a. momand impact of tb infection control …...there was a need to improve safety in health facility...

Impact of TB Infection Control Implementation on Health Workers in Afghanistan, 2011 Authors: A. Momand 1 , M. Rashidi 2 , G. Qader 3 , P.G. Suarez 4 , K. Seddiq 5 , S.W. Maroofi 6 , M.K. Ayoubi 7 , M. Gnizada 8 Affiliations: 1 Technical Advisor, TB CARE I; 2 Country Project Director, TB CARE I, Afghanistan; 3 Senior Technical Advisor, TB CARE I, Afghanistan; 4 Global TB Technical Lead, Management Sciences for Health, Arlington, USA; 5 Manager, National TB Program, Ministry of Public Health, Afghanistan; 6 Center for Disease Control Director, Ministry of Public Health, Afghanistan; 7 Training Officer, National TB Program, Afghanistan; 8 Deputy Director, National TB Institute, Afghanistan Afghanistan’s TB Control Need The risk of tuberculosis (TB) infection is higher among health care staff compared to the general population. There was a need to improve safety in health facility environments to reduce the risk of TB infection for: Health care staff Clients Communities Health facilities in Afghanistan are poorly designed for TB infection control (IC). Most health workers have a poor knowledge of TB IC strategies. The National Response The USAID-funded TB CARE I project with the National TB Program (NTP) improved TB IC in 45 health facilities by: Screening clients for TB at health facility entrances and waiting areas, Directing people with TB symptoms to TB treatment areas and laboratory rooms, Redesigning rooms to ensure natural and mechanical ventilation, Using mechanical ventilation to ensure airflow. Evaluating Impact TB CARE I and NTP assessed the impact of TB IC: In November 2011 in Kabul and Khost provinces Among 240 health workers from 10 hospitals in high-risk areas Used the World Health Organization’s staff risk assessment log to record symptoms, HIV status, TB infection, etc. Offered X-rays and testing to health workers For more information, please contact: Amanullah Momand, MD, Technical Advisor, TB CARE I, Afghanistan; Tel: +93 700 607 545 Email; [email protected] Acknowledgement The Government of the United States of America through the US Agency for International Development (USAID) for funding the TB CARE I project. Assessment Results: Low TB Infection in Facilities with TB Infection Control Measures National TB Institute staff discuss treatment options with a TB patient Conclusion TB IC significantly reduced the risk of TB infection for health workers. Because TB incidence is higher among health workers, TB IC should be expanded to other health facilities in similar settings. Indicator Intervention area (with TB IC) Control area (without TB IC) Sample size 120 120 Staff with TB symptoms (13) 11% (21) 18% Staff diagnosed with TB (3) 27% (7) 31% Staff providing daily treatment to TB patients who were diagnosed with TB 8% 19% Lab technicians who were diagnosed with TB 12% 29%

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Page 1: A. Momand Impact of TB Infection Control …...There was a need to improve safety in health facility environments to reduce the risk of TB infection for:! " Health care staff! " Clients!

Impact of TB Infection Control Implementation on Health Workers in Afghanistan, 2011

Authors: A. Momand1, M. Rashidi2, G. Qader3, ��P.G. Suarez4, K. Seddiq5, S.W. Maroofi6, M.K. Ayoubi7, ��M. Gnizada8 Affiliations: 1Technical Advisor, TB CARE I; 2Country Project Director, TB CARE I, Afghanistan; 3Senior Technical Advisor, TB CARE I, Afghanistan; 4Global TB Technical Lead, Management Sciences for Health, Arlington, USA; 5Manager, National TB Program, Ministry of Public Health, Afghanistan; 6Center for Disease Control Director, Ministry of Public Health, Afghanistan; 7Training Officer, National TB Program, Afghanistan; 8Deputy Director, National TB Institute, Afghanistan

Afghanistan’s TB Control Need §  The risk of tuberculosis (TB) infection is higher among health

care staff compared to the general population.

§  There was a need to improve safety in health facility environments to reduce the risk of TB infection for:

v Health care staff v Clients

v Communities

§  Health facilities in Afghanistan are poorly designed for TB infection control (IC).

§ Most health workers have a poor knowledge of TB IC strategies.

The National Response §  The USAID-funded TB CARE I project with the National TB

Program (NTP) improved TB IC in 45 health facilities by: v  Screening clients for TB at health facility entrances and

waiting areas,

v Directing people with TB symptoms to TB treatment ��areas and laboratory rooms,

v Redesigning rooms to ensure natural and mechanical ventilation,

v Using mechanical ventilation to ensure airflow.

Evaluating Impact §  TB CARE I and NTP assessed the impact of TB IC:

v  In November 2011 in Kabul and Khost provinces

v Among 240 health workers from 10 hospitals in high-risk areas

v Used the World Health Organization’s staff risk assessment log to record symptoms, HIV status, TB infection, etc.

v Offered X-rays and testing to health workers

For more information, please contact: Amanullah Momand, MD, Technical Advisor, TB CARE I, Afghanistan; Tel: +93 700 607 545 Email; [email protected]

Acknowledgement The Government of the United States of America through the US Agency for International Development (USAID) for funding the TB CARE I project.

Assessment Results: Low TB Infection in Facilities with TB Infection Control Measures

National TB Institute staff discuss treatment options with a TB patient

Conclusion §  TB IC significantly reduced the risk of TB infection for

health workers.

§  Because TB incidence is higher among health workers, ��TB IC should be expanded to other health facilities in ��similar settings.

Indicator Intervention area (with TB IC)

Control area (without ��TB IC)

Sample size

120 120

Staff with TB symptoms

(13) 11% (21) 18%

Staff diagnosed with TB