WHO, UNAIDS and the ILO launched international guidelines to protect health workers against HIV and TB infection in November 2010.
Among the recommendations are;
• Development and implementation of free, regular TB and HIV screening.
• Free HIV and TB treatment for infected health workers.
• Training on HIV and TB prevention, treatment, care and support for health workers.
• Integration of infection skills training into existing occupational health and safety as well as medial training programmes.
Health workers like nurses and laboratory technologists are at risk of contracting infectious diseases. The standard response is a six-month course of tuberculosis (TB) medicine.
PPE against HIV, TB risk
Personal protective equipment like respirators, gloves, ventilation, and secure biological waste disposal facilities are rarely available in rural areas.
Kenyan state officials cite problems with health materials and PPE supply and funding. Joseph Sitienei, head of Kenya’s National Leprosy and TB Control Programme said some health facilities delay requesting materials and PPE, until they run out.
PPE availability does not always translate to use. “We have to constantly sensitise personnel on the need to use personal protective gear. To reduce stigma of infection and PPE is also important. We had to inform patients why staff must wear masks.”
Ventilation and theft problems
“We have made patient waiting areas better ventilated, consultation rooms more spacious, and are providing respirators, streamlining procurement and supply of occupational health and safety commodities.”
Some NGOs comment that corruption in the health system is also to blame for haphazard availability of medical supplies. Some drugs are regularly stolen from state health facilities and sold to private pharmacies, even by some state pharmacists.
Health care waste problems
Victor Were, a clinical officer in western Kenya’s Mumias town, said overcrowded and poorly ventilated clinics pose a constant risk to health workers.
Isolation wards were being established in health centres where large numbers of TB patients attend.
Only one hospital in Mumias, western Kenya, has secure health care waste disposal facilities and an incinerator.
Kenya ranks 13th on the UN World Health Organization’s (WHO) list of 22 high-burden TB countries globally, and has the fifth-highest burden in Africa. According to WHO, the country has 130 000 new TB cases every year, reports IRIN.
Among 40 TB health workers in Mumias, who are not regularly screened for TB, four presented with signs of TB last year. They were then tested and treated.
Health workers lack training on infection risk reduction. Some have called for outdoor clinics to reduce the risk of infection, since clinics are typically not well designed with ventilation in mind.
Infected health workers delay getting treatment and thus infect several other people, including patients and colleagues, said Andrew Suleh, medical superintendent of Nairobi’s Mbagathi District Hospital.
IMAGE: Cover of the WHO, UNAIDS and International Labour Organisaation (ILO) publication on international guidelines to protect health workers against HIV and TB infection.