Reducing TB transmission among HCWs

    • Scope: NAP Countries
    • Focus: NTP
    • Objectives:
      • Describe certain risk determinants of TB relevant to healthcare workers
      • Describe existing IPC interventions aimed at reducing risk of TB transmission among healthcare workers
      • Describe measurement methods for understanding healthcare worker TB incidence (infection and active disease) and for monitoring and evaluating general IPC program effectiveness
      • Discuss existing country-level examples of HCW surveillance systems
    • Expected Outputs/Outcomes: After attending the webinar, participants will be able to
      • Describe TB transmission risks which are relevant to healthcare workers
        • Which types of health care workers are susceptible to TB acquisition
          • Clinical workers (doctors, nurses)
          • Administrative staff (cleaners, managers)
          • Both
        • Describe IPC interventions relevant to healthcare workers
          • Which of the following is an administrative control relevant to health care workers:
            • FAST
            • Training
            • Fit testing
          • Describe measurement, monitoring and evaluation methods for IPC programs with a focus on healthcare worker TB infection and TB disease
            • Which indicator can be used as a proxy for TB incidence:
              • Health care worker incidence compared to general incidence
              • Proportion of health care workers receiving a fit test
              • Proportion of health care workers trained in TB management
            • Detailed Outline:
              • Introduction/Purpose
                • Describe healthcare workers’ risk for TB and how this is higher than the general population
                • Describe IPC in the context of healthcare workers (i.e., what interventions are in place, what do we use to measure implementation and what is the path forward)
                • Describe using HCW incidence as a marker for general IPC implementation (i.e., if HCW incidence = incidence of the general population, facility-based IPC implementation is good)
              • Healthcare worker Risk
                • Duration/intensity of exposure
                • Not just in TB wards
                • Describe diagnostic tools here as well
                  • TST
                  • IGRA
                • IPC in the context of healthcare workers
                  • Managerial:
                    • Training
                    • IPC committees
                  • Administrative:
                    • FAST
                      • % healthcare workers screened for active TB disease
                      • % healthcare workers tested for LTBI
                    • Environmental:
                      • Sputum collection
                      • Waiting areas
                    • PPE:
                      • Fit testing for respirators
                    • Measuring IPC implementation through HCW incidence
                      • Concept: if incidence (HCW) = incidence (all), IPC implementation is good
                      • How to test HCWs? (IGRA, TST etc – benefits and challenges for both)
                      • How to report this?
                        • Capacity, quality etc
                      • Questions
                      • Conclusions