Occupational Awareness and Protection Teaching Sessions
There is growing evidence that healthcare workers (HCWs) working in developing countries and/or resource constrained settings have limited or incorrect information regarding the risks of TB exposure and infection, and the challenges posed by drug-resistant strains. We aim to empower staff members and students by creating greater awareness through our websites and multiple educational awareness sessions. Since we have started sharing our stories, we are struck by the sheer number of occupational TB accounts that we have encountered. The problem has largely been hidden due to fear of stigmatization (particularly in the context of the HIV epidemic), which is one factor we are trying to address with public disclosures that are as open and informative as possible.
The TB Proof awareness sessions include personal accounts of occupational TB / drug resistant TB, guidelines on how to use personal protective equipment (PPE) and recommendations on other preventative measures. The structure of these sessions was developed as part of an interventional research study which was published in the International Journal of Infection Control and evaluated knowledge, attitudes and predicted future practices of health science students regarding TB infection control.
Research, Surveillance and Policy Strengthening
- Working with relevant stakeholders (WHO, National, Provincial and academic teaching institutions) to improve existing TB Infection Control Policies for HCWs, students and patients and to draft policies where there are none.
- Working with Occupational Health (ILO and NIOH (should define)) to strengthen occupational health and surveillance systems.
Broader advocacy work
Members of TB Proof have been fortunate to shae their personal experiences on various national and global platforms, including conference presentations, panel discussions and media interviews. The following are focal points:
- Emphasising the difficulty in accessing and then coping with drug-resistant TB care, even under the “optimal” treatment and support conditions that were available to some of our members. Clearly the vast majority of patients face far greater challenges with direr consequences. More user-friendly regimes and greater levels of patient support are urgently needed to improve treatment outcomes.Promoting the accelerated development, testing and compassionate use of novel TB drugs.
- Addressing the emergence of incurable TB are our drug-resistant TB programmes failing? South Africa has the largest number of XDR-TB patients documented in the world, with cure rates reported to be 28% (Global Tuberculosis Report 2016). Discussions around identifying and addressing shortcomings at programmatic and health system levels, as well as the more efficient use of limited resources, are needed.
- Highlighting the alarming rise in occupational TB cases, including higher than average rates of DR-TB, coupled with deep-rooted stigmatization and suspected high rates of non-disclosure. HCWs living with HIV require additional support, as they are particularly vulnerable to acquiring TB and being confronted by stigmatization.
- Reaching the missing cases: the WHO estimated that in 2015, 4.6 million people infected with active tuberculosis were not diagnosed. Missed and delayed diagnoses of TB in patients in the private and public health sectors of South Africa (and other high burden countries) are alarming problems we aim to address through advocacy and education.
- Putting the patient first: we strongly support the recent focus on the safe service integration at primary healthcare and community levels. This includes not only HIV and TB integration, but all holistic patient-centric services.
- Emphasising and advocating for the urgent need for an effective new TB vaccine and for increased resources for TB research and development.