TB Infection Control
Hospital design to accommodate Multi- and Extensively DrugResistant TB patients
20th Congress of the International Federation of Hospital Engineering, 19-22 October 2008, Barcelona,
Spain. Hospital design to accommodate Multi- and Extensively DrugResistant TB patients.
Abstract:
South Africa faces one of the most devastating Mycobacterium tuberculosis (TB) epidemics in the world in terms of TB incidence (or number of cases per capita) and overall TB burden (or total number of cases). Recent studies by the Medical Research Council (MRC) indicate that more than half the TB patients are also HIV-infected, with the co-infection rate approaching 75% in some provinces.
The availability of antiretroviral therapy in Africa brings hope for the management of HIVassociated TB. However, the treatment brings together individuals with undiagnosed TB, or MDR-TB (and now XDR-TB), and immune-suppressed HIV-infected individuals in congregate settings, resulting in high risk to hospital workers and patients.
Tuberculosis (TB) is an airborne infectious disease that is curable. There is an international campaign to reduce the impact and spread of TB, and the WHO has set an ambitious target of getting 80% of sufferers on treatment by 2015. The impact of TB in South Africa is exacerbated by the vulnerability of people with HIV and Aids, leading to high co-infection rates. Drug resistant TB however, requires longer treatment and isolation from other TB patients and the
general public in order to stop the spread of those strains.
Little, if any, guidance is currently provided to design teams responsible for the development of new health facilities or the refurbishing of existing structures. Moreover, the need to improve the quality and functionality of health facilities through better design and operational management is a priority if infection control risk management processes are to be
accommodated, and the development of appropriate guidelines for facility design,
environmental infection control measures and functional methods for in-house risk management to prevent airborne infection are sorely needed.
This paper provides an overview of hospital design solutions to accommodate M(X)DR-TB patients and methodologies adopted to fast track the provision of much needed beds in the various high burden provinces in South Africa.
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