Evaluation of tuberculosis infection control measures implemented at primary health care facilities in Kwazulu-Natal province of South Africa

Background: Tuberculosis (TB) is a global public health concern. It is even more so as its incidence seems to be increasing in South Africa. The aim of this study was to describe and compare the tuberculosis infection control measures implemented by facilities in Ugu and Uthungulu health districts of Kwazulu-Natal province. Methods: This was a cross-sectional survey based on a self-administered questionnaire and site visit observations. Data were collected from healthcare workers at 52 health facilities from the beginning of February to mid-March 2012. The facilities that completed the questionnaires were visited for site observations. Results: The mean age of participants was 44.7 +/- 11.7 years of age, ranging from 22 to 66 years old; 89.1% of them were females and nurses. Overall, some 48.6% (18 out of 37) of aspects of tuberculosis infection control encompassing administrative, environmental, clinical and occupational health measures were complied with by at least 80% of facilities surveyed. The unfortunate outcome of this inadequate compliance was that 23 and 12 cases of nosocomial tuberculosis had been diagnosed among staff members respectively in Ugu and Uthungulu districts. Conclusions: Overall, it appears that at the facilities surveyed, less than 50% of tuberculosis infection control measures were complied with. This finding calls for appropriate interventions to be designed and implemented. These include the purchase and installation of environmental control systems; the implementation of administrative tuberculosis infection control measures at each facility together with the training of staff members on the strict adherence to preventive measures including the use of personal protective equipment.