Tuberculosis infection control practices in a high-burden metro in South Africa: A perpetual bane for efficient primary health care service delivery
Background: Tuberculosis (TB) prevention, including infection control, is a key element in the strategy to end the global TB epidemic. While effective infection control requires all health system components to function well, this is an area that has not received sufficient attention in South Africa...
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doaj-ecb073c989eb46858bff1714e34930992020-11-24T21:09:09ZengAOSISAfrican Journal of Primary Health Care & Family Medicine2071-29282071-29362018-05-01101e1e610.4102/phcfm.v10i1.1628541Tuberculosis infection control practices in a high-burden metro in South Africa: A perpetual bane for efficient primary health care service deliveryMichelle C. Engelbrecht0Gladys Kigozi1Andre P. Janse van Rensburg2Dingie H.C.J van Rensburg3Centre for Health Systems Research and Development, University of the Free StateCentre for Health Systems Research and Development, University of the Free StateCentre for Health Systems Research and Development, University of the Free State, South Africa; Health and Demographic Research Unit, Department of Sociology, Ghent University, Belguim; Department of Political Science, Stellenbosch UniversityCentre for Health Systems Research and Development, University of the Free StateBackground: Tuberculosis (TB) prevention, including infection control, is a key element in the strategy to end the global TB epidemic. While effective infection control requires all health system components to function well, this is an area that has not received sufficient attention in South Africa despite the availability of policy and guidelines. Aim: To describe the state of implementation of TB infection control measures in a high-burden metro in South Africa. Setting: The research was undertaken in a high TB- and HIV-burdened metropolitan area of South Africa. More specifically, the study sites were primary health care facilities (PHC), thatamong other services also diagnosed TB. Methods: A cross-sectional survey, focusing on the World Health Organization levels of infection control, which included structured interviews with nurses providing TB diagnosis and treatment services as well as observations, at all 41 PHC facilities in a high TB-burdened and HIV-burdened metro of South Africa. Results: Tuberculosis infection control was poorly implemented, with few facilities scoring 80% and above on compliance with infection control measures. Facility controls: 26 facilities (63.4%) had an infection control committee and 12 (29.3%) had a written infection control plan. Administrative controls: 26 facilities (63.4%) reported separating coughing and noncoughing patients, while observations revealed that only 11 facilities (26.8%) had separate waiting areas for (presumptive) TB patients. Environmental controls: most facilities used open windows for ventilation (n = 30; 73.2%); however, on the day of the visit, only 12 facilities (30.3%) had open windows in consulting rooms. Personal protective equipment: 9 facilities (22%) did not have any disposable respirators in stock and only 9 respondents (22%) had undergone fit testing. The most frequently reported barrier to implementing good TB infection control practices was lack of equipment (n = 22; 40%) such as masks and disposable respirators, as well as the structure or layout of the PHC facilities. The main recommendation to improve TB infection control was education for patients and health care workers (n = 18; 33.3%). Conclusion: All levels of the health care system should be engaged to address TB prevention and infection control in PHC facilities. Improved infection control will address the nosocomial spread of TB in health facilities and keep health care workers and patients safe from infection.https://phcfm.org/index.php/phcfm/article/view/1628TB infection controlprimary health carehealth care workers |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Michelle C. Engelbrecht Gladys Kigozi Andre P. Janse van Rensburg Dingie H.C.J van Rensburg |
spellingShingle |
Michelle C. Engelbrecht Gladys Kigozi Andre P. Janse van Rensburg Dingie H.C.J van Rensburg Tuberculosis infection control practices in a high-burden metro in South Africa: A perpetual bane for efficient primary health care service delivery African Journal of Primary Health Care & Family Medicine TB infection control primary health care health care workers |
author_facet |
Michelle C. Engelbrecht Gladys Kigozi Andre P. Janse van Rensburg Dingie H.C.J van Rensburg |
author_sort |
Michelle C. Engelbrecht |
title |
Tuberculosis infection control practices in a high-burden metro in South Africa: A perpetual bane for efficient primary health care service delivery |
title_short |
Tuberculosis infection control practices in a high-burden metro in South Africa: A perpetual bane for efficient primary health care service delivery |
title_full |
Tuberculosis infection control practices in a high-burden metro in South Africa: A perpetual bane for efficient primary health care service delivery |
title_fullStr |
Tuberculosis infection control practices in a high-burden metro in South Africa: A perpetual bane for efficient primary health care service delivery |
title_full_unstemmed |
Tuberculosis infection control practices in a high-burden metro in South Africa: A perpetual bane for efficient primary health care service delivery |
title_sort |
tuberculosis infection control practices in a high-burden metro in south africa: a perpetual bane for efficient primary health care service delivery |
publisher |
AOSIS |
series |
African Journal of Primary Health Care & Family Medicine |
issn |
2071-2928 2071-2936 |
publishDate |
2018-05-01 |
description |
Background: Tuberculosis (TB) prevention, including infection control, is a key element in the strategy to end the global TB epidemic. While effective infection control requires all health system components to function well, this is an area that has not received sufficient attention in
South Africa despite the availability of policy and guidelines.
Aim: To describe the state of implementation of TB infection control measures in a high-burden metro in South Africa.
Setting: The research was undertaken in a high TB- and HIV-burdened metropolitan area of South Africa. More specifically, the study sites were primary health care facilities (PHC), thatamong other services also diagnosed TB.
Methods: A cross-sectional survey, focusing on the World Health Organization levels of infection control, which included structured interviews with nurses providing TB diagnosis and treatment services as well as observations, at all 41 PHC facilities in a high TB-burdened and HIV-burdened metro of South Africa.
Results: Tuberculosis infection control was poorly implemented, with few facilities scoring 80% and above on compliance with infection control measures. Facility controls: 26 facilities (63.4%) had an infection control committee and 12 (29.3%) had a written infection control plan. Administrative controls: 26 facilities (63.4%) reported separating coughing and noncoughing patients, while observations revealed that only 11 facilities (26.8%) had separate waiting areas for (presumptive) TB patients. Environmental controls: most facilities used open windows for ventilation (n = 30; 73.2%); however, on the day of the visit, only 12 facilities (30.3%) had open windows in consulting rooms. Personal protective equipment: 9 facilities (22%) did not have any disposable respirators in stock and only 9 respondents (22%) had undergone fit testing. The most frequently reported barrier to implementing good TB
infection control practices was lack of equipment (n = 22; 40%) such as masks and disposable respirators, as well as the structure or layout of the PHC facilities. The main recommendation to improve TB infection control was education for patients and health care workers (n = 18; 33.3%).
Conclusion: All levels of the health care system should be engaged to address TB prevention and infection control in PHC facilities. Improved infection control will address the nosocomial spread of TB in health facilities and keep health care workers and patients safe from infection. |
topic |
TB infection control primary health care health care workers |
url |
https://phcfm.org/index.php/phcfm/article/view/1628 |
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