
4.6. Rhinitis .............................................. 98 9.15. Postmenopausal Bleeding ......................... 193
Chapter 5. Eye Conditions ...........................100 9.16. Pelvic Inflammatory Disease ...................... 195
5.1. Conjunctivitis (Red Eye) ............................100 9.17. Infertility ...........................................198
5.2. Trachoma ...........................................103 Chapter 10. Nutritional and Blood Conditions ........201
5.3. Glaucoma ...........................................105 10.1. Anemia .............................................201
Chapter 6. Cardiovascular System Conditions ........107 10.2. Thalassemia .......................................207
6.1. Systemic Hypertension .............................107 10.3. Malnutrition and Under-Nutrition ................208
6.1.1. Chronic Hypertension ..........................107 10.4. Vitamin A Deficiency ..............................212
6.1.2. Hypertension Emergency .......................113 10.5. Vitamin D Deficiency and Rickets .................217
6.2. Cardiac Failure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .114 10.6. Iodine Deficiency ..................................219
6.3. Rheumatic Fever .....................................117 Chapter 11. Urinary Tract and Renal Conditions .......220
6.4. Angina Pectoris ......................................121 11.1. Urinary Tract Infection ............................220
6.5. Acute Myocardial Infarction ........................123 11.1.1. Acute Pyelonephritis ..........................220
Chapter 7. Central Nervous System Disorders ........126 11.1.2. Cystitis and Urethritis .........................222
7.1. Epilepsy .............................................126 11.2. Acute Glomerulonephritis .........................224
7.2. Encephalitis and Meningitis ........................130 Chapter 12. Endocrine System Disorders .............226
Chapter 8. Mental Health Conditions ................ 135 12.1. Diabetes Mellitus ..................................226
12.2. Hyperglycemia and Ketoacidosis ..................231
Chapter 9. Obstetrics and Gynecological Conditions ..143
9.1. Pregnancy and Antenatal Care ......................143 Chapter 13. Skin Conditions .........................234
9.2. Anemia in Pregnancy ...............................149 13.1. Impetigo ............................................234
9.3. Hypertension Disorders of Pregnancy ...............151 13.2. Fungal Skin Infection and Napkin (Diaper) Rash .236
9.4. Antepartum Hemorrhage ...........................154 13.3. Furunculosis .......................................239
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C ontents C ontents
13.4. Sycosis .............................................241 16.2.2. Acute Appendicitis ............................330
13.5. Urticaria ...........................................243 16.2.3. Acute Cholecystitis ............................ 331
13.6. Pediculosis .........................................245 16.2.4. Perforated Peptic Ulcer .......................332
13.7. Scabies .............................................247 16.2.5. Bowel Obstruction ............................332
Chapter 14. Musculoskeletal Conditions .............251 16.2.6. Ruptured Ectopic Gestation ..................333
14.1. Arthritis and Arthralgia ............................ 251 16.2.7. Ureteric Colic ..................................334
14.2. Osteomyelitis ......................................256 16.3. Animal and Human Bites ..........................335
16.4. Insect Bites and Stings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 340
Chapter 15. Infectious Diseases, Parasitic Diseases,
16.4.1. Wasp and Bee Stings ...........................340
and Helminthic Infestations .........................259
16.4.2. Scorpion Stings ................................342
15.1. Pertussis (Whooping Cough) ......................259
16.4.3. Spider Bites ....................................343
15.2. Diphtheria .........................................261
16.5. Snake Bites .........................................345
15.3. Tetanus ............................................263
16.6. Burns ...............................................348
15.4. Poliomyelitis .......................................267
16.7. Eye Injuries (Trauma, Foreign Bodies,
15.5. Measles ............................................268
and Burns) .............................................355
15.6. Sepsis ..............................................272
16.8. Hypoglycemia ......................................360
15.7. Malaria .............................................274
16.9. Shock ...............................................363
15.7.1. First-Line Therapies ...........................277
16.10. Dislocation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 373
15.7.2. Second-Line Therapies ........................281
16.11. Abscess ...........................................373
15.8. Hepatitis ...........................................284
16.12. Poisoning .........................................377
15.9. Typhoid (Enteric) Fever ...........................287
15.10. Tuberculosis ......................................290 Chapter 17. Signs and Symptoms .....................390
15.11. Chickenpox .......................................300 17.1. Febrile Convulsion .................................390
15.12. Rabies .............................................302 17.2. Cough ..............................................394
15.13. Leishmaniasis ....................................304 17.3. Fever ...............................................397
15.14. Ascariasis (Roundworm) .........................306 17.4. Headache and Migraine ............................401
