India: Public health experts and patient groups ask govt to prevent infections at TB hospital
Health organizations, public health experts and patient groups have asked the government to take action to reduce the risk of healthcare workers from contracting tuberculosis at Mumbai-based Sewri Hospital - Asia's largest TB hospital. This comes in the wake of the recent death of a senior doctor who died of a potent form of multi- drug-resistant TB, falling prey to the infection which he reportedly acquired at the hospital.
Increasingly, healthcare workers in high-burden settings such as Sewri Hospital, have occupationally acquired TB, and several have developed active drug-resistant disease. The recent death of a TB-treating physician due to DR-TB is a tragic example of healthcare workers in Sewri Hospital losing their lives due to inadequate infection control measures.
Despite the increased vulnerability, the persistent shortage of protective equipment like respirators and apathy to infection control measures in Sewri Hospital have outraged healthcare workers, the TB and public health community.
The letter expresses concern regarding the shortage of personal protective equipment ie N-95 respirators, and the lack of implementation of infection control practices at the Sewri Hospital. The callous attitude of the Indian government towards its healthcare workers is disturbing, especially given that investment in infection control measures is much lower compared to the cost of diagnosing and treating drug-resistant TB cases, not accounting for the cost to the patient and his or her family, it says.
Keeping in mind the central TB division's, ministry of labour's, ministry of health's and BMC's obligations under the law, and national policies, the letter calls for, N-95 respirator masks that are critical to protect the health and safety of healthcare workers in Sewri Hospital be provided to them in adequate quantities. Patients should also be provided with surgical masks.
Respirator fit testing and training programmes should also be organized in Sewri Hospital to ensure that healthcare workers are properly trained and motivated in the correct technique of using these masks to ensure their effectiveness.
Healthcare workers should be regularly screened (bi-annually) for TB symptoms and provided access to early correct diagnosis (through drug sensitivity testing) and treatment for TB (including DR-TB drugs) free of cost.
Other effective infection control measures be implemented without delay in Sewri Hospital. In particular, environmental controls such as adequate amount of air changes per minute, linear flow of air away from patients to the outside environment (not towards staff), so designing or moving beds in wards and opening windows or directing fans taking this into account, can be very effective.
It is also unacceptable that health care facilities are sources of increased TB transmission, particularly drug-resistant strains in India. In Sewri hospital, which receives a large number of suspected DR TB patients, improved management of TB cases is the need of the hour, and therefore all patients should receive correct diagnosis (through drug sensitivity testing) and started on effective treatment to reduce infectivity very rapidly.
Source: The Times of India
