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Ahmad P, Arora VK. Prevalance of tuberculosis amongst healthcare workers, working in DOTS/sputum microscopy centre in two different districts of state of Uttarakhand & Uttar Pradesh of India. Indian J Tuberc 2023; 70:405-408. [PMID: 37968045 DOI: 10.1016/j.ijtb.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 02/04/2023] [Accepted: 03/22/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND & OBJECTIVE The Healthcare workers (HCWs) who work in DOTS/Sputum microscopy centre are exposed to higher risk of contacting tuberculosis (TB) comparatively to other health workers who are serving the other health sectors. The HCWs in DOTS are more exposed due to direct contact with patients suffering from TB or through sharing the infected air space with the infectious patients. The aim of the study is to know the prevalance of TB disease amongst the HCWs who are working in DOTS cum Sputum Microscopy Centre's under RNTCP in two different districts of state of Uttar Pradesh (UP) and Uttarakhand (UK) of india. METHODS The prospective cross-sectional study is conducted in two districts of different states having high burden of TB disease in UP and low burden of TB disease in UK state. All 100% (130) staff i.e. Medical officers, Sputum microscopy technicians, DOTS providers of DOTS cum Sputum Microscopy centre's of both selected Ghaziabad (UP) and Dehradun (UK) districts are covered in the study. RESULTS The 4.6% (6) healthcare workers of both the districts were taking ATT at the time of interview and 13.8% (18) HCWs had taken the ATT in past. The 62.5% (15) HCWs i.e 55.5% (5) from Dehradun district and 66.6% (10) from Ghaziabad district preferred to have a ATT from the private medical store inspite of taking DOTS with assumption of low efficacy of drugs and high toxicity. The 58.33% (14) HCWs ie 55.5% (5) staff members of DOTS/sputum microscopy centre in Dehradun & 60.0% (9) staff members of DOTS/sputum microscopy centre in Ghaziabad district had not notified about the status of their disease to the health care authority due the assumption that they may be asked to leave the job or to go on a long unpaid leave. CONCLUSION The 18.4% (24) HCWs of both the district got TB disease during their working in DOTS/Sputum microscopy centre and 4.6% (6) HCWs of both the districts were taking the ATT at the time of interview.
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Affiliation(s)
- Parvez Ahmad
- Department of Chest & TB, Santosh Medical College & University, Ghaziabad, UP, India.
| | - V K Arora
- Santosh University, Ghaziabad, UP, India
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Apriani L, McAllister S, Sharples K, Nurhasanah H, Aini IN, Susilawati N, Ruslami R, Alisjahbana B, Menzies D, Hill PC. Tuberculosis infection control measures and knowledge in primary health centres in Bandung, Indonesia. J Infect Prev 2022; 23:49-58. [PMID: 35340927 PMCID: PMC8941593 DOI: 10.1177/17571774211046880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 08/07/2021] [Indexed: 11/17/2022] Open
Abstract
Background Health care workers (HCWs) in low- and middle-income countries (LMICs) continue to have an unacceptably high prevalence and incidence of Mycobacterium tuberculosis infection due to high exposure to tuberculosis (TB) cases at health care facilities and often inadequate infection control measures. This can contribute to an increased risk of transmission not only to HCWs themselves but also to patients and the general population. Aim We assessed implementation of TB infection control measures in primary health centres (PHCs) in Bandung, Indonesia, and TB knowledge among HCWs. Methods A cross-sectional study was conducted between May and November 2017 amongst a stratified sample of the PHCs, and their HCWs, that manage TB patients in Bandung. Questionnaires were used to assess TB infection control measures plus HCW knowledge. Summary statistics, linear regression and the Kruskal-Wallis test were used for analysis. Results The median number of TB infection control measures implemented in 24 PHCs was 21 of 41 assessed. Only one of five management controls was implemented, 15 of 24 administrative controls, three of nine environmental controls and one of three personal respiratory protection controls. PHCs with TB laboratory facilities and high TB case numbers were more likely to implement TB infection control measures than other PHCs (p=0.003). In 398 HCWs, the median number of correct responses for knowledge was 10 (IQR 9-11) out of 11. Discussion HCWs had good TB knowledge. TB infection control measures were generally not implemented and need to be strengthened in PHCs to reduce M. tuberculosis transmission to HCWs, patients and visitors.
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Affiliation(s)
- Lika Apriani
- TB-HIV Research Centre, Faculty of
Medicine, Universitas Padjadjaran, Bandung, Indonesia,Department of Public Health,
Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia,Centre for International Health,
Department of Preventive and Social Medicine, University of Otago, Bandung, Indonesia
| | - Susan McAllister
- Centre for International Health,
Department of Preventive and Social Medicine, University of Otago, Bandung, Indonesia,Sue McAllister, Department of Preventive
and Social Medicine, Centre for International Health, University of Otago, PO
Box 56, Dunedin 9054, New Zealand.
