Free Content Implementation of tuberculosis infection control measures at HIV care and treatment sites in sub-Saharan Africa

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Abstract:

SETTING: A total of 663 human immunodeficiency virus (HIV) care and treatment sites in nine tuberculosis (TB) affected African countries, serving over 900 000 persons living with HIV.

OBJECTIVE: To determine the implementation of infection control (IC) measures and whether program and facility characteristics were associated with implementation of these measures.

DESIGN: A survey was conducted to assess the presence of a TB IC plan, triage practices for TB suspects, location of sputum collection and availability of particulate respirators. The association of facility characteristics with IC measures was examined using bivariate and multivariate methods.

RESULTS: Forty-seven per cent (range across countries [RAC] 2–77%) of sites had written TB IC plans; 60% (RAC 5–93%) practiced triage; of those with access to microscopy, 83% (RAC 59–91%) performed sputum collection outdoors and 13% (RAC 0–36%) in ventilated indoor rooms; 16% (RAC 1–87%) had particulate respirators available. Sites providing anti-tuberculosis treatment were more likely to have written IC plans (54% vs. 12%, P < 0.0001) and particulate respirators (18% vs. 8%, P = 0.0126), and to perform TB triage (65% vs. 40%, P = 0.0001) than those without anti-tuberculosis treatment services.

CONCLUSIONS: To protect HIV-infected patients and health care workers, there is an urgent need to scale up IC practices at HIV care and treatment sites, particularly at sites without anti-tuberculosis treatment services.

Keywords: HIV; infection control; tuberculosis

Document Type: Research Article

DOI: http://dx.doi.org/10.5588/ijtld.12.0033

Affiliations: 1: Botswana–University of Pennsylvania Partnership, University of Pennsylvania, Philadelphia, Pennsylvania, USA 2: International Center for AIDS Care and Treatment Programs, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA 3: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA; City University of New York School of Public Health, New York, New York, USA 4: International Center for AIDS Care and Treatment Programs, Mailman School of Public Health, Columbia University, New York, New York, USA

Publication date: December 1, 2012

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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