Practical and affordable preventive measures for health care workers against nosocomial transmission of tuberculosis in resource limited settings

Abstract

This review considers the occupational hazard to health care workers posed by the global increase in tuberculosis (TB), especially in multidrug-resistant tuberculosis. With the global upsurge in tuberculosis, fueled by the Human Immunodeficiency Virus infection pandemic, and the increase in multidrug-resistant tuberculosis, the condition has become a serious occupational hazard for health care workers worldwide. To document practically affordable preventive and protective measures for health care workers against nosocomial transmission of tuberculosis. The study involved library and internet search of literatures. Professional experience and personal discussion with colleagues and occupational health experts were also incorporated. This study focuses on health care workers because the nature of their work has probably the highest risk of contacting tuberculosis. The resource limited setting especially sub-Saharan Africa was targeted, because of its highest incidence of TB and HIV, its worst epidemic of HIV-related TB, and where the risk to health care workers is probably greatest. Protecting health care workers in resource limited settings involves administrative measures such as having appropriate policies and procedures in place to facilitate early diagnosis and treatment; appropriate environmental control, relevant personal protection and surveillance of health care workers. Political support and commitment should be given to research to examine the feasibility and cost-effectiveness of measures such as voluntary TB and HIV-testing of health care workers and isoniazid preventive therapy for workers in high-risk settings. All health facilities should have appropriate resources to operate control measures for nosocomial TB.

Nigerian Medical Practitioner Vol. 50(1) 2006: 9-11