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Hello All,

I am looking for 2 things. First: TB IC risk assessments, both programatic and facility levels, that use a scoring system. I am familiar with several risk assessment tools, but none of them use a scoring system.

Second: is there some kind of compendium of indicators available for TB IC programs? We have indicators that have been set for our program but I find them difficult or unrealistic to measure. For example "pecentage of HCWs observed wearing a respirator". I find this to be very subjective and would rather look at consumption data to determine if respirators are acutally being used. This is just one example of many. So, is there a generalized list of indicators and measures that I could adapt to my purposes?

Best Regards
Susan Adolph, RN
ICO, MSF Uzbekistan/Tajikistan

 
Amr Bakr
Replied at 5:40 AM, 28 Nov 2011

I working now on a compendium for TB IC indicators..let's share together its developments.. indicators are based on the SMART objectives..so let's start our discussion on the common SMART objectives in TB IC programs and then we can initiate discussions on the possible measurable indicators and which tools can be used to asses and monitor this indicators

Best Regards,
Amr Bakr
U.S. Naval Medical Research Unit
Cairo-Egypt

Grigory Volchenkov, MD
Replied at 6:06 AM, 28 Nov 2011

Dear Susan,
 
check ICAP web site for some English language TB IC related materials @ http://www.columbia-icap.org/resources/tbhiv/index.html
 
Regards,

Grigory Volchenkov

Vladimir, Russia
 
Sudogodskoe shosse, 63
Vladimir 600023 RUSSIA

phone/fax work: +7(4922)323265
mobile +7 9206253227; +7 9190189226

PPlease don't print this e-mail unless you really need to. Thank you!

Steve Ngoy KABAMBA
Replied at 6:09 AM, 28 Nov 2011

Dear colleagues can someone recommend a course online or sponsored on TB IC.
I am eager to get first insight on it.
Steve

--
*Dr **NGOY STEVE KABAMBA*
*Principal Medical Officer*
Swakopmund District Hospital
P.o Box 360 Swakopmund
*NAMIBIA*
Cell + 264813507290
Tel (W) +264644106011
*Help save paper - do you really need to print this email ?*
*"The person who says it cannot be done should not interrupt the person
doing it." - Chinese proverb. *
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Moses Bateganya
Replied at 7:13 AM, 28 Nov 2011

Not sure if this addresses your needs bou wanted to share the resource from the International Training and Education Center For Health.
http://www.tbpreventiontoolkit.org/tbic/action-steps


Moses Bateganya 
Phone: Office +1 (206) 616-7803
cel: +1 206 446 7295
Home +12062678270
email: ;
skype:  bategs

CLAUDE RUTANGA
Replied at 11:10 AM, 28 Nov 2011

Hi Steve,
 
I understand your concern,  and it's  a pleasure to  let you  know  that tentatively we have planned  a course TB Infection control under  the Centre of Excellence on Programmatic  Management  of Drug  Resistant  TB and TB  Infection Control in  the second  quarter of  2012.  That will be the second  international  TB IC course  organized  under  the  auspices of  the  School  of  Public  Health/national University  of  Rwanda.
At  some  point of  time, it  will  be advertised  on  the  web,  and I  will  inform  you on  this  with  website and  course  details .
Can  you let  me know  from  which country  are  you? (Hope this  question is not  embarrassing)
Otherwise,  if  you have  anotherone  before, it  will be  up  to  you to  make an option

RUTANGA Claude, MD, Msc FELTP candidate

Head of  TB Infection  Control Unit
TB  and  other  respiratory diseases Division
Rwanda  Bio-Medical  Centre/TRACPlus
Mobile phone:+250 788353895
skype  address: rutangaclaude
KIGALI

CLAUDE RUTANGA
Replied at 11:38 AM, 28 Nov 2011

Dear  Susan,
 
You received good references from various  colleagues.
My  point is we need to customize some  of  the indicators that have been developped  to fit in  a specific TB programme performance framework  as TB IC indicators  are among others, on top  of  the SMARTness  issue.
Secondly, though you gave an example of "% of  HCWs  wearing  respirators" among  others, we  should prioritize in  quite all  circumstances, if not all, the managerial  and  administrative  measures.
I'm ready to share with  you some of the indicators for  TB IC that  were set in our  TB programme performance  framework, as well as  the  quarterly  evaluation  tool.
Otherwise, it  depends... 
 
