Unofficial translation
In accordance with paragraph 4 of Article 157 of the Code of the Republic of Kazakhstan “On Public Health and the Healthcare system” as of July 7, 2020, I hereby ORDER:
1. To approve the appended Rules for conducting medical examination in order to recognize a person as sick the contagious type of tuberculosis in accordance with the appendix to this order
2. To invalidate Order № 481 of the Minister of Healthcare of the Republic of Kazakhstan as of September 30, 2009 “On approval of the Rules for conducting medical examination in order to recognize a citizen as sick with the contagious type of tuberculosis” (registered in the State Registration Register of Regulatory Legal Acts under № 5836, published in №174 (1771) of the “Yuridicheskaya Gazeta” newspaper on November 13, 2009).
3. In accordance with the procedure established by the legislation of the Republic of Kazakhstan, the Department of Medical and Social Assistance of the Ministry of Healthcare of the Republic of Kazakhstan shall ensure:
1) state registration of this order with the Ministry of Justice of the Republic of Kazakhstan;
2) the posting of this order on the website of the Ministry of Healthcare of the Republic of Kazakhstan;
3) the submission of information on the implementation of the measures provided for in subparagraphs 1) and 2) of this paragraph to the Legal Department of the Ministry of Healthcare of the Republic of Kazakhstan within ten working days of the state registration of this order with the Ministry of Justice of the Republic of Kazakhstan.
4. Control over the execution of this order shall be entrusted to the deputy minister of healthcare of the Republic of Kazakhstan, A.Giniyat.
5. This order comes into effect ten calendar days of its first official publication.
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Minister of Healthcare of the Republic of Kazakhstan |
A.Tsoi |
| Appendix to Order № KR DSM-107/2020 of the Minister of Healthcare of the Republic of Kazakhstan as of September 23, 2020 |
Rules for conducting medical examination in order to recognize a person as sick with the contagious type of tuberculosis
Chapter 1. General provisions
1. These Rules are developed in accordance with paragraph 4 of Article 157 of the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System” as of July 7, 2020 and establish the procedure for conducting a medical examination in order to recognize a person as sick with the contagious type of tuberculosis (hereinafter referred to as the Rules).
2. The following terms and definitions are used in these Rules:
1) contagious type of tuberculosis - a type of tuberculosis that poses a danger to others in connection with the patient’s excretion of TB bacteria into the external environment;
2) a patient - an individual who is (was) a consumer of medical services, regardless of the presence or absence of a disease or condition requiring medical care;
3) a person excreting bacteria - a person with pulmonary tuberculosis, in whom at least one portion of acid-fast bacteria was found in sputum smear microscopy before treatment.
Chapter 2. Procedure for conducting medical examination in order to recognize a person as sick with the contagious type of tuberculosis
3. Patients with the contagious type of tuberculosis are identified:
1) when a person visits a medical facility, including one providing outpatient care;
2) during preventive medical examination (to go to school, higher and secondary educational institutions, for employment, during targeted, screening medical examinations, clinical examination);
3) when diagnosing and treating other diseases;
4) during vaccination;
5) in other circumstances.
4. A patient undergoes a mandatory examination for tuberculosis if he/she complains about:
1) cough (more than 2 weeks);
2) sputum production;
3) sweating;
4) fatigue, weakness;
5) increased body temperature;
6) hemoptysis;
7) loss of appetite, weight.
A person with complaints suspicious of tuberculosis and (or) changes in the fluorine or radiograph is sent for microscopic examination of sputum within three days of his/her visit.
5. Examination for tuberculosis includes the following studies:
1) mandatory:
sputum examination for Xpert MTB RIF and microscopic examination of sputum (double examination of sputum);
2) additional:
X-ray (fluorography, radiography, computed tomography of the chest organs);
microbiological (bacterial sowing);
bronchological;
blood and urine tests;
ultrasound examination (extrapulmonary forms of tuberculosis).
6. A person is recognized as sick with the contagious type of tuberculosis on the basis of the opinion of a health facility providing medical assistance to TB patients.
7. A person who secretes mycobacterium tuberculosis is recognized as sick with the contagious type of tuberculosis or as a person excreting bacteria (BK +) in the following cases:
1) if as a result of examinations under a microscope, acid-fast bacteria were found in at least two sputum analyses;
2) one positive sputum sample for acid-fast bacteria and pathological changes detected by X-ray method;
3) single identification of acid-fast bacteria in a smear and isolation of mycobacterium tuberculosis.
8. A patient with tuberculosis is subject to compulsory medical supervision and treatment and is provided with necessary medicines within the guaranteed volume of free medical care.
9. A health professional at the place of identification of a patient with the contagious type of tuberculosis submits an emergency notification about each patient to the territorial subdivision of the department of the state body for the sanitary and epidemiological welfare of the population in accordance with the form determined in subparagraph 31) of Article 7 of the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System” as of July 7, 2020.
10. A patient with the contagious type of tuberculosis is hospitalized in a phthisiopulmonary organization for treatment and rehabilitation.
In the emergency room, a health professional provides a TB patient with information about his/her rights and obligations, the nature of his/her illness, the methods of treatment used and the rules of behavior.
After the termination of bacterial excretion (BK-), the patient is transferred to the outpatient stage of treatment.
The treatment of a TB patient is monitored by a health professional throughout the entire period of treatment.
11. Persons who are or have been in contact with a patient with the contagious type of tuberculosis are examined in order to exclude tuberculosis within two weeks of the establishment of contact.
12. A person recognized as sick with the contagious type of tuberculosis and being treated enjoys all the rights of citizens of the Republic of Kazakhstan with restrictions related to the need to comply with the regime of stay in a phthisiopulmonary organization.
13. A patient with the contagious type of tuberculosis who refuses treatment prescribed by a doctor, which is recorded in his/her medical records, is subject to compulsory treatment.
