Malawi Standard Treatment Guidelines (MSTG) 5th Edition …apps.who.int/medicinedocs/documents/s23103en/s23103en.pdf · 5th Edition 2015 Government of Malawi Malawi Standard Treatment

5th Edition 2015

Government of Malawi

Malawi Standard TreatmentGuidelines (MSTG)

Incorporating Malawi Essential Medicines List (MEML) 2015

Ministry of Health

Malawi Standard TreatmentGuidelines (MSTG)

Incorporating Malawi Essential Medicines List (MEML) 2015

Ministry of Health

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Foreword..............................................................................iii

References............................................................................v

Acknowledgements..............................................................vii

Prescribing Guidelines..........................................................xi

1.0 Blood and Haematological Condions........................1

2.0 Cardiovascular diseases............................................47

3.0 Central nervous system.............................................62

4.0 Ear nose and throat condions................................95

5.0 Emergencies...........................................................106

6.0 Endocrine disorders................................................121

7.0 Gastrointesnal condions...................................134

8.0 Hepac disorders....................................................161

9.0 Infecous diseases..................................................162

10.0 Oncology.................................................................225

11.0 Musculoskeletal disorders......................................246

12.0 Sexual and Reproducve Health ..............................257

13.0 Ophthalmic condions........................................304

14.0 Oral maxillofacial condions...................................320

15.0 Parasic diseases.....................................................333

16.0 Respiratory condions............................................371

17.0 Sexually transmied infecons................................393

18.0 Skin condions........................................................417

19.0 Vaccinaons............................................................437

Table of Contents

MSTG 2015

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20.0 Bites, burns and wounds.........................................439

21.0 Renal condions ....................................................454

22.0. Poisoning................................................................465

23.0 Nutrional Disorders.................................................475

24.0 Pain management and Palliave care....................504

25.0 Psychiatric condion..............................................520

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List of Core Contributors to the 5th Edion ofMSTG/MEML

NAME INSTITUTIONDr Charles Mwansambo Ministry of HealthDr George ChithopeMwale Ministry of HealthDr. A. Chitsa Banda Malawi Defence ForceDr. Henry Ndindi Ministry of HealthAlbert Khuwi Ministry of HealthEnock Phale Ministry of HealthTadala Hamisi Kamuzu Central HospitalEphraim Chale Kamuzu Central HospitalChikondi Kadawa Ministry of HealthDr Mebratu Bejiga Clinton Health Access

IniaveChristopher Connolly Clinton Health Access

IniaveAlfred Kasito Clinton Health Access

IniaveMichael Udedi Ministry of HealthDr Amos Nyaka Kamuzu Central HospitalDr Rachel MlothaMitole Kamuzu Central HospitalDr Peter Kazembe Baylor TrustDr Bridon Mbaya Malawi Blood

Transfusion ServicesDr Charles Dzamala College of medicineDr Dan Namarika Partners in Hope ClinicDr Rodney Kalanda The MEDI ClinicDr Tiffany Priester Seventh Day Advenst

HospitalDr Y. B Mlombe College of MedicineDr Moses Chisale Central Medical Stores

TrustChitsanzo Mafuta Zomba Mental HospitalDr Jen Ahrens College of Medicine

viii

MSTG 2015

NAME INSTITUTIONLevie Mwale Queen Elizabeth

Central HospitalDr Kondwani Chalulu Queen Elizabeth Central

HospitalDr Samson Mndolo Queen Elizabeth Central

HospitalDr Leo Masamba Queen Elizabeth

Central HospitalDr Jessie Mlotha Namarika Kamuzu Central HospitalDr Peter Jeke Mzuzu Central HospitalDr John Chipolombwe Mzuzu Central HospitalDr Carlos Valera Kamuzu Central HospitalCatherine Chiwaula Ministry of HealthEmmaculate Kambiya Ministry of HealthLumbani Makwakwa Chrisan Health

Associaon of MalawiDr Martha Makwero Queen Elizabeth Central

HospitalDr Kabeya Maguy Zomba Central HospitalJanet Guta Ministry of HealthSyliver Kathumba Ministry of HealthGodfrey Kadewere Pharmacy, Medicines

and Poisons BoardKent Kawonga Queen Elizabeth Central

HospitalGelson Kuweruza Queen Elizabeth Central

HospitalSamuel Nowa Kasungu District Health

OfficeDr Jarome Nkhambule Kasungu District Health

OfficeR. J Mwale College of MedicineAngellina Chilumpha Zomba Mental Hospital

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MSTG 2015

NAME INSTITUTION

Dr Gian Samonte Kamuzu Central HospitalMercy T.Z. Magombo Zomba Central HospitalEmma Mchikaya Zomba Central HospitalLaston Chiko Ministry of HealthLameck Thambo Palliave Associaon of

MalawiDr. Leonard Banza Kamuzu Central HospitalDoreen Alli Ministry of HealthDr Stone Kabuluzi Ministry of HealthSheila Bandazi Ministry of HealthDr Owen Malemia Blantyre District Health

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a Positive pressure ventilation should be initiated with air for infants with gestation > 32 weeks. For very preterm infants, it is preferable to start with 30% oxygen if possible. A and B are basic resuscitation steps

Chart 12. Neonatal resuscitation: Flow chart

No

Yes

Breathing

Breathing well

Not breathing, or gasping

After 3060 s

If HR 60/min

If HR < 60/min

Dry the infant immediately with a clean cloth. Keep warm by skin-to-skin contact and

covered.

Look for Breathing or crying Good muscle tone or vigorous movements

Stimulate by rubbing the back 2 to 3 times. Suction only if had meconium stained liquor

or the mouth or nose is full of secretions.

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and self-infl ating bag within 1 min of birth.a Make sure the chest is moving adequately.

Check the heart rate (HR) with a stethoscope.

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HR 60100/min: Take ventilation

corrective steps. Continue to

ventilate at 40 breaths per min.

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Suction, if necessary.

Reassess every 12 min.

Routine care (see section 3.1)

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breathing

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Give higher oxygen concentration.

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Other ventilatory support.

IV adrenaline. Refer where

possible If no HR for > 10

min or remains < 60/min for 20 min, discontinue (see section 3.2.2, p. 50).

If HR > 100/min

Neonatal resuscitation: Flow chart


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Documents

Malawi Standard Treatment Guidelines (MSTG) 5th Edition …apps.who.int/medicinedocs/documents/s23103en/s23103en.pdf · 5th Edition 2015 Government of Malawi Malawi Standard Treatment