Farley, Jason

Nursing

An Evaluation of Infection Control K.A.P. and Infrastructure in MDR and XDR-TB Centers in South Africa.

Background:  The importance of infection control (IC) in healthcare settings withMycobacterium tuberculosis (TB) patients has been highlighted by recent healthcare-associated outbreaks in South Africa.  Operational evaluations of IC within drug-resistant TB settings at a national level have not been conducted. Methods: A cross-sectional descriptive study was conducted from June to September 2009 in all M(X)DR-TB facilities in South Africa. Structured interviews with key-informants were completed along with observation of IC practices. Healthcare workers (HCWs) were asked to complete an anonymous knowledge, attitudes and practices (KAP) questionnaire. Multilevel modeling was used to examine the relationship between center and HCW level variables. Results: Twenty-four M(X)DR-TB facilities (100%) were enrolled. Facility infrastructure and staff adherence to IC recommendations was highly varied between facilities. Key-informant interviews were incongruent with direct observation of practices in all settings. A total of 499 HCWs were enrolled in the KAP evaluation. Higher level of clinical training was associated with greater IC knowledge (p<.001), more appropriate attitudes (p<0.001) and less time spent with coughing patients (p<.001). IC practices were poor across all disciplines. Conclusion:  These findings demonstrate a clear need to improve and standardize IC infrastructure in drug-resistant TB settings in South Africa.

Susan Dorman, MD, SOM.

People

Joanne Katz, ScD MS,BSc

Associate Chair, Director of Academic Programs

Caitlin Kennedy, PhD MPH,BA

Co-Director, MPH concentration in Social and Behavioral Sciences in Public Health; Associate Director, Center for Qualitative...

Stefan Baral, MD MPH,MBA,MSc

Director, Key Populations Program

Noreen Hynes, MD MPH

Director, Geographic Medicine Center of the Division of Infectious Diseases

Robert Bollinger Jr., MD MPH

Director, Johns Hopkins Center for Clinical Global Health Education (CCGHE); Associate Director, Johns Hopkins Center for Global...

Yukari C. Manabe, MD

Associate Director of Global Health Research and Innovation
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September 2017

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Projects

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