15.15. Taenia Saginata and Hymenolepis Nana 17.4.1. Headache ......................................401
(Tapeworm) ...........................................308 17.4.2. Migraine .......................................403
15.16. Anthrax ...........................................310 17.5. Jaundice. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 404
15.17. Brucellosis .........................................311 17.6. Chest Pain ..........................................407
15.18. Mumps ............................................ 313 17.7. Constipation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .411
15.19. Sexually Transmitted Infections ................. 315 17.8. Nausea and Vomiting ..............................413
Chapter 16. Emergencies And Trauma ................322 Chapter 18. Family Planning for Birth Spacing ........417
16.1. Acute Pulmonary Edema ..........................322 18.1. Preparing to Use a Family Planning Method ......417
16.2. Acute Abdominal Pain .............................323 18.2. Family Planning Options Available
16.2.1. Acute Peritonitis ..............................329 in Afghanistan .........................................421
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Contents
18.2.1. Condoms (Male) ...............................421 foRewoRD
18.2.2. Combined Oral Contraceptive Pills ...........422
18.2.3. Progestin-Only Pill ............................425 The Ministry of Public Health (MoPH) of the Islamic
18.2.4. Progestin-Only Injectables ...................427 Republic of Afghanistan is very pleased to present the first
18.2.5. Intrauterine Device ...........................428 edition of the National Standard Treatment Guidelines
18.2.6. Lactational Amenorrhea Method .............429 for Primary Level (NSTG-PL) 2013/1391. The NSTG-PL
18.2.7. Fertility Awareness Methods ..................430 reflects the recommended state-of-the-art treatments
18.2.8. Withdrawal Method (Coitus Interruptus) ....432 for the priority health conditions addressed by the Basic
18.2.9. Spermicides ...................................433 Package of Health Services (BPHS). The BPHS continues
Chapter 19. Immunization ...........................435 to serve as the foundation of the Afghan health system
and remains the key instrument in making sure that
Chapter 20. HIV Infection and AIDS .................439
the most important and effective health interventions
Annexes ............................................443
are made accessible to all Afghans. Afghanistan is a
Annex A. Medicine Dosages and Regimens .............443
country with limited resources, and the MoPH believes
Annex B. Newborn Resuscitation .......................459
that by continuing to focus on a BPHS, it will be able
Annex C. Partograph and Delivery Note ................461
to concentrate its resources on reducing mortality
Annex D. References ....................................462
among its most vulnerable citizens, especially women of
Annex E. Procedure to Apply for Modification of the
reproductive age and children under five years of age.
NSTG-PL by the MoPH of Afghanistan ...............466
Providing essential medicines is a cornerstone of the
Indexes .............................................473
BPHS, and the NSTG-PL will be a key instrument in
guiding all health workers at the primary level to use the
most efficient treatment for the conditions included in the
guidelines, thus promoting the rational use of medicines.
Where possible, the NSTG-PL refers to or uses standard
treatment protocols previously developed by various
MoPH programs.
The first edition of the NSTG-PL is the result of the
efforts and dedication of many. The MoPH, through the
General Directorate of Pharmaceutical Affairs, conducted
a medicines use study survey in 2009 and, based on the
results, asked experts in the areas of pharmaceutical
and clinical practice to form the Standard Treatment
Guidelines (STG) Working Group. Based on the past
experience of developing the essential drugs list, the
viii NAtIoNAl StANDARD tReAtMeNt GuIDelINeS foR tHe PRIMAR y level NAtIoNAl StANDARD tReAtMeNt GuIDelINeS foR tHe PRIMAR y level ix
STG Working Group consulted as widely as possible INtRoDuCtIoN
with departments in the MoPH, as well as with national
and international experts. We would like to take this This national standard treatment guidelines (STGs)
opportunity to thank all writers, technical reviewers, manual is designed for use at the first-level (i.e., primary)
contributors, and editors who participated in the facilities delivering the Basic Package of Health Services
tremendous effort of developing the NSTG-PL. Our special (BPHS). The guidelines can also be used by general
appreciation goes to sustained technical and financial practitioners in their private practice.
support provided by the Strengthening Pharmaceutical
The set of conditions included is not exhaustive, but rather
Systems project, funded by the United States Agency for
is based on the conditions recommended for management
International Development, and to technical support
and treatment in the BPHS. Likewise, recommended
provided by World Health Organization.
pharmaceutical treatments are primarily limited to the
This is a dynamic document that will regularly be updated medicines recommended in the BPHS (2010) and the
to reflect the state of the art in treatment at the primary essential drug list (2007).
level. We, therefore, welcome constructive comments on
The elaboration of the manual was a participatory effort
the usefulness and the acceptability of this first version,
between the STG Working Group and various medical and
which will guide us in keeping the guidelines updated with
paramedical professionals who volunteered their time and
the new developments in health care.
expertise.
