Job Type: Fixed Term
Job Location: Johannesburg
The Medical Officer – OST and Hepatitis: Roles and Responsibilities
- Prescribe methadone per client and conduct the assessment for OST
- Conduct physical examination of clients and over and above routine general physical examination, look for signs of:
- Intoxication and drug use
- Withdrawal, measure objectively using OOWS or COWS Scales
- Needle tracks and abscesses from injecting
- Cardiovascular examination to exclude arrhythmia
- Analyse the results of baseline investigations to determine client eligibility for OST, including:
- Urine drug test – mouth swab can be used as an alternative for drug test
- Pregnancy test – note that amenorrhea is common in female opioid
- Any other investigation the clinician deems necessary based on clinical findings, for example: liver function tests: AST, ALT and bilirubin; and HIV Testing as per HTS
- Managing dosing for methadone and ensuring that treatment is tailored to each client’s clinical
- Up-titration is done slowly under close
- Suppression of withdrawal tends to occur during peak levels which occur 2-4 hours after
- Enusre treatment is divided into four distinct stages: induction; up-titration and stabilisation; and
- Assess individual treatment plans designed in collaboration with the client, and preferably include the client’s immediate support system.
- Ensure treatment plan is responsive to the client’s goals and desired outcomes and include: a tailored treatment information pack prescription notes that clearly show date of first dosing, requirements for supervision rationale for dose adjustments instructions for referral (e.g. to NSP or mental health services), as well as clear follow up
- Manage cases of
- Examine Hepatitis B and C screening results for intravenous drug users. For HCV, treatment starts with Anti-HCV, then manage conduct HCV confirmatory test. If previously treated, testing should be PCR/VL directly. HCB immunization.
- If history of syncope or palpitations or evidence of arrythmia on physical examination: Treatment ECG to measure QTC interval, if warranted following history and physical examination. (See Principles of ECG Monitoring above).
- Assist with TB Management, including managing TB screening, if positive do GeneXpert and follow TB guidelines.
- Assist with ART management
- Assist in managing minor
- Assist in managing
Qualifications and Experience
- MBChB degree or equivalent
- Diploma in HIV Management or other related qualification, an advantage
- At least 2-3 years clinical experience in managing HIV & TB infected clients in public health facilities
- At least 2-3 years clinical experience in managing key populations