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Agents of change: The role of healthcare workers in the prevention of nosocomial and occupational tuberculosis

Nathavitharana, RR; Bond, P; Dramowski, A; Kotze, K; Lederer, P; Oxley, I; Peters, JA; ... Zumla, A; + view all (2017) Agents of change: The role of healthcare workers in the prevention of nosocomial and occupational tuberculosis. Presse Medicale , 46 (2) e53-e62. 10.1016/j.lpm.2017.01.014. Green open access

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Abstract

Summary Healthcare workers (HCWs) play a central role in global tuberculosis (TB) elimination efforts but their contributions are undermined by occupational TB. HCWs have higher rates of latent and active TB than the general population due to persistent occupational TB exposure, particularly in settings where there is a high prevalence of undiagnosed TB in healthcare facilities and TB infection control (TB-IC) programmes are absent or poorly implemented. Occupational health programmes in high TB burden settings are often weak or non-existent and thus data that record the extent of the increased risk of occupational TB globally are scarce. HCWs represent a limited resource in high TB burden settings and occupational TB can lead to workforce attrition. Stigma plays a role in delayed diagnosis, poor treatment outcomes and impaired well-being in HCWs who develop TB. Ensuring the prioritization and implementation of TB-IC interventions and occupational health programmes, which include robust monitoring and evaluation, is critical to reduce nosocomial TB transmission to patients and HCWs. The provision of preventive therapy for HCWs with latent TB infection (LTBI) can also prevent progression to active TB. Unlike other patient groups, HCWs are in a unique position to serve as agents of change to raise awareness, advocate for necessary resource allocation and implement TB-IC interventions, with appropriate support from dedicated TB-IC officers at the facility and national TB programme level. Students and community health workers (CHWs) must be engaged and involved in these efforts. Nosocomial TB transmission is an urgent public health problem and adopting rights-based approaches can be helpful. However, these efforts cannot succeed without increased political will, supportive legal frameworks and financial investments to support HCWs in efforts to decrease TB transmission.

Type: Article
Title: Agents of change: The role of healthcare workers in the prevention of nosocomial and occupational tuberculosis
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.lpm.2017.01.014
Publisher version: https://doi.org/10.1016/j.lpm.2017.01.014
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Medicine, General & Internal, General & Internal Medicine, DRUG-RESISTANT TUBERCULOSIS, INFECTION-CONTROL MEASURES, SOUTH-AFRICA, MEDICAL-STUDENTS, MYCOBACTERIUM-TUBERCULOSIS, MULTIDRUG-RESISTANT, RISK-FACTORS, CONTROLLED-TRIAL, FREE STATE, TB
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity
URI: https://discovery.ucl.ac.uk/id/eprint/10048873
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