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
(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%
