Implementation of the 3Is
Started by Moses Bateganya on 30 Dec 2009
Dear members. I have read about sebveral approaches to implementing the 3Is. Among some I have read about are some countries that have followed a stepwise implementation with Infection Control, Intensified case Finding, and IPT being implemented sequentially. Are there advantages to this approach as oposed to when all of them are implemented at the same time in facilities?
Moses
Grigory Volchenkov, MD
Dear Moses,
Sure we have to reduce nosocomial TB transmission risk before we start intensified case finding, otherwise we may create more new drug resistant TB cases than we can treat. It does not mean that we can stop think about TB IC after we start intensified case finding and IPT: nosocomial TB infection risk should be one of the priorities as long as we fight TB.
I am not sure why IPT should be the last intervention from 3Is to implement - may be Ed Nardell or others can comment on that.
Happy New Year!
Grigory Volchenkov,
Vladimir, Russia
3:15 AM, 9 Jan 2010 | Permalink
S. Mehtar
Dear Grigory
I don't think the idea is to implement the 3Is sequentially. but to ensure these are in place. IPC is essential to reduce or prevent spread, case findings are necessary to ensure that spread is reduced and IPT should do the same. The 3Is work as part of a good prevention programme. That is what I think and would like to hear the opinion of others.
Thanks
Shaheen
Prof Shaheen Mehtar
MBBS, FRC Path (UK), FCPath (Micro) (SA), MD (Eng)
Chair IPC Africa Network
Head of Academic Unit for Infection Prevention and Control
Tygerberg Hospital & Stellenbosch Uni
PO Box 19063,
Tygerberg 7505, Cape Town
Visit the First African IPC Congress website
http://www.ipcan2009.co.za
1:47 AM, 10 Jan 2010 | Permalink
Ana Serralheiro
Dear all,
Here in Swaziland we implemented ICF, IPT and IC all at once in one of the HIV/VCT centre. The first step was training all the team that is working in the HIV/VCT centre on the 3I's (IPT, ICF and IC - homestead and HC).
A form was introduced to record the screening of each patient in every consultation and with the "IC counselling" that should be given to the patient.
In another Health Centre we presently started with ICF only and I also don't think IC should come first or last but that the 3 measures should be fully implemented as a strategy.
ICF alone is always a benefit without the other 2I's because those undiagnosed patients that are already in the waiting area will be screened in every consultation. This means case detection will increase which is already important on its own.
We implement also ICF in the OPD alone and the number of patients identified as suspects increased dramatically.
The same with IC; recommendations to the HIV patients will be always a benefit to reduce infection even if the other I's are not implemented...
IPT of course has to come with ICF in place in order to be able select eligible patients before initiation on preventive therapy.
Happy New Year!
Ana Serralheiro
Infection Control Specialist
MSF Switzerland
Swaziland Mission
2:01 AM, 11 Jan 2010 | Permalink
Muboraksho Khodzaev
Happy New Year!
Dear Grigory,
It is well known fact, that Vladimer Region of Russia is the avengers on the struggles against TB, and I am believe that you may help me to find best typical plan of rooms for construction of District DOTS Center. It is great opportunity for all of us to participate on the planning of modern DOTS Center in Tajikistan in consideration of all aspects of building.
Best regards,
Muboraksho
10:10 PM, 11 Jan 2010 | Permalink
Grigory Volchenkov, MD
Dear Muboraksho,
Unfortunately there is no typical District DOTS Center design available. Many factors should be taken into account for appropriate design: functions of the center, daily patients load, amount of staff, climate conditions, available resources... Regarding TB infection control in the center I would recommend for particular Tajikistan project to plan sputum collection site, waiting areas and DOT point outside the building on fresh air, to design building relying mostly on natural ventilation and plan to install upper room UVGI fixtures in indoor high risk areas (if you still need to provide room for waiting patients during few colder winter months.
Kind regards,
Dr. Grigory V. Volchenkov
Head Doctor
Vladimir Oblast TB Dispansery
Sudogodskoe shosse, 63
Vladimir 600023 RUSSIA
7:07 AM, 18 Jan 2010 | Permalink