scholarly journals Assessment of knowledge, attitude and practices of healthcare workers about prevention and control of multidrug-resistant tuberculosis at Infectious Diseases Hospital Kano, Nigeria

2020 ◽  
Vol 12 (1) ◽  
pp. 30-39
Author(s):  
Salisu Aliyu Ahmad ◽  
Usman Hafsat ◽  
Alhaji Bura Haruna ◽  
Yahaya Auwalu ◽  
Yakubu Umar Nuru
Keyword(s):  
Infectious Diseases ◽  
Prevention And Control ◽  
Healthcare Workers ◽  
Multidrug Resistant ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
And Control

scholarly journals Task-shifting directly observed treatment and multidrug-resistant tuberculosis injection administration to lay health workers: stakeholder perceptions in rural Eswatini

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Ernest Peresu ◽  
J. Christo Heunis ◽  
N. Gladys Kigozi ◽  
Diana De Graeve
Keyword(s):  
Healthcare Workers ◽  
Health Workers ◽  
Multidrug Resistant ◽  
Task Shifting ◽  
Tb Treatment ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Key Stakeholders ◽  
Mdr Tb ◽  
Directly Observed Treatment

Abstract Background Eswatini is facing a critical shortage of human resources for health (HRH) and limited access to multidrug-resistant tuberculosis (MDR-TB) treatment in rural areas. This study assessed multiple stakeholders’ perceptions of task-shifting directly observed treatment (DOT) supervision and administration of intramuscular MDR-TB injections to lay health workers (LHWs). Methods A mixed methods study comprising a cross-sectional survey using a semi-structured questionnaire with community treatment supporters (CTSs) and a focus group discussion with key stakeholders including representatives from the Eswatini Ministry of Health (MOH), donor organisations, professional regulatory institutions, nursing academia, civil society and healthcare providers was conducted in May 2017. Descriptive statistics, thematic content analysis and data triangulation aided in the interpretation of results. Results A large majority of CTSs (n = 78; 95.1%) were female and 33 (40.2%) were older than 50 years. Most (n = 7; 70.0%) key stakeholders had over 10 years of work experience in policy-making, advocacy in the fields of HRH or day-to-day practice in MDR-TB management. Task-shifting of MDR-TB injection administration was implemented without national policy guidance and regulation. Stakeholders viewed the strategy to be driven by the prevailing shortage of professional frontline HRH and limited access to MDR-TB treatment. Task-shifting was perceived to improve medication adherence, and reduce stigma and transport-related MDR-TB treatment access barriers. Frontline healthcare workers and implementing donor partners fully supported task-shifting. Policy-makers and other stakeholders accepted task-shifting conditionally due to fears of poor standards of care related to perceived incompetence of CTSs. Appropriate compensation, adequate training and supervision, and non-financial incentives were suggested to retain CTSs. A holistic task-shifting policy and collaboration between the MOH, academia and nursing council in regulating the practice were recommended. Conclusions Stakeholders generally accepted the delegation of DOT supervision and administration of intramuscular MDR-TB injections to LHWs as a strategy to increase access to treatment, albeit with some apprehension. Findings from this study stress that task-shifting is not a panacea for HRH shortages, but a short-term solution that must form part of an overall simultaneous strategy to train, attract and retain adequate numbers of professional healthcare workers in Eswatini. To address some of the apprehension and ambivalence about expanding access to MDR-TB services through task-shifting, attention should be paid to important aspects such as competence-based training, certification and accreditation, adequate supportive on-the-job supervision, recognition, compensation, and expediting policy and regulatory support for LHWs.

scholarly journals WHO publishes the third edition of guidelines for the prevention and control of air-travel-associated tuberculosis

2008 ◽  
Vol 13 (23) ◽  
Author(s):  
I Abubakar ◽  
K Fernandez de la Hoz
Keyword(s):  
Multidrug Resistant ◽  
Air Travel ◽  
Public Health Agencies ◽  
The Public ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Published Evidence ◽  
Health Agencies ◽  
Mdr Tb ◽  
And Control

Air travel has increased over the last few decades resulting in greater risk of the spread of infectious diseases carried by infectious travellers. The risk of transmission of pathogens is particularly important for airborne organisms raising concern among public health agencies and the public. Despite limited research on the risk of tuberculosis associated with air travel, several reports have published evidence of the transmission of tuberculosis infection, including multidrug-resistant tuberculosis (MDR-TB) [1, 2].

scholarly journals Estimating the contribution of transmission in primary healthcare clinics to community-wide TB disease incidence, and the impact of infection prevention and control interventions, in KwaZulu-Natal, South Africa

2021 ◽  
Author(s):  
Nicky McCreesh ◽  
Aaron S Karat ◽  
Indira Govender ◽  
Kathy Baisley ◽  
Karin Diaconu ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Multidrug Resistant ◽  
Infection Prevention And Control ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Incidence And Mortality ◽  
Kwazulu Natal ◽  
And Control ◽  
Primary Healthcare Clinics ◽  
The Impact

Background There is a high risk of Mycobacterium tuberculosis (Mtb) transmission in healthcare facilities in high burden settings. Recent World Health Organization guidelines on tuberculosis infection prevention and control (IPC) recommend a range of measures to reduce transmission in healthcare and institutional settings. These were evaluated primarily based on evidence for their effects on transmission to healthcare workers in hospitals. To estimate the overall impact of IPC interventions, it is necessary to also consider their impact on overall community-wide tuberculosis incidence and mortality. Methods We developed an individual-based model of Mtb transmission between household members, in primary healthcare clinics (PHCs), and in other congregate settings; drug sensitive and multidrug resistant tuberculosis disease development and resolution; and HIV and antiretroviral therapy (ART) and their effects on tuberculosis. The model was parameterised using data from a high HIV prevalence, rural/peri-urban community in KwaZulu-Natal, South Africa, including data on social contact in clinics and other settings by sex, age group, and HIV/ART status; and data on the prevalence of tuberculosis in clinic attendees and the general population. We estimated the proportion of disease in adults that resulted from transmission in PHC clinics in 2019, and the impact of a range of IPC interventions in clinics on community-wide TB incidence and mortality. Results We estimate that 7.6% (plausible range 3.9-13.9%) of drug sensitive and multidrug resistant tuberculosis in adults resulted from transmission in PHC clinics in the study community in 2019. The proportion is higher in HIV-positive people, at 9.3% (4.8%-16.8%), compared to 5.3% (2.7%-10.1%) in HIV-negative people. We estimate that IPC interventions could reduce the number of incident TB cases in the community in 2021-2030 by 3.4-8.0%, and the number of deaths by 3.0-7.2%. Conclusions A non-trivial proportion of tuberculosis results from transmission in PHC clinics in the study communities, particularly in HIV-positive people. Implementing IPC interventions could lead to moderate reductions in disease burden. We therefore recommend that IPC measures in clinics should be implemented both for their benefits to staff and patients, but also for their likely effects on TB incidence and mortality in the surrounding community.

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