infection control measures dots plus strategy lrs institute of tuberculosis & respiratory...
TRANSCRIPT
INFECTION CONTROL MEASURES DOTS PLUS STRATEGY
LRS Institute of Tuberculosis & Respiratory Diseases
Sri Aurobindo Marg, New Delhi - 110030
INFECTION CONTROL MEASURES DOTS PLUS THE NEED
• MDR-TB is infectious
• MDR TB patient : – Delay in establishing the diagnosis.
– Visits more number of times - (approx 180 to 270 visits in a regimen IP of 6 to 9m)
– More number specimen collected - (12 to 18 specimen in IP 18 specimen in CP)
– More laboratory interventions (each specimen 4 interventions smear, culture, Identification & sensitivity test)
– More HCWs interact with the MDR-TB patient
WHAT IS EXISTING IN RNTCP
Administrative measures
– Objectives well defined
– Training of HCWs well established
– IEC - important component
Environmental measures
– Emphasis given on proper disposal of sputum specimen
– Waste management guidelines - implemented
Personal Protection
– Training
THE DEFICIENCIES
– Not much
– No periodic reviews
THE PROPOSAL
– Constitute an infection control committee
– Training manuals / Programmes
– Periodic reviews / assessment of IC plans
– Development of IEC materials. Highlighting the DOTS treatment / duration / benefits
– Reduction in lab infection control plans
Administrative Measures
THE PROPOSAL (Contd.)
Environmental measures:
– Maximize the natural ventilation (6-12 Air changes / Hour)
– Efficiency 99.9% Droplet Nuclei gets removed in - 69 to 35 minutes
– Mechanical ventilation Fixing exhaust system
ENVIRONMENTAL MEASURES:
– Establishment of TB isolation wards with single pass air system with HEFA filtration / UVGI
– LRSI - MDR TB Wards
THE PROPOSAL
Personal Respiratory Protection measures
– Emphasize on HCW
– Training in infection control measures
– Practice of Infection Control measures
– Review of Infection control measures at every opportunity by the supervisor
– MDR Patients and suspects can be provided with masks
CONCLUSION
Infection control in DOTS plus can be
implemented through
Administrative measures
Environmental measures
Personal respiratory protection measures
Thank You