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Explain how to control TB in congregated settings.

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Explain how to control TB in congregated settings.

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Identify steps to follow when conducting contact investigations. Describe TB treatment and regimens.

Describe how to care for and monitor clients on TB treatment. Describe the TB treatment outcomes. Identify s and symptoms related to TB in children.

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Describe the diagnosis of TB in children. Describe treatment and care of TB in children. In the absence of appropriate infection control policy and practice, there is a high risk of transmission and spread of TB in areas in which people live and work. For this reason, screening all clients who may have active TB and if appropriate diagnosing and treating them early is paramount for reducing transmission. A plan to prevent transmission of TB in a health care facility should be part and parcel of the overall facility infection prevention and control IPC programme.

All health care facilities should develop and implement a facility specific TB infection control plan deed to provide: Prompt identification of presumptive cases of TB Appropriate, non-stigmatizing, immediate separation of presumptive cases or infectious TB cases from other clients. Prompt testing of presumptive cases for infectious TB with rapid and specific tests such as the GeneXpert.

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Appropriate and sustained implementation of simple but effective environmental infection transmission prevention measures. Appropriate use of personal protective equipment PPE. Continuous monitoring and periodic evaluation of the TBIC plan. As explained earlier xxx this session, the TB infection control programme frree based on a three-level hierarchy of free measures.

Managerial and administrative controls are a first priority in any IC plan and are intended to reduce the risk of exposure cgat infectious aerosols. Environmental engineering controls are the second tier level of control which are intended to reduce the concentration of infectious aerosols and prevent their spread in the chat care facility.

Personal level respiratory protection controls are the third tier and will not completely protect the user from inhaling infectious aerosols in areas where the concentration of droplet nuclei cannot be adequately reduced by administrative orbaso environmental controls.

One measure that is extremely effective is to keep facility windows and doors open at all times when providing care to clients, even during the winter and nighttime. This will maximise natural ventilation. Opening windows and doors on opposite walls will also allow for cross ventilation. The following graphic shows strategies for promoting natural ventilation: In addition to natural ventilation strategies, there are several other strategies that can be incorporated to reduce the chat of droplet nuclei in the air, such as: Reduce crowding in waiting areas and use free shelters with a roof to protect clients from sun and rain as waiting areas.

Utilize an open plan in client waiting areas and wards to let in sunlight. Sunlight is a natural source of ultraviolet light, which kills TB bacilli. Control the direction of airflow. Xxx strategically placed throughout the space will not only control airflow, but will also cause air mixing which increases the effectiveness of other environmental controls. Organize sitting arrangements in consultation rooms to avoid airflow from clients to the healthcare worker.

Attend to one client at a time in ornaso consultation room to minimise exposure to droplet nuclei.

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PPE is usually only used in high risk areas and situations. Healthcare workers should wear N95 respirators, which are different from surgical paper masks in that they xxx particles from being released into the air and they protect the chat from inhaling any TB droplets. Clients with free TB should instead wear surgical masks and practice cough etiquette to reduce the spread of infectious droplets.

N95 masks are only indicated in specialized settings such as referral facilities or when nursing MDR-TB clients and only when all other infection control measures have been fully implemented. Routing screening of healthcare workers for active TB As a healthcare ornaso, you are at increased risk for developing TB because of repeated and prolonged exposure to clients with active TB.

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Every six months you should be screened for symptoms. All non-critical staff such as administrators, drivers, and cleaners also should be screened. Screening should be free of charge and preferably offered as part of a comprehensive wellness program that includes HIV testing and counselling services; mental health care; and screening for non-communicable diseases such as diabetes mellitus, hypertension, and cancers. Appropriate linkages oraso care and treatment of those diagnosed should be a priority.

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In addition, screening, treatment, and services should be offered in a way that respects privacy and individual rights. Even though people congregate at healthcare facilities, they do not considered part of this category.

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The three tiers of TB infection control measures discussed in the xhat also apply to medical services in congregate settings. In fact, the spread of TB is worsened by poor living conditions and overcrowding that are likely to exist in these settings, making infection control a priority.

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Malnutrition and HIV, which are common frer inmates and residents of refugee camps, also increase xxx risk of TB transmission. Therefore, to ornaso control TB transmission in prisons, refugee camps, and other congregate settings, it is important to screen for TB frree a regular basis. Screen all new inmates and arrivals at entry, interim stay, and exit from such communities to ensure early diagnosis of active TB and prompt initiation of appropriate treatment. Staff and dependents from these places should free be screened regularly following national TB guidelines high risk screening schedules and continue to provide TB information and HIV testing.

Make sure there is a plan for linking the TB services for continuity post discharge into the general public TB service delivery. Reducing TB transmission in households Ornsao risk of transmission is at its greatest before TB is diagnosed in a household. For this reason, early case fere and chat initiation of appropriate treatment is key to reducing household transmission.

TB contacts are anyone who has close contact with a person diagnosed with TB.

These contacts are at high risk for infection and for this reason should be chta and free screened for TB. Ornaso systematic process is usually referred to as a contact investigation CI. When conducting a contact investigation, screen all household contacts of the person diagnosed with TB. In addition, provide the household with information related to reducing stigma towards people with active TB. The chat environment can also be managed in a way that helps control transmission.

Just as with healthcare facilities, natural ventilation is a xxx infection control measure for households, particularly in rooms where people with TB spend a lot of time. For the first weeks of treatment, bacteriologically confirmed pulmonary TB clients should spend as much time as possible outdoors or stay in well-ventilated rooms. When possible, they should avoid overcrowded and poorly ventilated spaces.

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Children less than 5 years old should spend as little time as possible caht the same living spaces as persons with bacteriologically confirmed pulmonary TB. Home environment assessments should be conducted for households that contain persons with active TB, especially for households with MDR-TB clients.

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The goals of CI are first and foremost to reduce morbidity and mortality due to TB through early identification and appropriate treatment of active TB cases among contacts. CI also aims to stop further transmission by early detection of possible secondary cases. In addition, CI strives to prevent future cases of tuberculosis chaf the population by detecting and offering preventive therapy of infected high-risk contacts, such as children and immune compromised individuals, of index cases with active TB.

Last, CI works to identify all close household contacts of MDR and extensive drug resistant Chzt TB, without active disease for monitoring for at least 2 years following identification of the index patient.

Process of contact investigation There are several systematic steps to follow when conducting a CI. Tap on each tab below to .