Guidelines
46 entriesNDoH Primary Healthcare STG
- A Guide to Patient Adherence in Chronic ConditionsA Guide to Patient adherence in Chronic Conditions→
- AbbreviationsAbbreviations→
- Abdominal PainDescription Medicine Treatment Referral ICD-10 code: R10.0-4 DESCRIPTION Abdominal pain is a common symptom, which may be non-specific. It is frequently benign, but may indicate a serious acute pathology. A thorough evaluation is necessary to exclude a surgical abdomen or other serious conditions. The history should include: duration, location, type, radiation and severity of pain. relieving→
- AcknowledgementsAcknowledgements→
- Acne VulgarisAcne Vulgaris→
- Acute Asthma & Acute Exacerbation of COPD, AdultsDescription Medicine Treatment Referral J46/J45.0-1/J45.8-9 DESCRIPTION This is an emergency situation recognised by various combinations of: Wheeze Tightness of the chest Chest indrawing Breathlessness Respiratory distress Cough In adults, bronchospasm is usually associated with asthma (where the bronchospasm is usually completely reversible) or chronic obstructive pulmonary disease (COPD) (wher→
- Acute Asthma, ChildrenDescription Medicine Treatment Referral J46/J45.0-1/J45.8-9 DESCRIPTION Bronchospasm in children is usually associated with asthma or with infections such as bronchiolitis or bronchopneumonia. Consider foreign bodies or obstruction of airways due to tuberculous nodes or congenital malformation, especially if the wheeze is unilateral. Recognition and assessment of severity of attacks in children &→
- Acute Bronchiolitis in ChildrenAcute Bronchiolitis in Children→
- Acute Bronchitis in Adults or AdolescentsRespiratory Infections→
- Acute Exacerbation Of Chronic Obstructive Pulmonary Disease (COPD)Respiratory Infections→
- Acute Kidney InjuryAcute Kidney Injury→
- Acute MeningitisMeningitis→
- Acute PainPlease click on the link below to access the most up-to-date version of this guideline. The content on this page is currently being updated to align with the latest publication. Always check the version number at the bottom of the screen to confirm which version you are using. Click here to access the Primary_Healthcare_Chapter_20_Pain_with_supporting_NEMLC_Report_2025-9_Review_Version_1.0_(26_Fe→
- Acute and Transient Psychotic DisordersDescription General Measures Medicine Treatment Referral ICD-10 code: F23.0-F23.9/F24/F28/F29 + (F10.0-F19.9/R45.0-8/Z65.0-5/Z65.8-9/Z81.0-4/Z81.8) Description Sudden onset of ≥ 1 psychotic symptoms (usually delusions, hallucinations, or disorganised thinking) which resolves spontaneously, usually within 1 month, with a full return to premorbid social or occupational functioning. Stressful→
- Adverse Events Following Immunisation (AEFI)Report all AEFIs to the local EPI Coordinator. AEFI form may be accessed at: https://www.nicd.ac.za/diseases-a-z-index/adverse event-following-immunization-aefi/ and https://www.sahpra.org.za/health-products vigilance/ . AEFI forms should be emailed to AEFI@health.gov.za Alternatively, AEFI can be reported on the MedSafety application on a mobile device. Search for “ Medsafety ” on apple st→
- Aggressive Disruptive Behaviour in AdultsDescription General Measures Medicine Treatment Referral ICD-10 code: R45.1/R45.4-6 Description Agitation may escalate to overt aggression and often manifests with restlessness, pacing, and loud or demanding speech. Aggressive behaviour includes verbally abusive language, specific verbal threats, intimidating physical behaviour, and/or actual physical violence to self, others, or property. All ag→
- Aggressive Disruptive Behaviour in Children and AdolescentsGeneral measures Medicine Treatment ICD-10 code: R45.1/R45.4-6 As with adults, agitation among children and adolescents may escalate to overt aggression and violence. However, aggression may also occur suddenly, without warning signs, particularly in children with neurodevelopmental conditions such as intellectual disability and autism spectrum disorder. All children and adolescents should be tre→
- AlbinismAlbinism→
- Alcohol Withdrawal (Uncomplicated)Description General measures Medicine treatment Referral ICD-10 code: F10.3 Description A syndrome characterised by central nervous system hyperactivity that occurs when an alcohol dependent individual abruptly stops, or significantly reduces, alcohol consumption. The symptoms of complicated alcohol withdrawal syndrome, requiring referral, include: Autonomic: sweating, tachycardia, hypertension,→