 RUTANGA Claude, MD, Msc FELTP candidate

Head of  TB Infection  Control Unit
TB  and  other  respiratory diseases Division
Rwanda  Bio-Medical  Centre/TRACPlus
Mobile phone:+250 788353895
skype  address: rutangaclaude
KIGALI

Susan Adolph
Replied at 9:47 PM, 28 Nov 2011

Hello Claude,

Nice to hear from you Claude. I assure you I am prioritizing administrative controls. The respirator example was just am example, a simple one to clarify what it is I'm looking for.

Hello Amr,

Nice to hear from you too. I know you have explained to me before the SMART objectives, but I don't recall the details. I admit that creating program indicators is not a strength of mine and would be grateful for any tips on the subject. Also, feel free to contact me at my personal email:



Thank you both,
Susan Adolph, RN
ICO, MSF Uzbekistan/Tajikistan

Francoise NYWAGI LOUIS
Replied at 2:20 AM, 29 Nov 2011

Dear Susan,
Thanks for this request.
I had worked quite some time with MSF and it is true that at that time we did not have a standardized RA tool.
The organzination I am working for (URC, through our USAID TB project in South Africa here) now does have a scored one that I share with the GDHonline community as an attachment.
Please kindly feed back on its use and provide operational comments for its improvement if needed.
Cheers;
Dr Francoise NYWAGI LOUIS, MBChB, HIVMan, DTM&H
Regional TBHIV Technical Advisor
National Expansion Coordinator for the Eastern Cape (USAID TB project in SA)
University Research Co., LLC
Rigel Park
446, Rigel Avenue South
Erasmusrand 0181
Pretoria
Tel (switchboard): +27 (0) 12 484 9300
Tel (direct): +27 (0) 12 484 9309
Fax (direct): +27 (0)12 484 9369
Fax2email: +27 86 669 0677
Cell: +27 72 991 7973

www.urc-chs.com

Attached resource:

    Summary: Dear Susan,
    Thanks for this request.
    I had worked quite some time with MSF and it is true that at that time we did not have a standardized RA tool.
    The organzination I am working for (URC, through our USAID TB project in South Africa here) now does have a scored one that I share with the GDHonline community as an attachment.
    Please kindly feed back on its use and provide operational comments for its improvement if needed.
    Cheers;
    Dr Francoise NYWAGI LOUIS, MBChB, HIVMan, DTM&H
    Regional TBHIV Technical Advisor
    National Expansion Coordinator for the Eastern Cape (USAID TB project in SA)
    University Research Co., LLC
    Rigel Park
    446, Rigel Avenue South
    Erasmusrand 0181
    Pretoria
    Tel (switchboard): +27 (0) 12 484 9300
    Tel (direct): +27 (0) 12 484 9309
    Fax (direct): +27 (0)12 484 9369
    Fax2email: +27 86 669 0677
    Cell: +27 72 991 7973

    www.urc-chs.com

    Source: University Research Co., LLC - URC

    Keywords: Administrative Controls, program indicators, Risk Assessment, TB IC Guidelines

S. Mehtar
Replied at 3:16 AM, 29 Nov 2011

I don't know how helpful it is, but the Unit for IPC, Stellenbosch Uni has been running a Basic course in TB-IPC since 2007 with some success, I might add. We have run these courses not only in South Africa but Swaziland and Namibia as well. We usually go to the country and run the course there because it is cheaper.
As part of the Infection Control Africa Network (ICAN) education programme we will be expanding this programme calling it "From Cape to Cairo".
The course is obviously accredited by Stellenbosch University, it is short, practical and includes a lot of clinical ward rounds and discussion.
Thank you
Shaheen

