Tuberculosis infection prevention and control: why we need a whole systems approach

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dc.contributor.authorKielmann, Karina
dc.contributor.authorKarat, Aaron S
dc.contributor.authorZwama, Gimenne
dc.contributor.authorColvin, Christopher
dc.contributor.authorSwartz, Alison
dc.contributor.authorVoce, Anna S.
dc.contributor.authorYates, Tom A
dc.contributor.authorMacGregor, Hayley
dc.contributor.authorMcCreesh, Nicky
dc.contributor.authorKallon, Idriss
dc.contributor.authorVassall, Anna
dc.contributor.authorGovender, Indira
dc.contributor.authorSeeley, Janet
dc.contributor.authorGrant, Alison D
dc.date.accessioned2020-06-11T16:05:54Z
dc.date.available2020-06-11T16:05:54Z
dc.date.issued2020-05-25
dc.date.updated2020-05-31T03:15:52Z
dc.description.abstractInfection prevention and control (IPC) measures to reduce transmission of drug-resistant and drug-sensitive tuberculosis (TB) in health facilities are well described but poorly implemented. The implementation of TB IPC has been assessed primarily through quantitative and structured approaches that treat administrative, environmental, and personal protective measures as discrete entities. We present an on-going project entitled Umoya omuhle (“good air”), conducted in two provinces of South Africa, that adopts an interdisciplinary, ‘whole systems’ approach to problem analysis and intervention development for reducing nosocomial transmission of Mycobacterium tuberculosis (Mtb) through improved IPC. We suggest that TB IPC represents a complex intervention that is delivered within a dynamic context shaped by policy guidelines, health facility space, infrastructure, organisation of care, and management culture. Methods drawn from epidemiology, anthropology, and health policy and systems research enable rich contextual analysis of how nosocomial Mtb transmission occurs, as well as opportunities to address the problem holistically. A ‘whole systems’ approach can identify leverage points within the health facility infrastructure and organisation of care that can inform the design of interventions to reduce the risk of nosocomial Mtb transmission.en_US
dc.identifier.apacitationKielmann, K., Karat, A. S., Zwama, G., Colvin, C., Swartz, A., Voce, Anna S., ... Grant, A. D. (2020). Tuberculosis infection prevention and control: why we need a whole systems approach. <i>Infectious Diseases of Poverty</i>, 9(1), 56. http://hdl.handle.net/11427/32065en_ZA
dc.identifier.chicagocitationKielmann, Karina, Aaron S Karat, Gimenne Zwama, Christopher Colvin, Alison Swartz, Anna S. Voce, Tom A Yates, et al "Tuberculosis infection prevention and control: why we need a whole systems approach." <i>Infectious Diseases of Poverty</i> 9, 1. (2020): 56. http://hdl.handle.net/11427/32065en_ZA
dc.identifier.citationKielmann, K., Karat, A.S., Zwama, G., Colvin, C., Swartz, A., Voce, Anna S., Yates, T.A. & MacGregor, H. et al. 2020. Tuberculosis infection prevention and control: why we need a whole systems approach. <i>Infectious Diseases of Poverty.</i> 9(1):56. http://hdl.handle.net/11427/32065en_ZA
dc.identifier.ris TY - Journal Article AU - Kielmann, Karina AU - Karat, Aaron S AU - Zwama, Gimenne AU - Colvin, Christopher AU - Swartz, Alison AU - Voce, Anna S. AU - Yates, Tom A AU - MacGregor, Hayley AU - McCreesh, Nicky AU - Kallon, Idriss AU - Vassall, Anna AU - Govender, Indira AU - Seeley, Janet AU - Grant, Alison D AB - Infection prevention and control (IPC) measures to reduce transmission of drug-resistant and drug-sensitive tuberculosis (TB) in health facilities are well described but poorly implemented. The implementation of TB IPC has been assessed primarily through quantitative and structured approaches that treat administrative, environmental, and personal protective measures as discrete entities. We present an on-going project entitled Umoya omuhle (“good air”), conducted in two provinces of South Africa, that adopts an interdisciplinary, ‘whole systems’ approach to problem analysis and intervention development for reducing nosocomial transmission of Mycobacterium tuberculosis (Mtb) through improved IPC. We suggest that TB IPC represents a complex intervention that is delivered within a dynamic context shaped by policy guidelines, health facility space, infrastructure, organisation of care, and management culture. Methods drawn from epidemiology, anthropology, and health policy and systems research enable rich contextual analysis of how nosocomial Mtb transmission occurs, as well as opportunities to address the problem holistically. A ‘whole systems’ approach can identify leverage points within the health facility infrastructure and organisation of care that can inform the design of interventions to reduce the risk of nosocomial Mtb transmission. DA - 2020-05-25 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - Infectious Diseases of Poverty KW - Drug-resistant tuberculosis KW - Infection prevention and control KW - Health system KW - South Africa LK - https://open.uct.ac.za PY - 2020 T1 - Tuberculosis infection prevention and control: why we need a whole systems approach TI - Tuberculosis infection prevention and control: why we need a whole systems approach UR - http://hdl.handle.net/11427/32065 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s40249-020-00667-6
dc.identifier.urihttp://hdl.handle.net/11427/32065
dc.identifier.vancouvercitationKielmann K, Karat AS, Zwama G, Colvin C, Swartz A, Voce Anna S, et al. Tuberculosis infection prevention and control: why we need a whole systems approach. Infectious Diseases of Poverty. 2020;9(1):56. http://hdl.handle.net/11427/32065.en_ZA
dc.language.isoenen_US
dc.language.rfc3066en
dc.publisher.departmentDepartment of Public Health and Family Medicineen_US
dc.publisher.facultyFaculty of Health Sciencesen_US
dc.rights.holderThe Author(s)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.sourceInfectious Diseases of Povertyen_US
dc.source.journalissue1en_US
dc.source.journalvolume9en_US
dc.source.pagination56en_US
dc.source.urihttps://idpjournal.biomedcentral.com/
dc.subjectDrug-resistant tuberculosisen_US
dc.subjectInfection prevention and controlen_US
dc.subjectHealth systemen_US
dc.subjectSouth Africaen_US
dc.titleTuberculosis infection prevention and control: why we need a whole systems approachen_US
dc.typeJournal Articleen_US
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