We strongly encourage all health care providers in the
The manual was conceived to address, in the most
public and the private sectors to use the NSTG-PL, thus
practical way possible, the problems faced by clinical staff
promoting the access to affordable health care for all in
at the first-level facilities. The references used are the
Afghanistan.
existing MoPH guidelines for specific conditions, WHO
references when MoPH guidelines were insufficient, and
specialized works when deemed necessary. (See annex D.)
Despite all efforts, it is possible that certain errors have
been overlooked, or some therapeutic approaches are
Dr. Suraya Dalil
incomplete, and the authors would be grateful to have any
Minister of Public Health
such error or incompleteness reported. To this end, an
Kabul, Afghanistan
example of an STG modification form has been included
in annex E. See page xii for where to send changes.
Although we hope the manual will be a useful guide to
many prescribers, it is important to remember that, when
in doubt, it remains the responsibility of the prescribing
medical professional to ensure that the active substances
and doses prescribed correspond with the therapeutic
x NAtIoNAl StANDARD tReAtMeNt GuIDelINeS foR tHe PRIMAR y level NAtIoNAl StANDARD tReAtMeNt GuIDelINeS foR tHe PRIMAR y level xi
need of the patient and conform to the manufacturer’s ACkNowleDGMeNtS
specifications. Please send any identified errors or other
comments that may help improve future version of this The first National Standard Treatment Guideline for the
manual to the following address: Primary Level in Afghanistan is the result of national
and international efforts coordinated by the Standard
Ministry of Public Health
Treatment Guideline (STG) Working Group members
General Directorate of Pharmaceutical Affairs (GDPA)
from the Ministry of Public Health; Kabul Medical
STG Working Group
University, Faculty of Pharmacy; the Afghanistan
Kabul, Afghanistan
Physicians Association, the Strengthening Pharmaceutical
An electronic copy of the STG modification form may be
Systems (SPS) project funded by United States Agency for
sent to the following e-mail addresses:
International Development (USAID), the Health Sector
E-mail: [email protected] Support Project (HSSP) funded by USAID, and World
Phone: [phone] Health Organization.
OR The development of these STGs would not have been
E-mail: mailto:[email protected] possible without the full support of the Afghan health
Phone: [phone] authorities and the many Afghan health professionals
The manual is also available on the MoPH website: whose comments enriched this document. The STG
www.moph.gov.af/. Users are encouraged to check the Working Group thanks the MoPH; Kabul Medical
copy on the website for updates on this edition. University, Faculty of Pharmacy; WHO, the Afghanistan
Physicians Association and all the writers, reviewers
and contributors who have actively contributed to
the production of this National Standard Treatment
Guidelines for the Primary Level. Special appreciation
Pharmacist Abdul Hafiz “Quraishi” goes to the Strengthening Pharmaceutical Systems (SPS)
General Director of Pharmaceutical Affairs project funded by USAID for its technical and financial
Ministry of Public Health support throughout the development process of this
important guideline.
STG Working Group
n Dr. M. Rafi Rahmani, MD, Professor in the
Pharmacology Department, Kabul Medical University,
Head of the Committee
n Abdul Zahir Siddiqui, Pharmaceutical Services and
Field Coordination Program Manager, SPS
n Dr. Abdul Samad Omar, MD, Associate Professor and
Surgeon, Aliabad Teaching Hospital
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acknowledgments acknowledgments
n Dr. M. Amin Asghari, MD, Clinical Professor and Head de Formation Specialisée Approfondie–Paris (AFSA
of the Internal Medicine Ward, Wazir Akbar Khan Paris), Sardar M. Dawood Khan Hospital
Hospital (WAKH) n Dr. Ahmad Shah Wazir, MD, Chief of the Burn Center,
n Dr. Paul Ickx, MD, Senior Principal Technical Advisor, Isteqlal Hospital
