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Tuberculosis infection prevention and control:why we need a whole systems approach

Infectious Diseases of Poverty 2020年第3期9卷 97-100页

作者： Karina Kielmann Aaron S.Karat Gimenne Zwama Christopher Colvin Alison Swartz Anna S.Voce Tom A.Yates Hayley MacGregor Nicky McCreesh Idriss Kallon Anna Vassall Indira Govender janet seeley Alison D.Grant The Institute for Global Health and Development Queen Margaret UniversityEdinburgh EH216UUUK TB Centre London School of Hygiene&Tropical MedicineLondonUK Division of Social and Behavioural Sciences Faculty of Health SciencesUniversity of Cape TownCape TownSouth Africa Discipline Public Health Medicine School of Nursing and Public HealthUniversity of KwaZulu-NatalDurbanSouth Africa Department of Infectious Disease Faculty of MedicineImperial College LondonLondonUK The Institute of Development Studies University of SussexBrightonUK Department of Global Health and Development Faculty of Public Health and PolicyLondon School of Hygiene&Tropical MedicineLondonUK Africa Health Research Institute School of Nursing and Public HealthUniversity of KwaZulu-NatalDurbanSouth Africa School of Public Health Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa

Infection prevention and control(IPC)measures to reduce transmission of drug-resistant and drug-sensitive tuberculosis(TB)in health facilities are well described but poorly *** implementation of TB IPC has been assessed primarily through quantitative and structured approaches that treat administrative,environmental,and personal protective measures as discrete *** present an on-going project entitled Umoya omuhle(“good air”),conducted in two provinces of South Africa,that adopts an interdisciplinary,‘whole systems’approach to problem analysis and intervention development for reducing nosocomial transmission of Mycobacterium tuberculosis(Mtb)through improved *** suggest that TB IPC represents a complex intervention that is delivered within a dynamic context shaped by policy guidelines,health facility space,infrastructure,organisation of care,and management *** drawn from epidemiology,anthropology,and health policy and systems research enable rich contextual analysis of how nosocomial Mtb transmission occurs,as well as opportunities to address the problem holistically.A‘whole systems’approach can identify leverage points within the health facility infrastructure and organisation of care that can inform the design of interventions to reduce the risk of nosocomial Mtb transmission.

关键词： Drug-resistant tuberculosis Infection prevention and control Health system South Africa

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