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Health Centers Use Cost Effective Improvements to Reduce the Risk of Tuberculosis
The Coatepeque Health Center in Guatemala treats on average 60 new tuberculosis (TB) cases a year, a figure which might in fact be higher, since the search and detection of respiratory symptomatic cases is still very limited. The risk of contracting TB was an infection concern for patients and staff crowded in poorly ventilated waiting rooms and hallways. Located inside the center was the TB Clinic surrounded by corridors through which approximately 100 people pass per day, including patients, staff and visitors, factors which favor TB transmission.
Infection control was also a significant challenge at the Coatepeque hospital’s HIV Clinic which received about 50 HIV patients per day, including about 5-7 that were “coughers” and potentially infected with TB. Tuberculosis is an airborne disease that is endemic in Guatemala and a common coinfection among people living with HIV.
PEPFAR, through the Centers for Disease Control and Prevention (CDC) funded HIV/Co-infection Surveillance Strategies for Program Planning in the Central America Region project, implemented by University Research Co., LLC (URC), which addresses the infection concerns by providing training mentoring and educational materials to hospital staff for all PEPFAR prioritized clinics in Guatemala, specifically on TB infection control in health facilities, to improve accidental transmission in treatment settings.
"Having received the course, the training to teach it and having co-facilitated with the URC team gave me examples, tools and methodologies that have been useful for my professional practice," said Paola Meléndez, a laboratory expert with the National TB program who through training has gone on to co-facilitate courses aimed at educating key personal at hospital level in Guatemala.
Following training in TBIC, both facilities addressed TB infection control issues by implementing triage and screening processes in January 2016.
With little to no increased direct cost, the Coatepeque Health Center has successfully applied training to decrease the risk of TB transmission at the clinic creating a safer environment for personnel and patients.
"There have been improvements to reduce the risk of tuberculosis, both to staff and users,” said Vilma Hernández, Head of the TB Clinic at the Coatepeque Health Center.
In the Coatepeque hospital the most noticeable change is the location of the HIV clinic itself. The new space allows for sufficient ventilation and exposure to fresh air limiting the exposure of other patients to infected aerosol particulates. Patients are also provided with surgical masks and staff are trained to enforce proper cough etiquette.