تعليقThis annex is based on a tool produced by Médecins Sans Frontières (MSF) and Partners in Health. (1)
Instructions: This tool helps to give an idea of the risk of transmission of Mycobacterium tuberculosis in health-care facility or congregate settings. The results should be completed by the infection prevention and control (IPC) focal person and interpreted by the IPC committee. For the Yes/No questions, a Yes answer indicates good tuberculosis IPC practices. Any pertinent information on No answers is noted in the Comments section below each table.
Overview of the facility (interview with the health facility manager)
Comments________________________________________________________________________________________
Administrative measures
Risk identification and segregation
Comments________________________________________________________________________________________
Waiting areas (observe behaviour for 1 hour, ideally in the main (or in the specific TB) waiting area during the busy early morning hours
Comments________________________________________________________________________________________
Management of persons with presumptive or confirmed TB (interview health-care workers)
Comments________________________________________________________________________________________
Sputum specimen collection and preparation (witness a sputum sample collection and preparation)
Comments________________________________________________________________________________________
Staff measures (interview facility manager)
Comments________________________________________________________________________________________
Environmental measures (If possible, make rough estimates of ventilation using a vaneometer and smoke tube or incense stick)
Obtain a scale drawing of the floor plan of the whole facility including doors and windows (if this is not available, make a sketch). Shade the different areas according to the level of risk based on the observations on environmental measures:
- high risk of TB transmission – dark grey
- limited risk of TB transmission – grey
- low risk of TB transmission – white
Include patients and staff flow, and environmental measures (e.g. ventilation fans and GUV fixtures).
Comments________________________________________________________________________________________
Personal protective measures (walk unannounced around the facility and observe, then discuss with staff)
Comments________________________________________________________________________________________
ACH: air changes per hour; ART: antiretroviral therapy; DR-TB: drug-resistant TB; GUV: germicidal ultraviolet light; HIV: human immunodeficiency virus; IPC: infection prevention and control; OPD: outpatient department; SOP: standard operating procedure; TB: tuberculosis; TPT: TB preventive treatment; VCT: voluntary counselling and testing
Conclusions (debrief health facility manager after completing assessment)
According to the assessor and the facility manager, what are the current main issues and barriers in the implementation of TB IPC?
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According to the assessor and the facility manager, what are the priority actions for the implementation of TB IPC in this facility for the next 6–12 months?
Reference for Annex 3
- Varaine F, Rich ML. Appendix 16. Basic TB infection control risk assessment tool. In: Tuberculosis: Médecins Sans Frontières, Partners In Health; 2023: https://medicalguidelines.msf.org/sites/default/files/TBAppendix%2B16.pdf.