Prof Shaheen Mehtar
MBBS, FRC Path (UK), FCPath (Micro) (SA), MD (Lon)
Chair of Infection Control Africa Network (ICAN)
Head of Academic Unit for Infection Prevention and Control
Tygerberg Hospital &Fac of Health Sciences,  Stellenbosch Uni
PO Box 19063,
Tygerberg 7505, Cape Town
Tel: +27 21 938 5051
Fax: + 27 21 938 5065
Mobile: +27 82 852 3697
http://www.sun.ac.za/uipc
Want to know what is happening in Africa in infection control?
Visit Infection Control Africa Network (ICAN)
http://www.ICANetwork.co.za

Steve Ngoy KABAMBA
Replied at 3:24 AM, 29 Nov 2011

Hi Prof Sheehan
Nice to hear that.
I am currently in Namibia, would you like to give me some more details
especially on the cost of the course at Stellenbosch or when is your next
course in Windhoek.
I will really appreciate your reply on this matter.
Steve

--
*Dr **NGOY STEVE KABAMBA*
*Principal Medical Officer*
Swakopmund District Hospital
P.o Box 360 Swakopmund
*NAMIBIA*
Cell + 264813507290
Tel (W) +264644106011
*Help save paper - do you really need to print this email ?*
*"The person who says it cannot be done should not interrupt the person
doing it." - Chinese proverb. *
WebRep
Overall rating

S. Mehtar
Replied at 4:43 AM, 29 Nov 2011

Dear Steve
Thank you for your e-mail. We have just finished for 2011 but please talk to Ms Gordon at the DoH- there will be more courses next year. I hope this helps
S

Prof Shaheen Mehtar
MBBS, FRC Path (UK), FCPath (Micro) (SA), MD (Lon)
Chair of Infection Control Africa Network (ICAN)
Head of Academic Unit for Infection Prevention and Control
Tygerberg Hospital &Fac of Health Sciences,  Stellenbosch Uni
PO Box 19063,
Tygerberg 7505, Cape Town
Tel: +27 21 938 5051
Fax: + 27 21 938 5065
Mobile: +27 82 852 3697
http://www.sun.ac.za/uipc
Want to know what is happening in Africa in infection control?
Visit Infection Control Africa Network (ICAN)
http://www.ICANetwork.co.za

Katekani Ngobeni
Replied at 5:56 AM, 29 Nov 2011

Dear all,

The CSIR has developed a TB risk assessment tool, in collaboration with
CDC and the South African National Department of Health.
The tool has been piloted in a couple of health care facilities in
different provinces. Based on those findings it has since been amended
to ensure the collection of more reliable, effective data. Our tool does
not, however, use the scoring system.
I have attached a copy of the tool, broken-down according to the
hierarchy of controls, for your perusal.Since this tool is still under
review, we would really appreciate your inputs and comments.

Regards,




Katekani Ngobeni
CSIR Built Environment
Building Science & Technology
PO Box 395
Pretoria 0001
South Africa
Tel: +27 12 841 2518
Fax: +27 12 841 3539
Cell: +27 73 372 7772
Email:
www.csir.co.za

S. Mehtar
Replied at 6:01 AM, 29 Nov 2011

Dear Katekani
I would love to see the tool but cannot see it here.
Thanks
S

Prof Shaheen Mehtar
MBBS, FRC Path (UK), FCPath (Micro) (SA), MD (Lon)
Chair of Infection Control Africa Network (ICAN)
Head of Academic Unit for Infection Prevention and Control
Tygerberg Hospital &Fac of Health Sciences,  Stellenbosch Uni
PO Box 19063,
Tygerberg 7505, Cape Town
Tel: +27 21 938 5051
Fax: + 27 21 938 5065
Mobile: +27 82 852 3697
http://www.sun.ac.za/uipc
Want to know what is happening in Africa in infection control?
Visit Infection Control Africa Network (ICAN)
http://www.ICANetwork.co.za

Peta de Jager
Replied at 6:02 AM, 29 Nov 2011

nice...

