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Mine Health and Safety Act, 1996 (Act No. 29 of 1996)

Notices

Guidance Note on the Management and Control of HIV in the South African Mining Industry

Part A : The Guidance Note

9. Integration of HIV and TB Management

 

9.1 Before initiation on ART , screen for TB (cough questionnaire) as a baseline. Initial assessment of full blood count, HB and MCV to exclude anaemia of chronic disorders which might indicate the presence of/either opportunistic diseases e.g. TB, lymphoma etc.  Refer for monitoring of FBC bi-annually.

 

9.2 All employees with presumptive symptoms to have a chest X-ray, gene Xpert, or  a smear to exclude TB.

 

9.3 Those  diagnosed  with TB to be initiated on treatment  for two weeks  before ART initiation, to prevent IRIS.

 

9.4 Those without active TB, initiate or refer for ART treatment and isoniazid prophylaxis.

 

9.5 Employees diagnosed with NCD (e.g. diabetes and hypertension), monitor for drug-drug interactions whilst on ART treatment especially on FDC regimen containing Tenofovir. Monitor urea, creatinine and GFR for patients on Tenofovir at initiation of treatment and six-monthly .

 

9.6 Monitor drug-drug interaction whilst on ART.

 

9.7 Hypercholesterolemia - monitor LDL at initiation of treatment and follow-up yearly .

 

9.8 lsoniazid  prophylaxis  of all employees  diagnosed with  silicosis  and HIV and AIDS including those on ART.