- Allergic RhinitisEar, Nose and Throat Conditions→
- AnaemiaDescription Diagnosis Referral DESCRIPTION A condition characterised by low haemoglobin (Hb), clinically recognised by pallor, tiredness, shortness of breath. It is commonly caused by: Nutritional deficiency of iron or folate or vitamin B 12 . Chronic systemic diseases such as HIV, TB, malignancy. Blood loss (bleeding/haemorrhage) e.g. caused by parasites, ulcers, tumours, abnormal menstruation.→
- AnaemiaPlease click on the link below to access the most up-to-date version of this guideline. The content on this page is currently being updated to align with the latest publication. Always check the version number at the bottom of the screen to confirm which version you are using. Click here to access the Primary Health Care - PHC Chapter 11: Human Immunodeficiency Virus and Acquired Immune Deficienc→
- Anaemia in PregnancyDescription General measures Medicine treatment Referral O99.0 + (D64.9) DESCRIPTION Anaemia in pregnancy is a Hb < 11 g/dL, most commonly due to iron deficiency. Hb levels should be checked at the booking visit, between 28 and 32 weeks, and at ± 36 weeks. Treatment is recommended when the Hb falls below 10 g/dL. Women with iron deficiency often have 'pica', e.g. eating substances such a→
- Anaemia, iron deficiencyICD-10 codes: D50.0 / D50.8 / D50.9 Description General measures Medicine treatment Referral DESCRIPTION A common cause of anaemia in young children and women of childbearing age. A full blood count showing a low MCV suggests the diagnosis of iron deficiency anaemia. A full blood count is not required for children, unless referral criteria above are present. Note: Iron deficiency anae→
- Anaemia, macrocytic or megaloblasticICD-10 codes: D52.0 / D52.1 / D52.8 / D52.9 / D53.1 Description Investigations General measures Medicine treatment Referral DESCRIPTION Anaemia with large red blood cells is commonly due to folate or vitamin B 12 deficiency. Folate deficiency is common in pregnant women and in the postpartum period, and in alcoholics. Macrocytic anaemia in these patients can be assumed to be due to folate d→
- Anal FissuresDescription General Measures Medicine Treatment Referral ICD-10 code: K60.0-2 DESCRIPTION Painful small cracks just inside the anal margin, sometimes a linear ulcer. It is often seen together with a sentinel pile or external haemorrhoids. These may cause spasm of the anal sphincter, or bleeding on defaecation. GENERAL MEASURES Dietary advice to promote soft stools. MEDICINE TREATMENT Children Lac→
- AnaphylaxisDescription General Measures Emergency Treatment Medicine Treatment Referral ICD-10 code: T78.2/Y57.9 DESCRIPTION A very severe allergic reaction that usually occurs within seconds or minutes after exposure to an allergen, but may be delayed for up to 1 hour. The reaction can be short-lived, protracted or biphasic, i.e. acute with recurrence several hours later. Immediate reactions a→
- Angina Pectoris, StableAngina Pectoris, Stable→
- Angina Pectoris, Unstable/Non ST Elevation Myocardial Infarction (NSTEMI)Angina Pectoris, Unstable/Non ST Elevation Myocardial Infarction (NSTEMI)→
- AngioedemaAllergies→
- Animal BitesDescription Medicine Treatment Prevention Referral ICD-10 code: S01.0-9/S11.0-2/S11.7-9/S21.0-2/S21.7-9/S31.0-5/S31.7-8/S41.0-1/S41.7-8/S51.0/S51.7-9/S61.0-1/S61.7-9/S71.0-1/S71.7- 8/S81.0/S81.7-9/S91.0-3/S91.7/T01.0-3/T01.6/T01.8-9/T09.1/T11.1/T13.1/T14.0-1/A82.0-1/A82.9/Z24.2/Z20.3 + External Cause Code (W,X,Y,Z) Note: Rabies and tetanus are notifiable medical conditions. DESCRIPTION Anim→
- Antenatal SupplementsDescription General measures Medicine treatment Z36.9 + (Z29.9) DESCRIPTION Supplements before and during pregnancy and lactation can help to prevent, or lessen the effect of, a number of conditions or complications associated with pregnancy. Specifically: Folic acid, given for at least one month before conception and during pregnancy (particularly the first 12 weeks) can help to prevent neural t→
