[World Health Organization guidelines for prevention of tuberculosis in healthcare facilities in countries with limited resources (measures for prevention of tuberculosis)]

Abstract

Nearly 95% of people with M. tuberculosis infection live in countries with limited resources. Patients who do not suffer from tuberculosis and healthcare workers treating patients with tuberculosis in healthcare facilities are at increased risk of M tuberculosis infection. In 1999, the World Health Organization identified guidelines for prevention of tuberculosis in healthcare facilities in countries with limited resources. The guidelines include recommendations on two levels: district and referral. They are based upon three levels of infection control: administrative, environmental and personal respiratory protection. The first priority in infection control is use of administrative control measures in order to prevent the generation of infectious droplet nuclei. These measures contain an infection control plan, training of healthcare workers, patient education, sputum collection, triage and evaluation of patients suspected to have tuberculosis, reduction of exposure to M. tuberculosis of healthcare workers in laboratories, isolation of patients with multidrug-resistant tuberculosis, etc. The second priority would include environmental control methods in order to reduce the concentration of infectious droplet nuclei in the air. These measures include: natural ventilation, mechanical ventilation, ultraviolet germicidal irradiation, etc. The third priority is protection of healthcare workers (and patients) by means of personal respiratory protection (respirators) from inhaling infectious droplet nuclei. Environmental control methods and personal respiratory protection should not be implemented without or serve as replacement for administrative (first priority) control measures.