TB Infection Control

Dear Esther and community,

thank you for bringing this very relevant issue. As a matter of fact, though not answering to the post I would like to broaden the topic, asking to the Community how to handle "the less worse possible" this kind of real life situation:

* having HIV+ staff, working in poorly ventilated and TB-transmission exposed area in the public sector,
for whom you might or not know their CD4 level
* were your margin of action is limited (you have to follow local regulation, practice and resources)

Which practical options do we have ?

* for sure maximize prevention measures, but they are hardly enforced, after the initial few days-week following their initiation in our setting(s)
Having an influent "advocacy champion" in the facility always need to be attempted (anybody with experience ?)
* learn from material available on natural ventilation maximization (thanks to Sophie and others, BTW for posting all this)
* certainly ensure staff is on ART, and without low CD4 (above 350 ?) asap-even if possibly following early eligibility rules to initiate the staff which not be yet the guideline of the country
* IPT by all means, though not the magic bullet of course
* respirators for staff when attending cougher ? (nice ...

Dear Esther and community,

thank you for bringing this very relevant issue. As a matter of fact, though not answering to the post I would like to broaden the topic, asking to the Community how to handle "the less worse possible" this kind of real life situation:

* having HIV+ staff, working in poorly ventilated and TB-transmission exposed area in the public sector,
for whom you might or not know their CD4 level
* were your margin of action is limited (you have to follow local regulation, practice and resources)

Which practical options do we have ?

* for sure maximize prevention measures, but they are hardly enforced, after the initial few days-week following their initiation in our setting(s)
Having an influent "advocacy champion" in the facility always need to be attempted (anybody with experience ?)
* learn from material available on natural ventilation maximization (thanks to Sophie and others, BTW for posting all this)
* certainly ensure staff is on ART, and without low CD4 (above 350 ?) asap-even if possibly following early eligibility rules to initiate the staff which not be yet the guideline of the country
* IPT by all means, though not the magic bullet of course
* respirators for staff when attending cougher ? (nice in the case of a counseling cession !)

In fact I was considering putting forward our commitment as an NGO to protect our staff in the workplace to "impose" to the health facility authorities a more satisfying option, i.e. - in this dilapidated facility - resort to using a tent, with 2 entries wide open. I guess it can be hot like hell in there during the hot season, and issue of stigmatization can be raised as it is very unusual...

Thanks for your comments and input.

--
Gael Claquin
HIV project Coordinator
Maputo, Mozambique