TB Infection Control

Dr. Daniel Fiseha posted a response to this discussion in the Drug Resistant TB community (please see below). Thank you in advance, members of the TB IC community, for any guidance and/or resources you can offer Drs. Fiseha and Singh.

In line with the above request, I was looking for TB infection Control assessment tools at the facility level.
And are there any TB Infection control indicators that can be monitored and evaluated periodically?
Many Thanks,
Dr. Daniel

** The original reply is available here at http://www.ghdonline.org/drtb/discussion/checklist-score/#reply-371, but feel free to respond here in the TB IC community either online or by email.**

Hi all

I know of 3 assessment tools. The one was designed by the Western Cape Department of Health in South Africa. It has its limitations though (as the author admits) as it has not been validated in any way. I do think though that it is useful in terms of the fact that it reminds health care workers
of their responsibilities regarding infection control.

ICAP from Columbia University also has one that they use in the facilities that they are working in in the Eastern Cape Province.

RHRU in Johannesburg also has an assessment as part of their Infection Control manual.

I would be happy to post the Western Cape one and have cc'ed the relevant people to share theirs if they wish.

Please could the moderator advise on uploading docs.

Many thanks
Lesley

Lesley Odendal
TB/HIV Policy Researcher
Policy, Communications and Research Department
TREATMENT ACTION CAMPAIGN

Dear all,
I do not know of any checklists that use a scoring system on TB infection Control, but as Lesley was indicating, ICAP-SA has developed a facility TBIC practices assessment tool, as well as KAB surveys for professional and non-professional staff, which we used in a pilot TBIC project in two HIV care and treatment facilities in the Eastern Cape Province. This allowed us to identify the gaps in TBIC in those facilities, which were addressed in facility-specific TBIC plans.
Our main challenge at the moment is to actually get the facilities to implement their plans, and to ensure ownership by the TBIC teams, so that these aspects are incorporated in the routine facility practices and are sustainable.

One indicator we are trying to monitor in this program, is the time spent by patients with and without chronic cough in the facility (subdivided by arrival to consultation and arrival to departure time), using a triage form. Lay health care workers ask each patient questions about chronic cough, being investigated for TB and TB treatment, and record the time of arrival. The clinician attending to the patient records the time of consultation and the pharmacist the time of departure (as ...

Dear all,
I do not know of any checklists that use a scoring system on TB infection Control, but as Lesley was indicating, ICAP-SA has developed a facility TBIC practices assessment tool, as well as KAB surveys for professional and non-professional staff, which we used in a pilot TBIC project in two HIV care and treatment facilities in the Eastern Cape Province. This allowed us to identify the gaps in TBIC in those facilities, which were addressed in facility-specific TBIC plans.
Our main challenge at the moment is to actually get the facilities to implement their plans, and to ensure ownership by the TBIC teams, so that these aspects are incorporated in the routine facility practices and are sustainable.

One indicator we are trying to monitor in this program, is the time spent by patients with and without chronic cough in the facility (subdivided by arrival to consultation and arrival to departure time), using a triage form. Lay health care workers ask each patient questions about chronic cough, being investigated for TB and TB treatment, and record the time of arrival. The clinician attending to the patient records the time of consultation and the pharmacist the time of departure (as basically all patients end their visit to the clinic collecting their medication). We analyze these timings on a periodic basis.

Other indicators could include:
- The proportion of patient screened for chronic cough on arrival at the facility
- The proportion of TB suspects diagnosed with active TB
- The average time from identification as TB suspect to initiation of TB treatment
- Other general TB screening indicators (proportion of patients screened with symptom screening questionnaire, proportion of patients screened who screen positive, proportion of patients with positive screen who were consequently diagnosed with active TB, proportion of patients diagnosed with active TB who start TB treatment

I will try to upload the assessment tool, which is an excel file with three different worksheets (2 KAB surveys and the facility assessment).
Regards,
Sabine

_________________________________________________________________________________________________________
Sabine Verkuijl
Senior Technical Advisor: TB/HIV
ICAP South Africa, Mailman School of Public Health, Columbia University

Hi all,

We are also using an assessment tool in the Eastern Cape. It was in 58
clinics. CSIR also developed an assessment tool that's been used for
facility assessments.

If you need further details please e-mail me to

Annatjie Peters

My colleagues and I would be very interested in receiving the infection control assessment tools. Thanks

Gerald Friedland, MD,
Yale University School of Medicine
135 College Street, Ste 323
New Haven, CT 06510-2483

Dear Peters,

Please upload the checklist so that others can also be benefited.

Best regards,

Dr. Singh

Dr. Rajbir Singh
Regional Medical Coordinator - North,
German Leprosy & TB Relief Association - India
B 2/17, Janakpuri, New Delhi-110058

Dear all,
In case you missed it, the TB IC tool developed by ICAP-SA (MSPH, Columbia University), incorporating KAB surveys for professional and non-professional health care facility staff as well as a facility TBIC practices assessment, was published in the community thanks to member Sabine Verkuijl. It is available for download here: http://www.ghdonline.org/ic/resource/tbic-baseline-assessment-tool/

And remember: To add a resource (upload a document) to the community, please sign in on www.ghdonline.org, go to your community, and click on "Add resource". Thank you.