Institutional tuberculosis infection control in a rural sub-district in South Africa: A quality improvement study

Background: Tuberculosis (TB) is a major global health challenge, and South Africa is one of the high-burden countries. A national TB infection control (TBIC) guideline has stipulated three areas of infection control at health facilities: work practice and administrative control, environmental contr...

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Main Authors: Martha B. Mekebeb, Klaus von Pressentin, Louis S. Jenkins
Format: Article
Language:English
Published: AOSIS 2019-06-01
Series:African Journal of Primary Health Care & Family Medicine
Subjects:
Online Access:https://phcfm.org/index.php/phcfm/article/view/1971
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author Martha B. Mekebeb
Klaus von Pressentin
Louis S. Jenkins
author_facet Martha B. Mekebeb
Klaus von Pressentin
Louis S. Jenkins
author_sort Martha B. Mekebeb
collection DOAJ
description Background: Tuberculosis (TB) is a major global health challenge, and South Africa is one of the high-burden countries. A national TB infection control (TBIC) guideline has stipulated three areas of infection control at health facilities: work practice and administrative control, environmental control, and personal protection for health workers. Aim: The aim of this study was to identify the gaps and address the challenges in institutional TBIC. Setting: The district hospital and a primary health care clinic within the Mossel Bay sub-district in the Western Cape. Methods: According to the national TBIC draft guideline, a quality improvement cycle was used to evaluate and improve TBIC. Each facility had an existing infection and prevention control and occupational health and safety team, which were used as the audit teams. Results: A baseline assessment was followed by a set of interventions, which did not show a significant improvement in TBIC. The difference between the pre- and post-intervention TB screening rate was not statistically significant. An assessment of time interval between 101 patients presenting with TB symptoms and diagnosed with TB was 4 days at baseline and post-intervention. Most of the anticipated improvements were dependent on the health workers’ adherence to the local TBIC policies, which emerged as an unexpected finding. Conclusion: We found good managerial commitment reflected by the presence of various policies, guidelines, specific personnel and committees to deal with infection control in general. This study has created awareness about TBIC among staff and pointed out the complexity of health workers’ behaviour towards adhering to policies.
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spelling doaj.art-9bc8044fdfb040b495c01f9efc5dcb012022-12-21T19:27:05ZengAOSISAfrican Journal of Primary Health Care & Family Medicine2071-29282071-29362019-06-01111e1e810.4102/phcfm.v11i1.1971634Institutional tuberculosis infection control in a rural sub-district in South Africa: A quality improvement studyMartha B. Mekebeb0Klaus von Pressentin1Louis S. Jenkins2Department of Family and Emergency Medicine, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa; and, Mossel Bay Hospital, Garden Route DistrictDepartment of Family and Emergency Medicine, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa; and, Mossel Bay Hospital, Garden Route DistrictDepartment of Family and Emergency Medicine, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa; and, George Hospital, Garden Route DistrictBackground: Tuberculosis (TB) is a major global health challenge, and South Africa is one of the high-burden countries. A national TB infection control (TBIC) guideline has stipulated three areas of infection control at health facilities: work practice and administrative control, environmental control, and personal protection for health workers. Aim: The aim of this study was to identify the gaps and address the challenges in institutional TBIC. Setting: The district hospital and a primary health care clinic within the Mossel Bay sub-district in the Western Cape. Methods: According to the national TBIC draft guideline, a quality improvement cycle was used to evaluate and improve TBIC. Each facility had an existing infection and prevention control and occupational health and safety team, which were used as the audit teams. Results: A baseline assessment was followed by a set of interventions, which did not show a significant improvement in TBIC. The difference between the pre- and post-intervention TB screening rate was not statistically significant. An assessment of time interval between 101 patients presenting with TB symptoms and diagnosed with TB was 4 days at baseline and post-intervention. Most of the anticipated improvements were dependent on the health workers’ adherence to the local TBIC policies, which emerged as an unexpected finding. Conclusion: We found good managerial commitment reflected by the presence of various policies, guidelines, specific personnel and committees to deal with infection control in general. This study has created awareness about TBIC among staff and pointed out the complexity of health workers’ behaviour towards adhering to policies.https://phcfm.org/index.php/phcfm/article/view/1971tuberculosisinfection prevention and controlquality improvement cycleprimary health caredistrict health services
spellingShingle Martha B. Mekebeb
Klaus von Pressentin
Louis S. Jenkins
Institutional tuberculosis infection control in a rural sub-district in South Africa: A quality improvement study
African Journal of Primary Health Care & Family Medicine
tuberculosis
infection prevention and control
quality improvement cycle
primary health care
district health services
title Institutional tuberculosis infection control in a rural sub-district in South Africa: A quality improvement study
title_full Institutional tuberculosis infection control in a rural sub-district in South Africa: A quality improvement study
title_fullStr Institutional tuberculosis infection control in a rural sub-district in South Africa: A quality improvement study
title_full_unstemmed Institutional tuberculosis infection control in a rural sub-district in South Africa: A quality improvement study
title_short Institutional tuberculosis infection control in a rural sub-district in South Africa: A quality improvement study
title_sort institutional tuberculosis infection control in a rural sub district in south africa a quality improvement study
topic tuberculosis
infection prevention and control
quality improvement cycle
primary health care
district health services
url https://phcfm.org/index.php/phcfm/article/view/1971
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AT klausvonpressentin institutionaltuberculosisinfectioncontrolinaruralsubdistrictinsouthafricaaqualityimprovementstudy
AT louissjenkins institutionaltuberculosisinfectioncontrolinaruralsubdistrictinsouthafricaaqualityimprovementstudy