Assessment of Tuberculosis Infection Control Measures in Primary and Secondary Health Care Facilities in Enugu

Abstract

Background: Tuberculosis and HIV are major public health problems in Nigeria and preventing the transmission of TB in health care settings will reduce the burden of the disease in the country. This study assesses the implementation of TB infection control measures in health facilities providing HIV and TB services in Enugu state, Nigeria. Methodology: A cross-sectional descriptive study was conducted in 54 health facilities providing tuberculosis and HIV services in Enugu state, Nigeria. An interviewer administered semi structured questionnaire and observer checklist were used to assess the administrative/workpolicy and environmental control measures being implemented in the facilities for TB control. Results: Fifty four health facilities were studied, 30 secondary and 24 primary. Most of the respondents were medical officers and 52% were females. Nine administrative control/workpolicy and four environmental control measures were covered in the assessment. None of the health facilities had all the infection measures in place. Performance was worse with the administrative/ work policy measures as none of the measures were in place in up to 10 % of the facilities. A TB infection control plan was present in 4 (7.4%) of the facilities. Proper seating of patients and provider was in place in 70.4% of facilities and controlled natural ventilation in 37%. No one was assigned in charge of control measures in any of the facilities. Conclusion: In spite of the availability of national Guidelines for implementation of TB infection control, measures are yet to be in place in most facilities providing care for HIV and tuberculosis patients. Urgent measures are needed to implement the guidelines in the facilities in order to reduce TB transmission in these settings.