Infection Prevention And Control In TB Programs

P oor infection prevention and control in congregate settings such as health facilities and prisons is a serious obstacle to advancing public health efforts worldwide and can have deadly consequences, as in the 2015 Ebola outbreak in West Africa. Other areas of the world with similarly high burdens of infectious disease are also in urgent need of improved infection prevention and control. Countries in the former Soviet Union are facing tuberculosis (TB) and multidrugresistant TB burdens that are among the highest in the world. The lack of trained staff, equipment, motivation, and monitoring to adequately address infection prevention and control at health care facilities in these countries puts health care workers and patients at serious risk and threatens the sustainability of TB control efforts. At Project HOPE, infection prevention and control is a priority. Under the US Agency for International Development (USAID) Strengthening Tuberculosis Control Project in Ukraine, Project HOPE and Chemonics, an international development company, guided the National TB Control Programme in revising national and regional policies for infection prevention and control at TB health care facilities and laboratories. We also trained and mentored health care workers and laboratory personnel in effective infection prevention and control practices. As a result, these TB facilities and laboratories realigned their budgets to conform to international standards and introduced new standard operating procedures that significantly improve quality, efficiency, and safety. The most dramatic improvements are evident at Ukraine’s TB facilities in Odessa and Dnipropetrovsk, where the rate of infectionamonghealth care personnel has dropped fivefold over the past three years. In Tajikistan, under programs supported by the USAID TB CARE I Project; the Global Fund to Fight AIDS, Tuberculosis, and Malaria; and the Centers for Disease Control and Prevention (CDC), Project HOPE assisted Macheton National TB Hospital to form a team of expert infection prevention and control trainers who subsequently trained health care workers from seventeen pilot sites. In 2015, for the first time ever, TB cases among health workers throughout the country were systematically recorded and reported. Eighty-five percent of health care personnel at the seventeen pilot sites were screened for symptoms, and eleven TB cases were detected. As a result of its commitment to making TB infection prevention and control apriority, theMachetonTBHospital was designated by the Tajikistan government as the national infection control demonstration site and training base. Activities there are being scaled up across the nation, and fifteen national TB representatives from Uzbekistan, Kazakhstan, and Kyrgyzstan are being trained in infection prevention and control methods, practices, and mentoring by leading international experts. Successful infection prevention and control programs such as those implemented with Project HOPE’s technical expertise, in partnership with governments, donors, and other nongovernmental organizations, provide encouragement that TB can be eradicatedwhen evidence-based practices are followed. ▪