Guidelines
437 entriesNDoH Primary Healthcare STG
- Cracked nipples during breastfeeding *New*ICD-10 code: O92.1 Description General measures Medicine treatment Referral DESCRIPTION The areola and nipple are protected by the secretion of a lubricant from Montgomery's glands. Cracked nipples may lead to infection and mastitis. Causes of cracked nipples include: poor positioning of the baby and incorrect attachment to the breast. removing the baby from the breast before suction is broken. t→
- Croup (Laryngotracheobronchitis) in ChildrenStridor (Upper Airways Obstruction)→
- Cryptococcal MeningitisSee: Cryptococcosis, 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_15.8.3 Cryptococcal Meningitis→
- CryptococcosisPlease 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→
- DeliriumDescription General Measures Medicine Treatment Referral ICD-10 code: F05.0-1/F05.8-9/F44.8/R45.1/R45.4-6 DESCRIPTION Delirium is a medical emergency. Delirium is a disturbance in attention, awareness (reduced orientation to the environment), and cognition (e.g. deficits in memory, language, visuospatial ability, or perception). It is acute, developing within hours to days, and fluctuates during→
- DeliriumNeuropsychiatric Conditions→
- DementiaCentral Nervous System Conditions→
- Dental AbscessICD-10 code: K04.7 Description Medicine Treatment Referral DESCRIPTION Acute or chronic suppuration related to teeth, due to infection. It is characterised by: acute, severe, throbbing pain. swelling adjacent to the tooth, or on the face. pain worsened by tapping on affected teeth. restricted mouth opening or difficulty chewing. pus collection located around the tooth or at th→
- Dental CariesICD-10 code: K02.0, K02.1 , K02.2 , K02.3 , K02.4 , K02.5 / K02.8 , K02.9 To be managed by a dentist or dental therapist. For local anaesthesia for dental procedures: Lidocaine (Dentist and dental therapist). Lidocaine with adrenaline (epinephrine) (Dentist and dental therapist). Note: Dental rinses are not recommended for prevention of Covid-19 transmission during dental procedures.→
- DepressionNeuropsychiatric Conditions→
- Depressive DisordersMood Disorders→
- Dermatitis, SeborrhoeicEczema and Dermatitis→
- Developmental Delay or DeteriorationPlease 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→
- Diabetic EmergenciesDiabetic Emergencies→
- Diabetic Foot UlcersMicrovascular Complications of Diabetes→
- Diabetic NephropathyMicrovascular Scular Complications of Diabetes→
- Diabetic NeuropathyMicrovascular Complications of Diabetes→
- DiarrhoeaGastrointestinal Conditions→
- Diarrhoea, Acute in ChildrenDescription General Measures Medicine Treatment Referral CAUTION There is no place for anti-diarrhoeal preparations in the treatment of acute diarrhoea in children or in dysentery. ICD-10 code: A09.0/A09.9 DESCRIPTION A sudden onset of increased frequency of stools that are looser than normal, with or without vomiting. Commonly caused by a virus but may be caused by bacteria or parasites. The cau→
- Diarrhoea, Acute, Without Blood, in AdultsDescription Medicine Treatment Referral ICD-10 code: A09.0/A09.9/K52.2/K52.8/K52.9 DESCRIPTION Acute diarrhoea is usually self-limiting and is managed by fluid replacement. MEDICINE TREATMENT Treat dehydration vigorously: Oral rehydration solution (ORS). OR Homemade sugar and salt solution (SSS). Homemade sugar and salt solution (SSS) ½ level medicine measure of table salt plus 8 level medi→
- Diarrhoea, Chronic, in AdultsDescription General Measures Medicine Treatment Referral ICD-10 code: A07.1/A09.0/A09.9/K52.2/K52.8/K52.9 DESCRIPTION Defined as diarrhoea lasting > 4 weeks. LoE:IVb 12 GENERAL MEASURES Encourage HIV testing: Most cases are likely to be HIV related. Send a stool sample for microscopy for ova, cysts and parasites. Do not request culture and sensitivity of the stool sample. Giardiasis is→
- Diarrhoea, HIV-AssociatedDescription Medicine Treatment Referral B20.8 + (A07.2-3) DESCRIPTION Diarrhoea that persists for > 2 weeks. Often associated with wasting. Diarrhoea persisting for 4 weeks is a WHO stage 3 condition (if there is weight loss or fever it is stage 4). Send stool sample to look for ova, cysts and parasites in all cases. Note: A negative stool specimen does not exclude Cryptosporidium . If Cryptos→
- Diarrhoea, Persistent in ChildrenDescription General Measures Medicine Treatment Referral ICD-10 code: A09.0/A09.9/K52.2/K52.8/K52.9 DESCRIPTION Diarrhoea for 7–14 days. GENERAL MEASURES Assess for possible HIV infection and manage appropriately (See: Antiretroviral therapy, Adults ). Prevent dehydration using homemade sugar and salt solution. Counsel mother regarding feeding. If breastfeeding, give more frequent, longer feeds.→
- Disease Notification ProceduresDisease Notification Procedures→
- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)Severe Cutaneous Adverse Drug Reactions→
- Drug-Resistant Tuberculosis (MDR TB)TB, HIV and AIDS→
- Dry SkinDry Skin→