| | - Katrina Sharples
- Centre for International Health,
Department of Preventive and Social Medicine, University of Otago, Bandung, Indonesia,Department of Mathematics and
Statistics, University of Otago, New Zealand
| | - Hanifah Nurhasanah
- TB-HIV Research Centre, Faculty of
Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Isni Nurul Aini
- TB-HIV Research Centre, Faculty of
Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Nopi Susilawati
- TB-HIV Research Centre, Faculty of
Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Rovina Ruslami
- TB-HIV Research Centre, Faculty of
Medicine, Universitas Padjadjaran, Bandung, Indonesia,Department of Biomedical Sciences,
Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Bachti Alisjahbana
- TB-HIV Research Centre, Faculty of
Medicine, Universitas Padjadjaran, Bandung, Indonesia,Department of Internal Medicine,
Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Dick Menzies
- Montreal Chest Institute, McGill University, Montreal, QC, Canada
| | - Philip C Hill
- Centre for International Health,
Department of Preventive and Social Medicine, University of Otago, Bandung, Indonesia
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Raj A, Ramakrishnan D, Thomas CRMT, Mavila AD, Rajiv M, Suseela RPB. Assessment of Health Facilities for Airborne Infection Control Practices and Adherence to National Airborne Infection Control Guidelines: A Study from Kerala, Southern India. Indian J Community Med 2019; 44:S23-S26. [PMID: 31728084 PMCID: PMC6824168 DOI: 10.4103/ijcm.ijcm_25_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 09/03/2019] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Nosocomial transmission of airborne infections, such as H1N1, drug-resistant tuberculosis, and Nipah virus disease, has been reported recently and has been linked to the limited airborne infection control strategies. The objective of the current study was to assess the health facilities for airborne infection control (AIC) practices and adherence to the National AIC (NAIC) guidelines, 2010. MATERIALS AND METHODS A cross-sectional study was conducted in 25 public and 25 private hospitals selected from five randomly selected districts in the state of Kerala. A checklist with 62 components was developed based on the NAIC guidelines. Frequencies, percentages, and mean with standard deviation were used to summarize facility risk assessment and compliance to guidelines. RESULTS Most of the facilities had infection control committees 35 (70%). Annual infection control trainings were held for staff in 21 (42%) facilities. Twenty (40%) facilities were not familiar with NAIC guidelines. Counseling on cough etiquette at registration was practiced in 5 (10%) institutions. Cross ventilation was present in outpatient departments in 27 (54%) institutions. Sputum was disposed properly in 43 (86%) institutions. N95 masks were available in high-risk settings in 7 (14%) health facilities. CONCLUSION There exist deficiencies in adherence to all components of NAIC guidelines including administrative, environmental, and use of personal protective equipment in both government and private hospitals in the state.
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Affiliation(s)
- Arun Raj
- Department of Community Medicine and Public Health, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - Devraj Ramakrishnan
- Department of Community Medicine and Public Health, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | | | - Amrita Das Mavila
- Department of Community Medicine and Public Health, Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - Midhun Rajiv
- Department of Community Medicine and Public Health, Amrita Institute of Medical Sciences, Kochi, Kerala, India
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Sagili KD, Satyanarayana S, Chadha SS, Wilson NC, Kumar AMV, Moonan PK, Oeltmann JE, Chadha VK, Nagaraja SB, Ghosh S, Q Lo T, Volkmann T, Willis M, Shringarpure K, Reddy RC, Kumar P, Nair SA, Rao R, Yassin M, Mwangala P, Zachariah R, Tonsing J, Harries AD, Khaparde S. Operational research within a Global Fund supported tuberculosis project in India: why, how and its contribution towards change in policy and practice. Glob Health Action 2018; 11:1445467. [PMID: 29553308 PMCID: PMC5912428 DOI: 10.1080/16549716.2018.1445467] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The Global Fund encourages operational research (OR) in all its grants; however very few reports describe this aspect. In India, Project Axshya was supported by a Global Fund grant to improve the reach and visibility of the government Tuberculosis (TB) services among marginalised and vulnerable communities. OR was incorporated to build research capacity of professionals working with the national TB programme and to generate evidence to inform policies and practices. OBJECTIVES To describe how Project Axshya facilitated building OR capacity within the country, helped in addressing several TB control priority research questions, documented project activities and their outcomes, and influenced policy and practice. METHODS From September 2010 to September 2016, three key OR-related activities were implemented. First, practical output-oriented modular training courses were conducted (n = 3) to build research capacity of personnel involved in the TB programme, co-facilitated by The Union, in collaboration with the national TB programme, WHO country office and CDC, Atlanta. Second, two large-scale Knowledge, Attitude and Practice (KAP) surveys were conducted at baseline and mid-project to assess the changes pertaining to TB knowledge, attitudes and practices among the general population, TB patients and health care providers over the project period. Third, studies were conducted to describe the project's core activities and outcomes. RESULTS In the training courses, 44 participant teams were supported to develop research protocols on topics of national priority, resulting in 28 peer-reviewed scientific publications. The KAP surveys and description of project activities resulted in 14 peer-reviewed publications. Of the published papers at least 12 have influenced change in policy or practice. CONCLUSIONS OR within a Global Fund supported TB project has resulted in building OR capacity, facilitating research in areas of national priority and influencing policy and practice. We believe this experience will provide guidance for undertaking OR in Global Fund projects.
