A. Occupational Awareness and Protection Teaching Sessions:
We strongly believe Health Care Workers working in developing countries and/or resource constrained settings have limited or incorrect information regarding the risks of TB exposure and infection, particularly drug resistant strains, and we aim to empower junior staff members and students by creating greater awareness through our website and multiple contact sessions. Since we have started sharing our stories, we were startled by the sheer number of occupational TB accounts that we have encountered. The problem has largely been hidden due to fear of stigmatization, which is one factor we are trying to address with our full and public disclosures.
The student information sessions are driven by a group of enterprising medical students. They are conducting an interventional study (for which they obtained ethical clearance from Stellenbosch University) among the various groups of health care students that are at increased risk of TB transmission. The pre-intervention questionnaire is followed by an information session that consists of personal accounts of occupational TB / MDR-TB, guidelines on how to use personal protective equipment (PPE) and recommendations on other preventative measures. The hour long session is concluded by a post-intervention questionnaire to assess what impact the session made on the students’ knowledge, attitudes and predicted future practises.
B. Research, Surveillance and Policy Strengthening:
- We are working with relevant stakeholders to improve existing TB Infection Control Policies for health care workers, students and patients and to draft policies where there are none.
- Working with Occupational Health to strengthen surveillance systems.
- Android App – TB Proof: Facility TB risk report form (more applications for other platforms are in development).
- TB Proof related student study (see above for more details, please).
Information gathered will be used to improve existing education, support and infection control measures and inform future strategies.
C. Broader advocacy work:
Members of TB Proof have been fortunate to share their personal experiences on various National and Global platforms, including conference presentations, panel discussions and media interviews. The following are focal points:
- How difficult it is to access and then cope with drug-resistant TB care, even under “optimal” treatment and support conditions. Clearly the vast majority of patients face far greater challenges with more dire consequences.
- Promoting the accelerated development, testing and compassionate use of novel TB drugs: Dalene von Delft was very fortunate to get compassionate access to bedaquiline in 2011, but the MCC inexplicably withdrew approval shortly thereafter and up until 2013 only four South Africans had been granted access to this very promising drug outside trial conditions. Safety and efficacy are critically important, but these considerations should be balanced against the low efficacy and tolerability of existing ‘treatment’ options.
- Are our drug resistant TB programs failing? Discussion about how to identify and address shortcomings at programmatic and health system levels as well as the more efficient use of limited resources.
- Alarming rise in occupational TB cases, particularly drug-resistant strains, coupled with deep-rooted stigmatization and suspected high rates of non-disclosure.