Frank van Leth

Associate Professor Health Sciences

Implementation of tuberculosis infection prevention and control in Mozambican health care facilities.


Journal article


Miranda Brouwer, E. Coelho, C. D. D. Mosse, F. V. Leth
The International Journal of Tuberculosis and Lung Disease, 2015

Semantic Scholar DOI PubMed
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APA   Click to copy
Brouwer, M., Coelho, E., Mosse, C. D. D., & Leth, F. V. (2015). Implementation of tuberculosis infection prevention and control in Mozambican health care facilities. The International Journal of Tuberculosis and Lung Disease.


Chicago/Turabian   Click to copy
Brouwer, Miranda, E. Coelho, C. D. D. Mosse, and F. V. Leth. “Implementation of Tuberculosis Infection Prevention and Control in Mozambican Health Care Facilities.” The International Journal of Tuberculosis and Lung Disease (2015).


MLA   Click to copy
Brouwer, Miranda, et al. “Implementation of Tuberculosis Infection Prevention and Control in Mozambican Health Care Facilities.” The International Journal of Tuberculosis and Lung Disease, 2015.


BibTeX   Click to copy

@article{miranda2015a,
  title = {Implementation of tuberculosis infection prevention and control in Mozambican health care facilities.},
  year = {2015},
  journal = {The International Journal of Tuberculosis and Lung Disease},
  author = {Brouwer, Miranda and Coelho, E. and Mosse, C. D. D. and Leth, F. V.}
}

Abstract

SETTING District and urban health care facilities in three provinces (Manica, Sofala, Tete) in central Mozambique.

OBJECTIVE To assess the level of implementation of selected tuberculosis infection prevention and control (TB-IPC) measures.

DESIGN In a cross-sectional study of TB-IPC implementation in 29 health care facilities, we assessed TB clinics, laboratories, out-patient departments and medical and TB wards. Assessment included selected managerial, administrative and environmental measures and the availability and use of respiratory protective equipment (N95 respirators).

RESULTS Guidelines for diagnosis and treatment of (presumptive) TB patients were not present in all facilities. Staff instructed patients on sputum collection in 91%, but only 4% observed it. Using a pragmatic '20% rule', 52% of the rooms assessed had adequate ventilation. Potentially, this could be increased to 76%. Three quarters of the health care workers had N95 respirators. Only 36% knew how to use it correctly.

CONCLUSION Implementation of TB-IPC measures showed wide variations within health care facilities. Relatively simple measures to improve TB-IPC include the availability of guidelines, opening doors and windows to improve ventilation, and training and support on correct N95 respirator use. However, even relatively simple measures are challenging to implement, and require careful attention in and evaluation of the implementation process.