2.4.1 Develop or strengthen existing infection control programmes, especially with respect to TB infection control, and ensure integration with other workplace health and safety programmes.

The evidence for this statement was reviewed in-depth for the recent WHO Policy on TB Infection Control in Health-Care Facilities, Congregate Settings and Households and on infection control generally. and therefore will not be elaborated upon extensively here. These WHO infection control guidelines must be observed in their own right as well as being an essential component of improving health worker access to prevention, treatment, care and support for HIV and TB.

.AS noted in the recent guidelines, the literature review suggests that implementation of controls as a combination of measures reduces transmission of TB in health-care facilities. Administrative controls should be implemented as the first priority because they have been shown to reduce transmission of TB in health-care facilities. Administrative controls are needed to ensure that people with TB symptoms can be rapidly identified and, if infectious, can be separated into an appropriate environment and treated The administrative controls should be complemented by the environmental controls and personal protective equipment, because evidence shows that these measures also contribute to a further reduction of transmission of TB

The environmental controls implemented will depend on building design, construction, renovation and use, which in turn must be tailored to local climatic and socioeconomic conditions. However, installation of ventilation systems should be a priority, because ventilation reduces the number of infectious particles in the air. Natural ventilation, mixed-mode and mechanical ventilation systems can be used, supplemented with ultraviolet germicidal irradiation (UVGI) in areas where adequate ventilation is difficult to achieve. Personal protective equipment (particulate respirators) should be used with administrative and environmental controls in situations where there is an increased risk of transmission.

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