What tuberculosis infection control measures are effective in resource-constrained primary healthcare facilities? A systematic review of the literature
Introduction: Tuberculosis (TB) remains a major global health challenge, killing millions of people, despite the availability of preventive TB medication. The majority of these infections and deaths occur in low-income countries. Therefore, practical public health strategies are required to reduc...
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| Format: | Article |
| Language: | English |
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James Cook University
2023-03-01
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| Series: | Rural and Remote Health |
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| Online Access: | https://www.rrh.org.au/journal/article/7175/ |
| _version_ | 1827981976472125440 |
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| author | Gigil Marme Shannon Rutherford Neil Harris |
| author_facet | Gigil Marme Shannon Rutherford Neil Harris |
| author_sort | Gigil Marme |
| collection | DOAJ |
| description |
Introduction: Tuberculosis (TB) remains a major global health challenge, killing millions of people, despite the availability of preventive TB medication. The majority of these infections and deaths occur in low-income countries. Therefore, practical public health strategies are required to reduce the global TB burden in these countries effectively. The purpose of this review was to examine the current evidence of tuberculosis infection control (TBIC) measures in reducing TB transmission and explore the barriers and enablers of TBIC measures in resource-constrained primary healthcare settings.
Methods: The PRISMA framework was adopted to identify studies that report on the evidence and barriers and facilitators of administrative, environmental and respiratory control measures at healthcare settings in low- and middle-income countries (LMICs). ProQuest, Scopus, ScienceDirect, Embase and PubMed were searched for English language peer-reviewed studies published since the introduction of TBIC guidelines. Studies not relevant to the topic, were not on TBIC measures or were reviews or commentary-style papers were excluded. Included articles were evaluated based on their aim, study design, geography and health settings interventions (TBIC measures), economic setting (ie LMICs) and main findings.
Results: Our review of the 15 included studies identified a cough officer screening system, isolation of TB patients, modification of consultation rooms, and opening windows and doors as effective TB prevention measures. Lack of patient education, unsupportive workplace culture, inadequate supply of particulate respirators, insufficient isolation facilities and poor physical infrastructures were identified as barriers to TBIC practices. Triaging TB patients, maintenance of health infrastructure, appropriate use of personal protective equipment (PPE) and healthcare workers (HCWs) training on the correct use of PPE were reported as facilitators of TBIC in primary healthcare facilities.
Conclusion: Our review provides consistent evidence of TBIC measures in reducing TB transmission in resource-constrained primary healthcare settings. This review has demonstrated that TB transmission can be successfully controlled using multiple and simple low-cost TBIC measures including administrative, environmental and respiratory controls. Effective implementation of triaging patients with suspected TB alongside maintenance of health infrastructure, appropriate use of PPE and robust HCWs training on TBIC could improve implementation of TBIC measures in primary healthcare settings. Healthcare management should address these areas particularly in rural and remote locations to improve the implementation of TBIC measures in primary healthcare facilities in LMICs.
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| first_indexed | 2024-04-09T22:17:22Z |
| format | Article |
| id | doaj.art-8873223c0cdb4eb081ab6071f312dfc6 |
| institution | Directory Open Access Journal |
| issn | 1445-6354 |
| language | English |
| last_indexed | 2024-04-09T22:17:22Z |
| publishDate | 2023-03-01 |
| publisher | James Cook University |
| record_format | Article |
| series | Rural and Remote Health |
| spelling | doaj.art-8873223c0cdb4eb081ab6071f312dfc62023-03-22T22:52:36ZengJames Cook UniversityRural and Remote Health1445-63542023-03-012310.22605/RRH7175What tuberculosis infection control measures are effective in resource-constrained primary healthcare facilities? A systematic review of the literatureGigil Marme0Shannon Rutherford1Neil Harris2Public Health, Divine Word University, Madang Province, Papua New Guinea; and School of Medicine and Dentistry, Griffith University, Southport, Qld, AustraliaSchool of Medicine and Dentistry, Griffith University, Southport, Qld, AustraliaSchool of Medicine and Dentistry, Griffith University, Southport, Qld, Australia Introduction: Tuberculosis (TB) remains a major global health challenge, killing millions of people, despite the availability of preventive TB medication. The majority of these infections and deaths occur in low-income countries. Therefore, practical public health strategies are required to reduce the global TB burden in these countries effectively. The purpose of this review was to examine the current evidence of tuberculosis infection control (TBIC) measures in reducing TB transmission and explore the barriers and enablers of TBIC measures in resource-constrained primary healthcare settings. Methods: The PRISMA framework was adopted to identify studies that report on the evidence and barriers and facilitators of administrative, environmental and respiratory control measures at healthcare settings in low- and middle-income countries (LMICs). ProQuest, Scopus, ScienceDirect, Embase and PubMed were searched for English language peer-reviewed studies published since the introduction of TBIC guidelines. Studies not relevant to the topic, were not on TBIC measures or were reviews or commentary-style papers were excluded. Included articles were evaluated based on their aim, study design, geography and health settings interventions (TBIC measures), economic setting (ie LMICs) and main findings. Results: Our review of the 15 included studies identified a cough officer screening system, isolation of TB patients, modification of consultation rooms, and opening windows and doors as effective TB prevention measures. Lack of patient education, unsupportive workplace culture, inadequate supply of particulate respirators, insufficient isolation facilities and poor physical infrastructures were identified as barriers to TBIC practices. Triaging TB patients, maintenance of health infrastructure, appropriate use of personal protective equipment (PPE) and healthcare workers (HCWs) training on the correct use of PPE were reported as facilitators of TBIC in primary healthcare facilities. Conclusion: Our review provides consistent evidence of TBIC measures in reducing TB transmission in resource-constrained primary healthcare settings. This review has demonstrated that TB transmission can be successfully controlled using multiple and simple low-cost TBIC measures including administrative, environmental and respiratory controls. Effective implementation of triaging patients with suspected TB alongside maintenance of health infrastructure, appropriate use of PPE and robust HCWs training on TBIC could improve implementation of TBIC measures in primary healthcare settings. Healthcare management should address these areas particularly in rural and remote locations to improve the implementation of TBIC measures in primary healthcare facilities in LMICs. https://www.rrh.org.au/journal/article/7175/infection controllow- and middle-income countriesresource-constrained primary health care settingssystematic reviewtuberculosisWorld Health Organization. |
| spellingShingle | Gigil Marme Shannon Rutherford Neil Harris What tuberculosis infection control measures are effective in resource-constrained primary healthcare facilities? A systematic review of the literature Rural and Remote Health infection control low- and middle-income countries resource-constrained primary health care settings systematic review tuberculosis World Health Organization. |
| title | What tuberculosis infection control measures are effective in resource-constrained primary healthcare facilities? A systematic review of the literature |
| title_full | What tuberculosis infection control measures are effective in resource-constrained primary healthcare facilities? A systematic review of the literature |
| title_fullStr | What tuberculosis infection control measures are effective in resource-constrained primary healthcare facilities? A systematic review of the literature |
| title_full_unstemmed | What tuberculosis infection control measures are effective in resource-constrained primary healthcare facilities? A systematic review of the literature |
| title_short | What tuberculosis infection control measures are effective in resource-constrained primary healthcare facilities? A systematic review of the literature |
| title_sort | what tuberculosis infection control measures are effective in resource constrained primary healthcare facilities a systematic review of the literature |
| topic | infection control low- and middle-income countries resource-constrained primary health care settings systematic review tuberculosis World Health Organization. |
| url | https://www.rrh.org.au/journal/article/7175/ |
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