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
