Assessment of the protective measures taken in preventing nosocomial transmission of pulmonary tuberculosis among health-care workers.

Abstract

Abstract. To assess the protective measures taken at a public sector hospital in preventing nosocomial transmission of pulmonary tuberculosis (TB) among health-care workers, a study was conducted in Civil Hospital Karachi during the period of January 2011 to June 2011. The sample comprised of doctors, registered nurses and non-medical staff working in medical units. Participants were asked about the routine precautionary measures taken against TB as well as those they taken while attending patients suspected of having TB as well as diagnosed TB patients. They were also questioned about the administrative and personal protective measures which were employed against TB.  Collected data was entered and analyzed by SPSS software, version 17.0. Chi-square test was applied to test association between categorical variables and Student’s t-test for continuous variables.

Total of 150 participants were included in the study. 26.7% of the participants had undergone screening test for TB at the time of their employment while only 16% undergo regular screening test. None of those interviewed ever took any precautionary medication against TB. 46.7% of the participants ensured proper ventilation at their working place. 72.7% stated that the management didn’t take appropriate steps to ensure their safety. 6% of the participants had suffered from TB during their service while 13.3% had suffered some other respiratory disease. Participants were more cautious when attending diagnosed TB patients as compared to those who were suspected of having TB. Measures taken to prevent the nosocomial transmission of TB in health-care workers are suboptimal. Factors contributing to the transmission should be explored and subsequently addressed.

Key words: Health-care workers, nosocomial transmission, protective measures, pulmonary tuberculosis

Keywords

• -

Kaynakça

1. Pakistan Tuberculosis Profile. WHO Global TB Report 2009. Available at http://www.usaid.gov. Accessed 21st Feb 2011.
2. Fennelly KP, Iseman MD. Health care workers and tuberculosis: The battle of a century. Int J Tuberc Lung Dis 1999; 3: 363-364.
3. Sepkowitz KA. Tuberculin skin testing and the health care worker: Lessons of the Prophit Survey. Tuber Lung Dis 1996; 77: 81-85.
4. Sepkowitz KA. Tuberculosis and the health care worker: A historical perspective. Ann Intern Med 1994; 120: 71-79.
5. Joshi R, Reingold AL, Menzies D, Pai M. Tuberculosis among health-care workers in low- and middle-income countries: A systematic review. PLoS Med 2006; 3: 494.
6. Harries AD, Maher D, Nunn P. Practical and affordable measures for the protection of health care workers from tuberculosis in low-income countries. Bull World Health Organ 1997; 75: 477-489.
7. Pai M, Kalantri S, Aggarwal AN, Menzies D, Blumberg HM. Nosocomial tuberculosis in India. Emerg Infect Dis 2006; 12: 1311-1318.
8. Chauhan LS. Status report on RNTCP. Indian J Tuberc 2008; 55: 145-148.

9. Whitehead M, Dahlgren G, Evans T. Equity and health sector reforms: Can low-income countries escape the medical poverty trap? Lancet 2001; 358: 833.
10. Jones-Lopez EC, Ellner JJ. Tuberculosis infection among HCWs. Int J Tuberc Lung Dis 2005; 9: 591.
11. Suzuki Y, Sone T. A study on preventive measures against tuberculosis in care facilities for the elderly in a Tokyo metropolitan district. Kekkaku 2011; 86: 437-444.
12. Li CY, Sung FC. A review of the healthy worker effect in occupational epidemiology. Occup Med (Lond) 1999; 49: 225-229.
13. Harries AD, Nyirenda TE, Banerjee A, Boeree MJ, Salaniponi FM. Tuberculosis in health care workers in Malawi. Trans R Soc Trop Med Hyg 1999; 93: 32-35.
14. Granich R, Binkin NJ, Jarvis WR, et al. Guidelines for the prevention of tuberculosis in health care facilities in resource-limited settings. WHO/CDS/TB/99.269. Geneva, Switzerland: World Health Organization; 1999. 51 p. p. Available:http://www.who.int/docstore/gtb/publicati ons/healthcare/PDF/WHO99–269.pdf. Accessed 23 March 2011
15. Luksamijarulkul P, Supapvanit C, Loosereewanich P, Aiumlaor P. Risk assessment towards tuberculosis among hospital personnel: administrative control, risk exposure, use of protective barriers and microbial air quality. Southeast Asian J Trop Med Public Health 2004; 35: 1005-1011.