Center for Health Services (CHS), MSH n Dr. Malali Alami, MD, Obstetrics/Gynecology Trainer
n Dr. M. Fayaz Safi, MD, Associate Professor, Afghanistan Specialist, Rabia Balkhi Hospital
Physicians Association n Dr. Bashir Ahmad Sarwari, MD, Psychiatrist and
n M. Hasan Frotan, Associate Professor and Lecturer, Director of Mental Health and Substances Abuse
Faculty of Pharmacy, Kabul University Department, MoPH
n Haji M. Naimi, Professor and Lecturer, Faculty of n Dr. Motawali Younusi MD, Integrated Management
Pharmacy, Kabul University of Childhood Illness, Child and Adolescent Health
n Dr. Tawfiq Mashaal, MD, Director for Preventive and Department, MoPH
Health Care, MoPH n Dr. Najibullah Tawhidwal, MD, Ear Nose and Throat
n Dr. Ahmad Shah Pardis, MD, National Professional Trainer Specialist, Ibn-e -Sina Emergency Hospital
Officer, WHO n Dr. Sohaila Ziaee, MD, Reproductive Health
n Dr. Safiullah Nadeeb, MD, National Professional Officer, Department, MoPH
WHO n Dr. Nooria Atta, MD, Lecturer, Kabul Medical University
n Dr. Mohammad Alem Asem, MD, General Directorate of n Dr. Hasibullah Mohammadi, MD, Internal Medicine
the Health Care Unit, MoPH Specialist, WAKH
n Dr. Ahmad Shah Noorzada, MD, Training and n Dr. Hamida Hamid, MD, National Malaria and
Performance Manager, HSSP Leishmania Control Program, MoPH
Writers n Dr. Khalilullah Hamdard, MD, Internal Medicine
Trainer Specialist, Isteqlal Hospital
n Dr. Katayon Sadat, MD, Obstetrics/Gynecology
Specialist, Malalai Hospital n Dr. Atiqullah Halimi, MD, Children Specialist, Indira
Gandhi Child Health Hospital
n Dr. Homa Kabiri, MD, Obstetrics/Gynecology Specialist,
Malalai Hospital n Dr. Mirwais Saleh, MD, PGD, DO, Eye Specialist and
Trainer, Eye Teaching Hospital
n Dr. Sultan Najib Dabiry, MD, Assistant Clinical
Professor of Dermatology and Trainer Specialist, Ibn-e- n Dr. Roqia Naser, MD, Expanded Programme on
Immunization Department, MoPH
Sina Emergency Hospital
n Dr. M. Nazir Sherzai, MD, MS, Assistant Professor of n Dr. M. Najib Roshan, MD, Eye Specialist, Noor Eye
Hospital
Orthopedic and General Director, Sardar M. Dawood
Khan Hospital n Dr. Anisa Ezat, MD, Dental Surgeon Specialist,
Stomatology Hospital
n Dr. Yaqub Noorzai, MD, MS, PGD, Professor of
Urology and General Surgery Specialist, Attestation n Dr. Ajmal Yadgari, MD, National Tuberculosis Control
Program, MoPH
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acknowledgments acknowledgments
n Dr. Assadullah Safi, MD, Neurosurgeon and Trainer, Technical Reviewers of Monographs
Ibn-e-Sina Emergency Hospital n Dr. M. Rafi Rahmani, MD, Professor in the
n Dr. Abdul Wali Wali, MD, Associate Professor of the Pharmacology Department, Kabul Medical University
Pediatrics Department, Maiwand Teaching Hospital n Dr. Abdul Samad Omar, MD, Associate Professor and
n Dr. M. Wali Karimi, MD, Ear Nose and Throat Specialist, Surgeon, Aliabad Teaching Hospital
Maiwand Teaching Hospital n Dr. M. Amin Asghari, MD, Clinical Professor and Head
n Dr. Abdul Hai Wali, MD, Dermatologist of Maiwand of the Internal Medicine Ward, WAKH
Teaching Hospital n Dr. William Holmes, SPS Consultant
n Dr. Samarudin, MD, HIV Department, MoPH n Dr. Paul Ickx, MD, Senior Principal Technical Advisor,
n Dr. Shaista Koshan, MD, Nutrition Department, MoPH CHS, MSH
n Dr. Ruhullah Zaheer, MD, Clinical Professor, Internal Technical Reviewers of Final Draft (Quick Reviewers)
Medicine Specialist, Isteqlal Hospital
n Mohammad. Nowrooz Haqmal, MD, DPH, MBA, District
n Dr. Zabiullah Azizi, MD, Internal Medicine Specialist, Health System Support Project Manager, MoPH
Sardar M. Dawood Khan Hospital
n Dr. Hamidullah Habibi, MD, National Consultant to
n Dr. Sultan M. Naji, MD, Surgeon Specialist and Trainer, Provincial Liaison Directorate, MoPH
Ibn-e-Sina Chest Hospital
n Dr. M. Yasin Rahimyar, Technical Deputy Director, Care
n Dr. Bismellah Nejrabi, MD, Professor of Orthopedic of Afghan Families
Surgery and Lecturer, Kabul Medical University
n Dr. Jawid Omar Senior, Contract Consultant, Grant
n Dr. Gul Aqa Wader, MD, Internal Medicine Specialist Contract Management Unit
and Trainer, Ibn-e-Sina Emergency Hospital
