INFECTION CONTROL MEASURES DOTS PLUS STRATEGY

LRS Institute of Tuberculosis & Respiratory Diseases

Sri Aurobindo Marg, New Delhi - 110030

INFECTION CONTROL MEASURES DOTS PLUS THE NEED

• MDR-TB is infectious

• MDR TB patient : – Delay in establishing the diagnosis.

– Visits more number of times - (approx 180 to 270 visits in a regimen IP of 6 to 9m)

– More number specimen collected - (12 to 18 specimen in IP 18 specimen in CP)

– More laboratory interventions (each specimen 4 interventions smear, culture, Identification & sensitivity test)

– More HCWs interact with the MDR-TB patient

WHAT IS EXISTING IN RNTCP

Administrative measures

– Objectives well defined

– Training of HCWs well established

– IEC - important component

Environmental measures

– Emphasis given on proper disposal of sputum specimen

– Waste management guidelines - implemented

Personal Protection

– Training

THE DEFICIENCIES

– Not much

– No periodic reviews

THE PROPOSAL

– Constitute an infection control committee

– Training manuals / Programmes

– Periodic reviews / assessment of IC plans

– Development of IEC materials. Highlighting the DOTS treatment / duration / benefits

– Reduction in lab infection control plans

Administrative Measures

THE PROPOSAL (Contd.)

Environmental measures:

– Maximize the natural ventilation (6-12 Air changes / Hour)

– Efficiency 99.9% Droplet Nuclei gets removed in - 69 to 35 minutes

– Mechanical ventilation Fixing exhaust system

ENVIRONMENTAL MEASURES:

– Establishment of TB isolation wards with single pass air system with HEFA filtration / UVGI

– LRSI - MDR TB Wards

THE PROPOSAL

Personal Respiratory Protection measures

– Emphasize on HCW

– Training in infection control measures

– Practice of Infection Control measures

– Review of Infection control measures at every opportunity by the supervisor

– MDR Patients and suspects can be provided with masks

CONCLUSION

Infection control in DOTS plus can be

implemented through

Administrative measures

Environmental measures

Personal respiratory protection measures

Thank You