Yates, Tom A;
Karat, Aaron S;
Bozzani, Fiammetta;
McCreesh, Nicky;
MacGregor, Hayley;
Beckwith, Peter G;
Govender, Indira;
... Grant, Alison D; + view all
(2023)
Time to change the way we think about tuberculosis infection prevention and control in health facilities: insights from recent research.
Antimicrobial Stewardship & Healthcare Epidemiology
, 3
(1)
, Article e117. 10.1017/ash.2023.192.
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Abstract
In clinical settings where airborne pathogens, such as Mycobacterium tuberculosis, are prevalent, they constitute an important threat to health workers and people accessing healthcare. We report key insights from a 3-year project conducted in primary healthcare clinics in South Africa, alongside other recent tuberculosis infection prevention and control (TB-IPC) research. We discuss the fragmentation of TB-IPC policies and budgets; the characteristics of individuals attending clinics with prevalent pulmonary tuberculosis; clinic congestion and patient flow; clinic design and natural ventilation; and the facility-level determinants of the implementation (or not) of TB-IPC interventions. We present modeling studies that describe the contribution of M. tuberculosis transmission in clinics to the community tuberculosis burden and economic evaluations showing that TB-IPC interventions are highly cost-effective. We argue for a set of changes to TB-IPC, including better coordination of policymaking, clinic decongestion, changes to clinic design and building regulations, and budgeting for enablers to sustain implementation of TB-IPC interventions. Additional research is needed to find the most effective means of improving the implementation of TB-IPC interventions; to develop approaches to screening for prevalent pulmonary tuberculosis that do not rely on symptoms; and to identify groups of patients that can be seen in clinic less frequently.
| Type: | Article |
|---|---|
| Title: | Time to change the way we think about tuberculosis infection prevention and control in health facilities: insights from recent research |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1017/ash.2023.192 |
| Publisher version: | https://doi.org/10.1017/ash.2023.192 |
| Language: | English |
| Additional information: | © The Author(s),2023. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10173964 |
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