Reducing TB Transmission Risk Through Implementation of TB Infection Control Measures

The 24 de Diciembre Health Center in Panama City serves a community with high risk for TB infection due to high levels of poverty, low educational levels, poor access to basic services, overcrowding, and large migrant and indigenous populations. In 2015, 30 cases of TB were detected at the health center, and the lack of TB infection control measures put other patients, health facility staff and those accompanying infected patients, at risk to contract TB. Ventilation was inadequate, there was no triage point for those infected or potentially infected with TB, and sputum samples were taken from patients in the health center’s corridors.

To reduce the risk of the infection spreading within the health center, at the beginning of 2016, TB infection control was prioritized and control measures were put in place. With the support of 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), and in close coordination with the National Tuberculosis Program, structural changes were implemented by the health center team based on advice received from the regional team.


Equipment Designated Facilities Training
  • New equipment acquired, including N95 respirators, surgical masks, and disposable gowns
  • Improvements made to the laboratory equipment
  • A separate clinic was created specifically for coughing patients suspected to have TB and patients with confirmed cases
  • Booth created for collecting sputum from patients
  • Staff were trained in TB infection control
  • Key personnel attended the International TB Course in Peru in April 2017


They are the first clinic to implement TBIC measures in the country and are serving as a model to other TB clinics who are following their steps. The successful implementation of these measures has resulted in a decreased risk of TB transmission within the 24 de Diciembre Health Center, and has provided health center staff with the necessary tools to ensure the sustainability of this improvement. This was made possible through the hard work of the local team, including Dr. Elvia Rosa Evers, Mireya Martinez, Delia Navarro, and Xiomara Mendieta, who received invaluable support and guidance from the URC project team, and overcame many challenges to implement these measures. According to Dr. Evers, “The advice received during these months has been of vital importance. The advice and trust placed in the local team have made it easier to implement the recommendations, in the context of the national regulations of Panama.” In recognition of their excellent work and initiative, a plaque was presented to the local team by the CDC Central America Regional office in September of 2017.


Publication Date 
March 2018
Resource Type 
Success Stories
Regions/ Countries