Guidelines

25 entries

NDoH Primary Healthcare STG

MalariaDescription Diagnosis General Measures Medicine Treatment Note: notifiable medical condition. Refer to the most recent Malaria Treatment Guidelines from the Department of Health for the most suitable management in the various endemic areas. Global malaria endemic areas: https://www.iamat.org/risks/malaria?gclid=CjwKEAiAjIbBBRCitNvJ1o257WESJADpoUt072u5_X4Wb0fVtkQLiEFrWye263Ef_on8eykkOwLK_hoC→
Malaria, Non-severe/UncomplicatedMedicine Treatment Referral ICD-10 codes: B50.9/B51.9/B52.9/B53.0/B54 Note: notifiable medical condition. MEDICINE TREATMENT Artemether/ lumefantrine, oral, 20/120mg, with fat-containing food/ full cream milk to ensure adequate absorption. Give the first dose immediately. Follow with second dose 8 hours later. Then 12 hourly for another 2 days (total number of doses in 3 days = 6). Click on→
Malaria, ProphylaxisDescription General Measures Medicine Treatment ICD-10 codes: Z29.1 DESCRIPTION In South Africa, malaria chemoprophylaxis should be used, together with preventive measures against mosquito bites, from September to May in moderate-risk malaria-endemic areas. Risk areas in South Africa are shown in the map included in the National Guidelines for the Prevention of Malaria (2018) found at→
Malaria, Severe/ComplicatedDescription Medicine Treatment Referral ICD-10 codes: B50.0/B50.8 Note: notifiable medical condition. DESCRIPTION Any one of the following is a sign of severe (complicated) malaria, is associated with a higher mortality, and requires urgent referral (after initial artesunate dose as below): prostration (severe general body weakness) sleepiness, confusion, unconsciousness or coma, convulsion→
Male Urethritis Syndrome (MUS)Sexually Transmitted Infections→
Management of HIV-Infected Children (<10 years)Update - 20 June 2025 Links not working not linked out - https://www.nacosa.org.za/wp-content/uploads/2016/11/IntegratedAdherence-Guidelines-NDOH.pdf→
Management of Incomplete Miscarriage in the 1st Trimester, at Primary Health Care LevelGeneral measures Medicine treatment Referral O02.1/O03.4 Both Manual Vacuum Aspiration (MVA) and medical evacuation are equally effective for miscarriage. GENERAL MEASURES Counselling. Evacuation of the uterus. MEDICINE TREATMENT Medical evacuation: Misoprostol, SL/PV/buccal, 800 mcg immediately as a single dose. Repeat after 24 hours if necessary. LoE:IIIb 1 Manual vacuum aspir→
Management of Suspected Choking/ Foreign Body Aspiration in ChildrenICD-10 code: T17.2-5/T17.8-9/ T18.0-1 Table 21.3: Managing suspected choking/foreign body aspiration in children If the child is able to talk and breathe Encourage the child to cough repeatedly while arranging transfer urgently with supervision. If the child is conscious but with no effective cough or breathing Give up to 5 abdominal thrusts and if ineffective up to 5 back slaps, followed by re-a→
Management of Termination of Pregnancy at Primary Health Care Level: Gestation up to 12 Weeks and 0 DaysGeneral measures Medicine treatment Referral O04.9 GENERAL MEASURES Confirm pregnancy with urine pregnancy test. Determine gestational age with ultrasound. If ultrasound is unavailable, use dates (LMP) and bimanual (pelvic) examination. If unsure of dates, or examination disagrees with dates, or uterus palpable abdominally, or the woman is obese or difficult to examine, arrange pre-procedure ultr→
MastitisDescription General measures Medicine treatment Referral O91.2 DESCRIPTION Inflammation of the breast tissue surrounding the milk ducts. Risk factor includes retrograde infection from a fissured nipple and milk stasis. Commonly isolated pathogens include S. aureus and S. epidermidis. Presentation includes painful breast(s), fever, erythema and malaise. GENERAL MEASURES Compresses. Regular express→
Maternal Mental HealthIn vulnerable women, pregnancy exacerbates the risk of developing a mental illness. Approximately one in three women in South Africa have depression and/or anxiety in the perinatal period. Globally, postpartum psychosis affects 1 to 2 women in every 1000 after childbirth. Risk factors for maternal mental illness include past history of mental illness, recent major life event, (e.g. bereavement) e→
