TB Infection Control
Examples of Good Basic Triage Strategy
Hi All,
I did not contribute to the 10 essential IC discussion but I wanted to share with you what I believe is a good (but not perfect) basic triage strategy used in our Haiti facility for many years.
It is based on smear and HIV status and requires 3 areas: 1) general medical ward, 2) TB ward, and 3) several isolation rooms. It is captured in this presentation with photos available in the community here: http://www.ghdonline.org/ic/resource/transmission-of-mdr-mtb-infection-contro...
Most TB in Haiti is treated in the community with paid community workers.
When patients require hospitalization, smear negative patients go to the general medical ward regardless of HIV status - presumably no one is very infectious. Smear positive/HIV negative patients go to the TB ward which has extra ventilation and UV lamps. Patients who are smear positive and HIV + cannot go to the general or TB ward, and require one of 6 isolation rooms.
It is not perfect because smears are not perfect indicators of infectiousness, and unsuspected TB patients and HIV infected patients may result in patients where they should not be, but it is probably better than what I have seen in many parts of the world and it is workable in our experience.
I offer this for discussion. Please share other examples.
Ed
Attached resource:
S. Mehtar
Dear Ed
I agree. What we need to do in low resource countries is to concentrate on triaging (separating) as soon as possible the potentially infectious cases from the rest. I like the Haiti model. At TBH we are going to start trying triaging based on any history of cough (it is really difficult in a high endemic area to do anything else) especially in OPD and clinics. Will let you know how it goes.
How can access some of the previous presentations? I am at home and need to get hold of the presentations here?
Talk soon
Shaheen
6:12 AM, 2 Nov 2008 | Permalink
Sophie Beauvais
Dear Prof. Mehtar,
I'm looking forward to reading more about your new triage strategy based on cough when it is implemented, and thanks again for your contributions to this discussion and all others.
If you wish to view all the presentations available in the TB Infection Control community, you can click on a topic and then select “Resource” in the filter navigation menu on the left, or do a search with a keyword (or several) in the "Search" bar at the top of the page in "All Communities".
You can then refine results by languages, organizations (the source of the document) or the document type (PDF – a lot of the presentations are saved in that format, PowerPoint, Word, etc.). All files can then be downloaded and saved on your computer for future reference for example.
Last, a lot of the recent presentations published in the community, including the ones from the July 2008 Engineering Methods course and from The Union conference, are saved under the "Training" topic: http://www.ghdonline.org/get/search/?N=0+700132+100002.
I hope this answered your question but please let me know if you need more clarification and I’d be happy to ...
10:22 AM, 3 Nov 2008 | Permalink