n Dr. Laurence Laumonier-Ickx, MD, Senior Principal
n Dr. M. Sadiq Naimi, MD, Internal Medicine Specialist, Technical Advisor, CHS, MSH
Antani Hospital
n Yakoub Aden Abdi, MD, PhD, WHO
n Dr. Habibullah Raghbat, MD, Internal Medicine n Professor, Dr. Ahmad Farid Danish, MD, Pharmacology
Specialist, Ibn-e-Sina Chest Hospital
Department, Kabul Medical University
n Dr. Seddiq Faizi, MD, Children Specialist, Indira Gandhi
Contributors
Child Health Hospital
n Dr. Mirwais Norani Safi, MD, Surgeon Specialist, Wazir n Mohammad Zafar Omari, SPS
Akbar Khan Hospital (WAKH) n Pharmacist Aisha Noorzaee, General Directorate of
Pharmaceutical Affairs (GDPA)/Avicenna Pharmacy
n Dr. Abdulhaq Qiam, MD, Internal Medicine Specialist,
Institute (API)
Diploma in Child Health, Ataturk Hospital
n Dr. M. Jawid Shahab, MD, Surgeon and Urology n Assistant Professor Jawid Onib, Faculty of Pharmacy
Kabul University
Specialist, Jamhoriat Hospital
n Dr. Rafiullah Ahmadzai, MD, Children Specialist, Indira n Mark Morris, SPS
Gandhi Child Health Hospital n Pharmacist Lutfullah Ehsaas, SPS
n Niranjan Konduri, SPS
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acknowledgments
n Dr. Nadir Arab, MoPH How to uSe tHIS GuIDelINe
n Pharmacist Zakia Aadil, GDPA/API
n Pharmacist Fahima Habib, GDPA/API The National Standard Treatment Guidelines for the
n Dr. Bahram Sadat, Dental Specialist, Stomatology Hospital Primary Level serves as a reference treatment guide for
n Pharmacist Aziza Habib, WHO delivering the Basic Package of Health Services (BPHS)
n Terry Green, SPS in the primary health care facilities in Afghanistan. It is
n Dr. Ibne Amin Khalid, MoPH important that you become familiar with the content and
n Pharmacist Nahid Ayubi, SPS layout of the manual to use standard treatment guidelines
n Dr. Noor Safi, MoPH (STGs) effectively.
n Dr. Habibullah Habib, National Tuberculosis Control The conditions included in these STGs have been selected
Program, MoPH
among the BPHS and common diseases in Afghanistan
n Dr. Faridullah Omary, National Malaria Program, MoPH seen at the primary health care level facilities from
n Dr. Faiz M. Delawer, National Tuberculosis Control sub–health centers up to the district hospitals. The
Program, MoPH
medicines recommended for use are all included in the
n Dr. Nasir Orya, SPS essential drugs list for facilities of primary level. The 20
n Pharmacist Khan Aqa Karim Ghazi, GDPA chapters are presented according to the organ systems
n Dr. William Holmes, SPS of the body; a common format has been adopted for each
n Dr. Khalid Amini, SPS condition: brief description; diagnosis with the common
n Pharmacist Shakila Amarkhil, GDPA/API signs and symptoms of the condition; management that
n Pharmacist Khalilullah Khakzad, GDPA/API includes objectives, nonpharmacologic management, and
n Pharmacist Nazir Haiderzad, GDPA pharmacologic management; prevention; and instructions
Editorial Committee: to the patient. The instructions to the patient, especially in
n Dr. Laurence Laumonier-Ickx, MD, Senior Principal chronic conditions, aims at helping health care providers
Technical Advisor, CHS, MSH to improve patient compliance and health generally.
n Dr. M. Rafi Rahmani, MD, Professor in the Pharmacology When appropriate, a guideline also makes provision for
Department, Kabul Medical University referral of patients to higher level health facilities when
n Dr. Paul Ickx, MD, Senior Principal Technical Advisor, equipment, medicines available, and staff do not permit
CHS, MSH proper treatment at the actual level. A distinction is made
n Abdul Zahir Siddiqui, Pharmaceutical Services and Field between the terms refer, which indicates routine referral,
Coordination Program Manager, SPS and refer urgently, which designates conditions that
require immediate action; for the latter, the patient must
Editors of the English Version:
be stabilized, and immediate transportation must be
n Laurie B. Hall, Managing Editor, Center for
arranged.
Pharmaceutical Management, MSH
n Marilyn K. Nelson, writer/editor
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