Steve Ngoy KABAMBA
Replied at 6:13 AM, 29 Nov 2011

Dear Colleagues, I I downloadedd it on the GHDonline
Hope it will help
Steve

--
*Dr **NGOY STEVE KABAMBA*
*Principal Medical Officer*
Swakopmund District Hospital
P.o Box 360 Swakopmund
*NAMIBIA*
Cell + 264813507290
Tel (W) +264644106011
*Help save paper - do you really need to print this email ?*
*"The person who says it cannot be done should not interrupt the person
doing it." - Chinese proverb. *
WebRep
Overall rating

Katekani Ngobeni
Replied at 6:18 AM, 29 Nov 2011

Dear Shaheen,

Kindly send me your email address and I will forward it to you
A.S.A.P.
The same applies to whom ever is interested in reviewing our RAT, it
would be highly appreciated.

Regards,
Katekani


Katekani Ngobeni
CSIR Built Environment
Building Science & Technology
PO Box 395
Pretoria 0001
South Africa
Tel: +27 12 841 2518
Fax: +27 12 841 3539
Cell: +27 73 372 7772
Email:
www.csir.co.za

Eric Senyo Dzade
Replied at 6:33 AM, 29 Nov 2011


Sent from my BlackBerry® smartphone from Vodafone

Zahir Kanjee
Replied at 11:49 AM, 29 Nov 2011

Our research group has conducted a couple studies looking at healthcare worker TB IC implementation in rural South Africa that may be useful for those looking for risk assessment tools/assessments. I have attached our surveys and data collection tools. Unfortunately I am not able to attach the manuscripts.

The first study is a knowledge-attitude-practice assessment in the Journal of Hospital Infection, (Kanjee et al, JHI 2011). The second study uses behavioral modeling and is soon to be published in the Journal of Infection and Public Health (Kanjee et al, JIPH 2011).

Hope this is useful. I'd be happy to provide more information.

Attached resource:

    Summary: Our research group has conducted a couple studies looking at healthcare worker TB IC implementation in rural South Africa that may be useful for those looking for risk assessment tools/assessments. I have attached our surveys and data collection tools. Unfortunately I am not able to attach the manuscripts.

    The first study is a knowledge-attitude-practice assessment in the Journal of Hospital Infection, (Kanjee et al, JHI 2011). The second study uses behavioral modeling and is soon to be published in the Journal of Infection and Public Health (Kanjee et al, JIPH 2011).

    Hope this is useful. I'd be happy to provide more information.

    Source: Yale University School of Medicine

    Keywords: Administrative Controls, program indicators, Risk Assessment, TB IC Guidelines

Zahir Kanjee
Replied at 11:53 AM, 29 Nov 2011

Here is the second survey (the one that uses behavioral modeling).

Zahir Kanjee, MD
Internal Medicine Residency Program, Brigham and Women's Hospital

Attached resource:

    Summary: Here is the second survey (the one that uses behavioral modeling).

    Zahir Kanjee, MD
    Internal Medicine Residency Program, Brigham and Women's Hospital

    Source: Yale University School of Medicine

    Keywords: Administrative Controls, program indicators, Risk Assessment, TB IC Guidelines

Susan Adolph
Replied at 3:30 AM, 2 Dec 2011

Thank you all for your replies and assistance.