- DysenteryDescription General Measures Referral ICD-10 code: A06.0 DESCRIPTION Dysentery, or diarrhoeal stool with blood or mucus, is usually due to bacteria. Commonly encountered infectious conditions include Shigella, Salmonella, E. Coli, Entamoeba histolytica and Campylobacter . GENERAL MEASURES Treat initial presentations as bacillary dysentery (See: Dysentery, bacillary ). If there is no clinical resp→
- Dysentery, BacillarySee: Gastrointestinal conditions. 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_10.4 Dysentery, Bacillary→
- Dysentery, BacillaryDescription General Measures Medicine Treatment Referral ICD-10 code: A02.0/A02.9/A03.0-3/A03.8-9/A04.2-3/A04.5/A04.8-9 DESCRIPTION Acute infection of the bowel usually caused by Shigella, Salmonella or Campylobacter. There is sudden onset diarrhoea with: blood (not due to haemorrhoids or anal fissure) or mucous in the stools. convulsions (in children). fever. tenesmus. GENERAL MEASURES Prevent s→
- Dyslipidaemia in DiabetesCardiovascular Risk in Diabetes→
- DysmenorrhoeaDescription General measures Medicine treatment Referral N94.4-6 DESCRIPTION Pain associated with menstrual cycles. In primary dysmenorrhoea there is no known cause. Secondary dysmenorrhoea usually has an organic cause. GENERAL MEASURES Advise and reassure women with primary dysmenorrhoea about the nature of the condition. Encourage patient to carry on with normal everyday activities. MEDICINE TR→
- Dyspepsia, Heartburn and Indigestion, in AdultsDescription General Measures Medicine Treatment Referral ICD-10 code: K30/R12 DESCRIPTION Dyspepsia, heartburn and indigestion are common conditions and may be caused by gastro-oesophageal reflux or gastroduodenal pathology. These conditions often present with epigastric discomfort and minimal change in bowel habits. Intermittent indigestion, heartburn or dyspepsia may be associated with: use of→
- DyspnoeaRespiratory Conditions→
- EclampsiaGeneral measures Medicine treatment Referral O15.0-2/O15.9 GENERAL MEASURES Stabilise prior to urgent referral. Ensure safe airway. Place patient in left lateral position. Insert a Foley’s catheter and monitor urine output hourly. Monitor BP and check reflexes every 30 minutes. MEDICINE TREATMENT Administer oxygen. Magnesium sulfate, IV, 4 g as a loading dose diluted with 200 mL sodium chloride 0→
- Ectopic PregnancyDescription General measures Medicine treatment Referral O00.0-2/O00.8-9 DESCRIPTION Pregnancy outside the uterus, usually presenting with the combination of: amenorrhoea (missed menstrual period) sudden lower abdominal pain/ pelvic pain vaginal bleeding (os closed) dizziness shock anaemia urine pregnancy test usually positive shoulder tip pain Note: Consider ectopic pregnancy in young women who→
- Eczema, Acute, Moist or WeepingEczema and Dermatitis→
- Eczema, AtopicEczema and Dermatitis→
- Eczema, SeborrhoeicSee: Dermatitis, seborrhoeic . Click here to access the pdf . Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare_V1.0_26 February 2026 Chapter 11: Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV AND AIDS)_11.3 Opportunistic Infections, Treatment in Adult_11.3.6 Eczema, Seborrhoeic→
- Emerging Respiratory Pathogens, e.g. COVID-19: Coronavirus Disease-19; Middle East Respiratory Syndrome Coronavirus Infection: MERS COVDescription General Measures Management Referral Note: notifiable medical conditions. Consult the most recent guidelines from the National Department of Health or NICD. DESCRIPTION Viral respiratory illness caused by coronaviruses, including Middle East respiratory syndrome (MERS-CoV), severe acute respiratory syndrome (SARS), and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). SARS→
- End of Life CareEnd of Life Care→
- EnuresisUrology→
- EpilepsyEpilepsy→
- Epilepsy SyndromesEpilepsy Syndromes→
- Epilepsy in Adolescents and AdultsEpilepsy in Adolescents and Adults→
- Epilepsy in Children <13 Years of AgeEpilepsy→
- Epileptic SeizuresDescription Diagnosis Seizure types G40.6-7; G41.0-2; G41.8-9; R56.8 DESCRIPTION An epileptic seizure is a change in movement, attention or level of awareness that is sustained or repetitive and occurs because of abnormal and excessive neuronal discharge within the brain. LoE:IVb 7 Epileptic seizures should be differentiated from: Collapse, e.g. syncope, anoxic seizures, transient ischaemic attac→
- Epileptic Seizures and Status Epilepticus in Adolescents (13-18 Years) and AdultsDescription General measures Medicine treatment Referral DESCRIPTION Additional causes of epileptic seizures to consider in adolescents and adults are categorised below: Pregnancy related Infections Substances & poisoning - eclampsia (See Adult Hospital STGs and EML, Eclampsia ) - electrolyte abnormalities (e.g. in hyperemesis gravidarum) - stroke - reduced blood levels of antiseizure m→
- Epileptic Seizures and Status Epilepticus in Children <13 Years of AgeDescription General measures Medicine treatment Referral DESCRIPTION Central nervous system infections are a common cause of epileptic seizures in children < 13 years of age in South Africa. The most common seizures in children are febrile seizures (See Febrile seizures ) but the history, examination and investigations must aim at excluding the following conditions: Perinatal conditions Infect→
- Erythema MultiformeAllergies→