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Assessment of Organizational Measures to Prevent Nosocomial Tuberculosis in Health Facilities of 4 Sub-Saharan Countries in 2010

Published online by Cambridge University Press:  02 January 2015

Jérôme Robert ,
Dissou Affolabi ,
Fantché Awokou ,
Désiré Nolna ,
Bilé Adou Philippe Manouan ,
Yapo Blaise Acho ,
Martin Gninafon  and
Arnaud Trebucq
Jérôme Robert*
Affiliation:
Laboratoire de Bactériologie Hygiène Hospitalière, Hôpital Pitié-Salpêtrière Assistance Publique–Hôpitaux de Paris, Equipe d'Accueil 1541, Université Pierre et Marie Curie–Paris 6, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Paris, France
Dissou Affolabi
Affiliation:
Programme National contre la Tuberculose, Cotonou, Benin
Fantché Awokou
Affiliation:
National Tuberculosis Control Programme, Ministère de la Santé du Togo, Lomé, Togo
Désiré Nolna
Affiliation:
National Tuberculosis Control Programme, Yaoundé, Cameroon
Bilé Adou Philippe Manouan
Affiliation:
Programme National de Lutte contre la Tuberculose, Abidjan, Côte d'lvoire
Yapo Blaise Acho
Affiliation:
Centre Hospitalier Universitaire de Cocody et Direction Générale de l'Hygiène Publique, Abidjan, Côte d'Ivoire
Martin Gninafon
Affiliation:
Programme National contre la Tuberculose, Cotonou, Benin
Arnaud Trebucq
Affiliation:
International Union against Tuberculosis and Lung Disease, Paris, France
*
Laboratoire de Bactériologie-Hygiène, Faculté de Médecine Pierre et Marie Curie (UPMC Paris 6), 91 boulevard de l'hôpital, 75634 Paris Cedex 13, France (jerome.robert@psl.aphp.fr)
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Abstract

Background.

The prevention of tuberculosis (TB) transmission in healthcare settings is a major issue, particularly because of the interaction between human immunodeficiency virus and TB and the emergence of multidrug-resistant TB.

Setting.

Healthcare facilities involved in TB management in 4 African countries (Benin, Cameroon, Cote d'Ivoire, and Togo).

Methods.

A questionnaire was developed by representatives of the 4 countries to evaluate the organizational measures implemented in facilities involved in TB management. On-site visits were performed between July 2010 and July 2011.

Results.

A total of 115 facilities, including 10 university hospitals and 92 basic management units, were visited. None had a TB infection control plan, and only 5.2% provided education for staff about nosocomial TB. Overall, 48.3% of the facilities performed triage of suspected TB cases on hospital arrival or admission, 89.6% provided education for TB cases on cough etiquette, 20.0% segregated smear-positive TB cases, and 15.7% segregated previously treated cases. A total of 15.5% of the facilities registered TB among staff, for a global prevalence rate of 348 cases per 100,000 staff members.

Conclusion.

This survey identified simple and mostly costless administrative measures to be urgently implemented at the local level to prevent nosocomial TB, such as staff education, triage on admission, and segregation of previously treated patients.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 2 , February 2013 , pp. 190 - 194
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013 

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References

1. Beck-Sagué, C, Dooley, SW, Hutton, MD, et al. Hospital outbreak of multidrug-resistant Mycobacterium tuberculosis infections: factors in transmission to staff and HIV-infected patients. JAMA 1992;268(10):1280–1286.Google Scholar
2. Frieden, TR, Sherman, LF, Maw, KL, et al. A multi-institutional outbreak of highly drug-resistant tuberculosis: epidemiology and clinical outcomes. JAMA 1996;276(15):1229–1235.Google Scholar
3. Campos, PE, Suarez, PG, Sanchez, J, et al. Multidrug-resistant Mycobacterium tuberculosis in HIV-infected persons, Peru. Emerg Infectious Dis 2003;9(12):1571–1578.Google Scholar
4. Gandhi, NR, Moll, A, Sturm, AW, et al. Extensively drug-resistant tuberculosis as a cause of death in patients co-infected with tuberculosis and HIV in a rural area of South Africa. Lancet 2006;368(9547):1575–1580.Google Scholar
5. World Health Organization (WHO). WHO Policy on TB Infection Control in Health-Care Facilities, Congregate Settings and Households. Geneva: WHO, 2009.Google Scholar
6. Centers for Disease Control and Prevention. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005. MMWR Recomm Rep 2005;54(RR-17):1–141.Google Scholar
7. TB data. World Health Organization website, http://www.who.int/tb/data. Accessed September 7, 2012.Google Scholar
8. World Health Organization (WHO). Towards Universal Access to Diagnosis and Treatment of Multidrug-Resistant and Extensively Drug-Resistant Tuberculosis by 2015: WHO Progress Report 2011. Geneva: WHO, 2011.Google Scholar
9. Trébucq, A, Enarson, DA, Chiang, CY, et al. Xpert® MTB/RIF for national tuberculosis programmes in low-income countries: when, where and how? Int J Tuberc Lung Dis 2011;15(12):1567–1572.Google Scholar
10. Menzies, D, Joshi, R, Pai, M. Risk of tuberculosis infection and disease associated with work in health care settings. Int J Tuberc Lung Dis 2007;11(6):593–605.Google Scholar
11. Harries, AD, Zachariah, R, Chimzizi, R, et al. Operational research in Malawi: making a difference with cotrimoxazole preventive therapy in patients with tuberculosis and HIV. BMC Public Health 2011;11:593.Google Scholar
12. Kanyerere, HS, Salaniponi, FM. Tuberculosis in health care workers in a central hospital in Malawi. Int J Tuberc Lung Dis 2003; 7(5):489–492.Google Scholar