Susan Adolph, RN
ICO MSF Uzbekistan/Tajikistan

S. Mehtar
Replied at 11:50 AM, 5 Dec 2011

Dear Steve
I got the tool. I have had a look at it and find it very comprehensive. When we carry out risk assessment for IPC at the various healthcare facilities our tool is more general but does include a section specifically on TB-IPC control and it is not nearly as comprehensive as this one. I have a bit of a concern which becomes most apparent during our HCF visits- there is a total reliance on N95 respirators! The use of these has been translated to use for patients as well as staff which is a bit alarming! I was wondering whether there is any way the appropriate use of PPE rather than the sole reliance on respirators could be included? The environmental controls and administrative controls are sort of working. Is there any way of including the hierarchy of appropriate application for TB-IPC in this tool? I know it is there but is quite scattered. We also interview staff to glean their level of knowledge which helps to assess their perceived and real risk- it is usually quite different despite a vast amount of teaching in this field! Any comments?
Regards
Shaheen

Prof Shaheen Mehtar
MBBS, FRC Path (UK), FCPath (Micro) (SA), MD (Lon)
Chair of Infection Control Africa Network (ICAN)
Head of Academic Unit for Infection Prevention and Control
Tygerberg Hospital &Fac of Health Sciences, Stellenbosch Uni
PO Box 19063,
Tygerberg 7505, Cape Town
Tel: +27 21 938 5051
Fax: + 27 21 938 5065
Mobile: +27 82 852 3697
http://www.sun.ac.za/uipc
Visit the Infection Control Africa Network (ICAN) website on
http://www.ICANetwork.co.za

CLAUDE RUTANGA
Replied at 3:03 AM, 6 Dec 2011

Dear Prof,
 
Can  you  assist by  providing technical  specifications  of  Ultra-violet germicidal  lamps  for  TB  patients  wards,  Outpatients  waiting  rooms,  and  similarly  high  TB risk facility  areas? I'm planning  to procure those materials ,  but  I don't  have  standards  specification. 
If you  have  some,  please  share  them  with me.   
As the use of  these  requires  some measures  to  ensure their  appropriate function, I  will appreciate getting the technical specifications of   UV  light meters as well.

Regards
 
RUTANGA Claude. 
TB IC focal  person /NTP  Rwanda
Kigali

S. Mehtar
Replied at 4:42 AM, 6 Dec 2011

Dear Clauda
At my hospital we do not use UVGI as you might have seen in our previous correspondence. We rely on good administrative policy, natural ventilation or mechanical in isolation rooms and surgical mask for ordinary (sensitive) TB and N95 respirators for MDR-TB. Perhaps I am not the right person to ask.
Cheers
Shaheen

Prof Shaheen Mehtar
MBBS, FRC Path (UK), FCPath (Micro) (SA), MD (Lon)
Chair of Infection Control Africa Network (ICAN)
Head of Academic Unit for Infection Prevention and Control
Tygerberg Hospital &Fac of Health Sciences, Stellenbosch Uni
PO Box 19063,
Tygerberg 7505, Cape Town
Tel: +27 21 938 5051
Fax: + 27 21 938 5065
Mobile: +27 82 852 3697
http://www.sun.ac.za/uipc
Want to know what is happening in Africa in infection control?
Visit Infection Control Africa Network (ICAN)
http://www.ICANetwork.co.za

Dates for your diary!
4th ICAN conference: 26-29th November, 2012, Cape Town

Edward Nardell, MD
Replied at 11:03 AM, 10 Dec 2011

Specifications for UVGI in resource-limited conditions are not available in the format we would like. The South African guidelines have been available on the MRC website. The most important thing to do is to identify a knowledgeable consultant and have that person work with you to identify good quality UV fixtures, plan the installation, usually including air mixing fans, and check it out before you use the system to be sure that it is likely to be safe and effective.

There have been engineers from Rwanda at the Harvard Building Design and Engineering course and we will get those names for you.

For the past two days there was an NIH (Fogarty)-funded international conference on upper room UVGI use in low resource conditions. Those guidelines, however, will be a while before we get them published.

Ed Nardell

Edward A. Nardell, MD (note: new address below, effective immediately)
Associate Professor
Harvard Medical School (Medicine; Global Health and Social Medicine)
Harvard School of Public Health (Environmental Health; Immunology and Infectious Diseases)

Brigham and Women's Hospital
Division of Global Health Equity
Partners In Health
461 Huntington Avenue, 3A-03
Boston, MA 02115

617 432-2080 (academic office) 617 877-9412 (cell)

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