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Affiliation(s)
- Karuna D Sagili
- a Department of Tuberculosis and Communicable Diseases , International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office , New Delhi , India
| | - Srinath Satyanarayana
- b Centre for Operational Research , International Union Against Tuberculosis and Lung Disease , Paris , France
| | - Sarabjit S Chadha
- a Department of Tuberculosis and Communicable Diseases , International Union Against Tuberculosis and Lung Disease, South-East Asia Regional Office , New Delhi , India
| | - Nevin C Wilson
- c Independent Senior Public Health Consultant , Nilgiris , Tamil Nadu , India
| | - Ajay M V Kumar
- b Centre for Operational Research , International Union Against Tuberculosis and Lung Disease , Paris , France
| | - Patrick K Moonan
- d Division of Global HIV and Tuberculosis , US Centers for Disease Control , Atlanta , GA , USA
| | - John E Oeltmann
- d Division of Global HIV and Tuberculosis , US Centers for Disease Control , Atlanta , GA , USA
| | - Vineet K Chadha
- e Epidemiology and Research Division , National Tuberculosis Institute , Bangalore , India
| | | | - Smita Ghosh
- d Division of Global HIV and Tuberculosis , US Centers for Disease Control , Atlanta , GA , USA
| | - Terrence Q Lo
- d Division of Global HIV and Tuberculosis , US Centers for Disease Control , Atlanta , GA , USA
| | - Tyson Volkmann
- d Division of Global HIV and Tuberculosis , US Centers for Disease Control , Atlanta , GA , USA
| | - Matthew Willis
- d Division of Global HIV and Tuberculosis , US Centers for Disease Control , Atlanta , GA , USA
| | - Kalpita Shringarpure
- g Department of Community Medicine , Government Medical College and SSG Hospital , Vadodara , India
| | | | - Prahlad Kumar
- h National Tuberculosis Institute , Bangalore , India
| | - Sreenivas A Nair
- i World Health Organisation India Country Office , New Delhi , India
| | - Raghuram Rao
- j Central Tuberculosis Division , Ministry of Health and Family Welfare, Government of India
| | - Mohammed Yassin
- k The Global Fund to fight AIDS , Tuberculosis and Malaria , Geneva , Switzerland
| | - Perry Mwangala
- k The Global Fund to fight AIDS , Tuberculosis and Malaria , Geneva , Switzerland
| | - Rony Zachariah
- l Médecins sans Frontières , Brussels Operational Center (LuxoR) , Luxembourg City , Luxembourg
| | - Jamhoih Tonsing
- m International Union Against Tuberculosis and Lung Disease , South-East Asia Regional Office , New Delhi , India
| | - Anthony D Harries
- b Centre for Operational Research , International Union Against Tuberculosis and Lung Disease , Paris , France
| | - Sunil Khaparde
- j Central Tuberculosis Division , Ministry of Health and Family Welfare, Government of India
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Tremblay N, Musa E, Cooper C, Van den Bergh R, Owiti P, Baller A, Siafa T, Woldeyohannes D, Shringarpure K, Gasasira A. Infection prevention and control in health facilities in post-Ebola Liberia: don't forget the private sector! Public Health Action 2017; 7:S94-S99. [PMID: 28744446 DOI: 10.5588/pha.16.0098] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 01/05/2017] [Indexed: 11/10/2022] Open
Abstract
Setting: Recognising the importance of infection prevention and control (IPC), a minimum standards tool (MST) was developed in Liberia to guide the safe (re-) opening and provision of care in health facilities. Objectives: To analyse the implementation of specific IPC measures after the 2014 Ebola virus outbreak between June 2015 and May 2016, and to compare the relative improvements in IPC between the public and private sectors. Design: A retrospective comparative cohort study. Results: We evaluated 723 (94%) of the 769 health facilities in Liberia. Of these, 437 (60%) were public and 286 (40%) were private. There was an overall improvement in the MST scores from a median of 13 to 14 out of a maximum possible score of 16. While improvements were observed in all aspects of IPC in both public and private health facilities, IPC implementation was systematically higher in public facilities. Conclusions: We demonstrate the feasibility of monitoring IPC implementation using the MST checklist in post-Ebola Liberia. Our study shows that improvements were made in key aspects of IPC after 1 year of evaluations and tailored recommendations. We also highlight the need to increase the focus on the private sector to achieve further improvements in IPC.
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Affiliation(s)
- N Tremblay
- World Health Organization Country Office, Monrovia, Liberia
| | - E Musa
- World Health Organization Country Office, Monrovia, Liberia
| | - C Cooper
- Department of Health Services, Ministry of Health, Monrovia, Liberia
| | | | - P Owiti
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.,International Union Against Tuberculosis and Lung Disease, Paris, France
| | - A Baller
- World Health Organization Country Office, Monrovia, Liberia
| | - T Siafa
- World Health Organization Country Office, Monrovia, Liberia
| | - D Woldeyohannes
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - K Shringarpure
- Department of Community Medicine, Baroda Medical College, Vadodara, India
| | - A Gasasira
- World Health Organization Country Office, Monrovia, Liberia
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