Administrative Controls/FAST

    • Scope: 24 Priority countries + Global?
    • Focus: NTP, NGOs, civil society?
    • Objectives:
      • Describe the FAST approach to infection control
      • Describe FAST in the context of updated WHO guidelines
      • Describe measurement, monitoring and evaluation of FAST
    • Expected Outputs/Outcomes: After attending the webinar, participants will be able to
      • Describe the concepts behind FAST
        • Which of the following is NOT a FAST concept:
          • Screening upon entry
          • Immediate contact tracing
          • Prompt testing with molecular diagnostics
        • Describe measurement, monitoring and evaluation aspects of FAST
          • Which is an example process indicator for measuring FAST
            • Proportion of patients screened for active TB disease upon hospital entry
            • Proportion of presumptive patients given a mask
            • Proportion of all confirmed TB contacts tested
          • Understand how FAST concepts fit into the updated WHO guidelines
            • Are FAST principles included in the updated WHO IPC guidelines?
              • Yes
            • Detailed Outline:
              • Introduction/Purpose:
                • Describe the FAST approach at a high level
                  • Country examples
                • Describe FAST in the context of new WHO guidelines and as a way to implement administrative controls
                • Describe the measurement, monitoring and evaluation of FAST
              • An overview of FAST
                • Finding cases Actively
                  • Deliver a symptom screen for each person entering a facility
                • Separating Safely
                  • For those screening presumptive for TB, move to a separate waiting area
                • Treating Effectively
                  • For those who are presumptive, collect sputum for a molecular test (usually GeneXpert)
                  • Deliver results quickly (<2 days) and begin appropriate therapy (taking into account the patient’s drug resistance profile)
                • FAST as an administrative control approach
                  • Can work to identify TB patients who would be missed by the health system otherwise
                    • e., in HIV wards, antenatal care wards, staff clinics etc (i.e., not TB wards)
                  • Can deliver more effective therapy through universal drug resistance profiling
                  • Can initiate people on treatment more quickly through rapid molecular tests like GXP
                • Measuring, monitoring and evaluating FAST
                  • Facility level
                    • % of hospitalized patients screened for active TB
                    • % of presumptive patients tested for TB with GXP
                    • % of presumptive patients tested for TB with GXP within one day of admission
                      • Ideally collect admission and test date to derive actual number of days
                    • % of those testing positive for TB who initiate appropriate therapy
                  • National level
                    • % of facilities with:
                      • > 90% patients screened for active TB
                      • >90% presumptive patients tested for active TB with Xpert
                      • >90% of presumptive patients tested for active TB with Xpert within 1 day of admission
                      • >90% confirmed patients started on appropriate therapy
                    • Could add something about cost per patient identified
                  • Country example: Implementing FAST in South Africa
                    • Initial rollout
                      • Describe ward level screening
                    • Scale up
                    • Measurement
                      • Focus on data analytics and on TAT calculation
                    • Plans for future expansion
                  • Questions
                  • Conclusions
    • Click here to join the webinar on July 22, 2019 Time at 9 AM EST