- Antepartum HaemorrhageDescription General measures Medicine treatment Referral O46.0/O46.8-9 DESCRIPTION Vaginal bleeding in pregnancy from 22 weeks' gestation. Important causes include the following: abruptio placentae placenta praevia uterine rupture (particularly when misoprostol was used to attempt an unlawful TOP) GENERAL MEASURES Monitor vital parameters, e.g. Hb, pulse, BP, temperature. Treat for shock if→
- Antiretroviral Therapy, Adults and Adolescents (10-19 years old)Please click on the link below to access the most up-to-date version of this guideline. The content on this page is currently being updated to align with the latest publication. Always check the version number at the bottom of the screen to confirm which version you are using. Click here to access the Primary Health Care - PHC Chapter 11: Human Immunodeficiency Virus and Acquired Immune Deficienc→
- Antiseptics and DisinfectantsDescription Disinfecting Surfaces Intact Skin Wounds and Mucous Membranes Articles and Instruments DESCRIPTION Disinfectants are used to kill micro-organisms on working surfaces and instruments, but cannot be relied on to destroy all micro-organisms. Antiseptics are used for reducing bacterial load on skin and mucous membranes. Disinfecting surfaces Guidelines for the use of disinfectants Cleansi→
- AnxietyNeuropsychiatric Conditions→
- Anxiety DisordersDescription General measures Medicine treatment Referral ICD-10 code: F40.0-2/F40.8-9/F41.0-3/F41.8-9/F42.0-2 + (F10.0-F19.9/R42/R45.0-8/Z65.0-5/Z65.8-9/Z81.0-4/ Z81.8) Description Anxiety is an emotional response to an apparent stress. It is diagnosed as a disorder when it is excessive or persistent and impacts daily functioning. Anxiety disorders are associated with an increase in cigarette smo→
- Aphthous Ulcers in HIV InfectionPlease click on the link below to access the most up-to-date version of this guideline. The content on this page is currently being updated to align with the latest publication. Always check the version number at the bottom of the screen to confirm which version you are using. Click here to access the Primary Health Care - PHC Chapter 11: Human Immunodeficiency Virus and Acquired Immune Deficienc→
- Aphthous ulcersICD-10 code: K12.0 Description Medicine Treatment Referral DESCRIPTION Painful ulcers in the mouth, except the gums, hard palate and dorsum of the tongue. Minor ulcers (< 1 cm diameter) usually heal within 10 days. Major ulcers (> 1 cm diameter) are very painful, often very deep and persist. Major ulcers usually indicate advanced HIV infection. MEDICINE TREATMENT Minor aphthous ulcers: Chil→
- AppendicitisDescription General Measures Medicine Treatment Referral ICD-10 code: K35.0-3/K35.8-9/K37 DESCRIPTION This is characterised by inflammation of the appendix, and usually requires urgent surgical intervention. Clinical features include: Sudden peri-umbilical pain often migrating to the right iliac fossa. Nausea and vomiting. Loss of appetite. Fever. Constipation or occasionally diarrhoea. Bloated a→
- Appendix I Asthma MonitoringPeak expiratory flow rates Peak expiratory flow in normal adult subjects Calculating % Predicted Peak Flow Rate Calculating bronchodilator responsive using peak flow in adults Calculating peak flow variability in children and adults Asthma control test PEAK EXPIRATORY FLOW RATES Suggested reference peak expiratory flow (PEF) values for children: Click on the image to enlarge. Click on the→
- Appendix II Devices for Respiratory Conditions Inhaler DevicesSpacer Devices Metered Dose Inhalers (MDIs) Dry Powder Inhalers (DPIs) Nebulisers References SPACER DEVICES Spacers are vital for an adequate therapeutic effect of inhaled therapy. Spacer devices should be used for all inhaled medications in all age groups to improve efficacy of medicine delivery and limit adverse effects. Use a spacer that is appropriate for the patient’s age. Infants <→
- Appendix III Cardiovascular Risk AssessmentNon-laboratory based risk screening Laboratory based risk screening NON-LABORATORY BASED RISK SCREENING BMI-BASED RISK ASSESSMENT Measure body mass index (BMI): BMI=weight (kg)/[height (m) x height (m)] Measure blood pressure. Calculate 10-year risk of a cardiovascular event using the BMI-based CVD risk tool below. Use the patient’s sex, age, BMI, systolic BP and smoking status to work out what c→
- ArthralgiaArthralgia→
- Arthritis, RheumatoidArthritis, Rheumatoid→
- Arthritis, SepticArthritis, Septic→