MeaslesCase Definition Description General Measures Medicine Treatment Referral ICD-10 codes: B05.0-4/B05.8-9 Note: Notifiable medical condition CASE DEFINITION Fever. AND Red maculopapular (blotchy) rash. AND Cough or coryza (runny nose) or conjunctivitis. Inform the local EPI co-ordinator about all cases of suspected measles, (i.e. which fulfil the case definition criteria). Send clotted bl→
Medicines used in Palliative Care: IntroductionMedicines used in Palliative Care→
MeningitisSee: Acute meningitis Meningococcal meningitis, prophylaxis Cryptococcal meningitis Click here to access the pdf . Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-4_Version 1.0_26 May 2025 Chapter 15: Central Nervous System Conditions_15.8 Meningitis→
MeningitisSee: Central nervous system . Click here to access the pdf . Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-2024_Version 1.1_20 January 2025 Chapter 10: Infections and Related Conditions_10.9 Meningitis→
Meningococcal Meningitis, ProphylaxisMeningitis→
Mental Health Conditions NEMLC Recommendations for Medicine Amendments (2020-2023 Review Cycle)South African Primary Healthcare Level Essential Medicine List. Medicine amendment recommendations, with supporting evidence and rationale are listed below. Kindly review the medicine amendments in the context of the respective standard treatment guideline (STG). Click here for the Mental health conditions NEMLC Recommendations for medicine amendments (2020-2023 Review Cycle) Click here for→
Mental Health Conditions: IntroductionNurses with authorisation as provided by Section 56(6) of the Nursing Act 33 of 2005 may initiate and/or maintain treatment with medicines as per the STGs and in accordance with their scope of practice. Precepts of the Mental Health Care Act (MHCA) No. 17 of 2002 include: All people with mental illness and/or intellectually disability must be managed under the Act and its regulations as either Vo→
MiscarriageDescription General measures Medicine treatment Referral O02.1/O03.4/O03.9 DESCRIPTION Bleeding from the genital tract < 22 weeks' gestation, which may or may not be associated with lower abdominal pain (LAP). Miscarriage is classified as follows Cervix closed on digital examination Cervix dilated on digital examination - Threatened miscarriage: - mild vaginal bleeding, usual→
Missed Pills (Contraception, Hormonal)Progestin only pills Efficacy is rapidly lost if one pill is forgotten or taken >3 hours late. Recommend dual contraception for all scenarios for at least 7 days. LoE:IVb 23 Scenario Action One pill forgotten or pill taken >3 hours late, and unprotected sexual intercourse has not occurred in the past 5 days. Take pill as soon as remembered and continue taking one pill daily at the usual tim→
Moderate acute malnutrition (MAM) *New*ICD-10 code: E44.0 Description General measures Medicine treatment Referral DESCRIPTION Children and infants older than 6 months who have either: A WHZ-score between -2 and -3. MUAC between 11.5 cm and 12.5 cm. No pitting oedema or SAM danger signs (see Severe acute malnutrition (SAM) ). Good appetite. All cases require careful assessment for possible TB or HIV. GENERAL MEASURES Provide ready to→
Molluscum ContagiosumMolluscum Contagiosum→
Mood DisordersDescription The person’s thoughts and behaviour are driven by their mood, which may be depressed, sad, angry, happy, elated, manic, or any of these in combination. Mood disorders may be: Due to another medical condition, e.g. HIV, TB, anaemia of any cause, malignancy, hypothyroidism, and chronic pain conditions. Comorbid with other medical conditions e.g. epilepsy, diabetes, and cardiovascular di→
MumpsDescription General Measures Medicine Treatment Referral ICD-10 codes: B26.0-3/B26.8-9 DESCRIPTION Incubation period: 14–21 days. A viral infection primarily involving the salivary glands. Signs and symptoms: Fever. Pain on opening the mouth or eating. About two days later a tender swelling appears below the ears at the angle of the jaw, often first on one side and later on the→
Myocardial Infarction, Acute (AMI)/ST Elevation Myocardial Infarction (STEMI)Myocardial Infarction, Acute (AMI)/ST Elevation Myocardial Infarction (STEMI)→