Implementation of tuberculosis infection control measures at HIV care and treatment sites in sub-Saharan Africa
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.
Document Type: Research Article
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: 2012-12-01
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