Original Research

Tuberculosis infection control practices in a high-burden metro in South Africa: A perpetual bane for efficient primary health care service delivery

Michelle C. Engelbrecht, Gladys Kigozi, Andre P. Janse van Rensburg, Dingie H.C.J van Rensburg
African Journal of Primary Health Care & Family Medicine | Vol 10, No 1 | a1628 | DOI: https://doi.org/10.4102/phcfm.v10i1.1628 | © 2018 Michelle C. Engelbrecht, Gladys Kigozi, Andre P. Janse van Rensburg, Dingie H.C.J Van Rensburg | This work is licensed under CC Attribution 4.0
Submitted: 15 September 2017 | Published: 30 May 2018

About the author(s)

Michelle C. Engelbrecht, Centre for Health Systems Research and Development, University of the Free State, South Africa
Gladys Kigozi, Centre for Health Systems Research and Development, University of the Free State, South Africa
Andre P. Janse van Rensburg, Centre for Health Systems Research and Development, University of the Free State, South Africa; Health and Demographic Research Unit, Department of Sociology, Ghent University, Belguim; Department of Political Science, Stellenbosch University, South Africa
Dingie H.C.J van Rensburg, Centre for Health Systems Research and Development, University of the Free State, South Africa


Share this article

Bookmark and Share

Abstract

Background: Tuberculosis (TB) prevention, including infection control, is a key element in the strategy to end the global TB epidemic. While effective infection control requires all health system components to function well, this is an area that has not received sufficient attention in
South Africa despite the availability of policy and guidelines.

Aim: To describe the state of implementation of TB infection control measures in a high-burden metro in South Africa.

Setting: The research was undertaken in a high TB- and HIV-burdened metropolitan area of South Africa. More specifically, the study sites were primary health care facilities (PHC), thatamong other services also diagnosed TB.

Methods: A cross-sectional survey, focusing on the World Health Organization levels of infection control, which included structured interviews with nurses providing TB diagnosis and treatment services as well as observations, at all 41 PHC facilities in a high TB-burdened and HIV-burdened metro of South Africa.
Results: Tuberculosis infection control was poorly implemented, with few facilities scoring 80% and above on compliance with infection control measures. Facility controls: 26 facilities (63.4%) had an infection control committee and 12 (29.3%) had a written infection control plan. Administrative controls: 26 facilities (63.4%) reported separating coughing and noncoughing patients, while observations revealed that only 11 facilities (26.8%) had separate waiting areas for (presumptive) TB patients. Environmental controls: most facilities used open windows for ventilation (n = 30; 73.2%); however, on the day of the visit, only 12 facilities (30.3%) had open windows in consulting rooms. Personal protective equipment: 9 facilities (22%) did not have any disposable respirators in stock and only 9 respondents (22%) had undergone fit testing. The most frequently reported barrier to implementing good TB
infection control practices was lack of equipment (n = 22; 40%) such as masks and disposable respirators, as well as the structure or layout of the PHC facilities. The main recommendation to improve TB infection control was education for patients and health care workers (n = 18; 33.3%).
Conclusion: All levels of the health care system should be engaged to address TB prevention and infection control in PHC facilities. Improved infection control will address the nosocomial spread of TB in health facilities and keep health care workers and patients safe from infection.


Keywords

TB infection control; primary health care; health care workers

Metrics

Total abstract views: 93
Total article views: 59


Crossref Citations

No related citations found.