Nepal Elephant TB Control and Mgt Action Plan.pdf - Elephant Care ...

Nepal Elephant Tuberculosis ulosisControl andManagement agemenAction Plan (2011-2015)2015)Record keeping: Keeping accurate records isvery important. Each elephant under treatmentwill have a log book to record how muchmedicaon is consumed and enter commentsabout treatment. The log book will be providedby the TB Plan and the TB Plan Veterinary Officerwill explain how to use the log. Instruct staff tobe honest in reporng whether elephants haveconsumed all or only a poron of the medicaon.This informaon will help the TB Plan VeterinaryOfficer to assess treatment and make anyadjustments if needed. The TB Plan VeterinaryOfficer may review the log book at any me.Upon compleon of treatment the log book willbecome part of the elephant’s permanent recordmaintained in the TB Plan office.Monitoring: The TB Plan Veterinary Officerwill monitor all government elephants undertreatment. Private veterinarians who are treangelephants will report at least monthly to the TBPlan veterinarian who will stay informed of theirtreatment progress, offer advice, and maintaina record on the elephant. All privately ownedelephants that are treated should also have a logbook in which daily notes of the amount of drugoffered and the amount consumed are recorded.At the compleon of treatment a copy of the logbook will become part of the elephant’s record inthe TB Plan office to document compliance withthe program.A. Protocol for Management Group 2: TBsuspectelephants (Prophylac!c treatment)Elephants in Group 2 receive two drugs for 9months.Oral therapy:1. Isoniazid (INH) at a dosage of 5 mg/kg for 270full doses2. Rifampin (RIF) at a dosage of 10 mg/kg for 270full doses Isoniazid and rifampin are availableas a combinaon product. Each tabletcontains 300 mg of INH and 600 mg of RIF.Rectal therapy:1. Isoniazid (INH) at a dosage of 5 mg/kg for 270full doses2. Ethambutol (EMB) at a dosage of 30 mg/kg for270 full dosesPost-treatment monitoringThe Elephant TB Stat-Pak ® test may remainreacve even a!er treatment. Elephants thathave been treated prophylaccally should bemonitored annually using the DPP. If the DPPbecomes reacve the elephant may have been reinfected.An elephant with a reacve DPP shi!s toGroup 3 and should undergo full TB treatment.B. Protocol for Management Group 3: TBinfectedelephantsElephants in Group 3 receive three drugs for twomonths followed by two drugs for another 10months.1. Isoniazid (INH) at a dosage of 5 mg/kg for 360full doses2. Rifampin (RIF) at a dosage of 10 mg/kg for 360full doses3. Ethambutol (EMB) at a dosage of 30 mg/kgfor 60 full doses given the first 2 months oftreatment (60 doses)Elephants in Group 3 must receive 3 drugs fortreatment. Administering fewer drugs has beenshown to result in treatment failure. Other drugsmay be prescribed based on posive cultures anddrug sensivity tesng.The first 60 doses of all three drugs should beadministered within a period of 90 days (i.e.no more than 30 days of refused medicaon14