Examining pulmonary TB patient management and healthcare workers exposures in two public tertiary care hospitals, Bangladesh

Bibliographic Data

ID19592005
AuthorsMd Saiful Islam (0000-0002-5690-5971, International Centre for Diarrhoeal Disease Research), Sayera Banu (0000-0002-5121-1962, International Centre for Diarrhoeal Disease Research), Sayeeda Tarannum (International Centre for Diarrhoeal Disease Research), Kamal Ibne Amin Chowdhury (0000-0001-7125-7071, International Centre for Diarrhoeal Disease Research), Arifa Nazneen (0000-0002-9699-0947, International Centre for Diarrhoeal Disease Research), Mohammad Tauhidul Islam (International Centre for Diarrhoeal Disease Research), S M Zafor Shafique, Sohana Shafique (0000-0002-5234-8522, International Centre for Diarrhoeal Disease Research), S M Hasibul Islam (International Centre for Diarrhoeal Disease Research), Abrar Ahmad Chughtai (0000-0003-4203-7891, UNSW Sydney), Holly Seale (0000-0002-1877-5395, UNSW Sydney)
EditorsRaquel Muñiz-Salazar (0000-0001-5528-7772)
Year2022
Volume2
Issue1
Pagese0000064
Publication date2022-01-05
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0000064
PMID36962098
OpenAlexW4205849463
LanguageEN
Citations received1
References cited26

Implementation of tuberculosis (TB) infection prevention and control (IPC) guidelines in public tertiary care general hospitals remain challenging due to limited evidence of pulmonary TB (PTB) patients’ duration of hospital stay and management. To fill this evidence gap, this study examined adult PTB patient management, healthcare workers’ (HCWs) exposures and IPC practices in two public tertiary care hospitals in Bangladesh.Between December 2017 and September 2019, a multidisciplinary team conducted structured observations, a hospital record review, and in-depth interviews with hospital staff from four adult medicine wards.Over 20 months, we identified 1,200 presumptive TB patients through the hospital record review, of whom 263 were confirmed PTB patients who stayed in the hospital, a median of 4.7 days without TB treatment and possibly contaminated the inpatients wards. Over 141 observation hours, we found a median of 3.35 occupants present per 10 m 2 of floor space and recorded a total of 17,085 coughs and 316 sneezes: a median of 3.9 coughs or sneezes per 10 m 2 per hour per ward. Only 8.4% of coughs and 21% of sneezes were covered by cloths, paper, tissues, or by hand. The HCWs reportedly could not isolate the TB patients due to limited resources and space and could not provide them with a mask. Further, patients and HCWs did not wear any respirators.The study identified that most TB patients stayed in the hospitals untreated for some duration of time. These PTB patients frequently coughed and sneezed without any facial protection that potentially contaminated the ward environment and put everyone, including the HCWs, at risk of TB infection. Interventions that target TB patients screening on admission, isolation of presumptive TB patients, respiratory hygiene, and HCWs’ use of personal protective equipment need to be enhanced and evaluated for acceptability, practicality and scale-up

Economic growth · Environmental health · Family medicine · Health care · Medical emergency · Public health · Tertiary care · Medicine · Nursing · Pneumonia and Respiratory Infections · Tuberculosis Research and Epidemiology · Vaccine Coverage and Hesitancy

Tools

Open DOIOpen Access