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Occupational Risks for Extensively Drug Resistant Tuberculosis (XDR-TB) Among Heath Care Workers in South Africa
Project Started : April 2009
Project Ends : Ongoing
Lead Researcher : Andrew Gibbs
Project Donor : JFA
Overview
Globally tuberculosis (TB) is the most common opportunistic infection associated with HIV/AIDS. And TB is the leading cause of death amongst HIV-infected patients in Sub-Saharan Africa. Extensively Drug Resistant TB (XDR-TB) is TB that is resistant to all but a small number of drugs. South Africa is increasingly reporting high levels of drug-resistant TB, and globally is reporting the highest incidence of drug resistant TB in the world.
Recent research from South Africa shows that health care workers are between 6 and 7 times more likely to contract MDR-TB and XDR-TB than the general population. And there is an increasing body of evidence suggesting that hospital transmission of XDR-TB is the way people contract it.
Understanding health care workers perspectives on the occupational risks, practices and activities that place them at particular risk of infection by XDR-TB is crucial in starting to develop policies and procedures to reduce the risks of infection and understanding why or why not these policies get implemented.
The objective of this study is to understand from the perspective of healthcare workers the activities and underlying reasons that place HCWs at risk of TB and specifically XDR-TB in hospitals in South Africa.
Research Questions
- To determine the activities and settings that increase the risk of personal exposure to drug-resistant tuberculosis for health care workers in KwaZulu-Natal, South Africa.
- To determine barriers to effective implementation of infection control and occupational health policies to prevent exposure to drug-resistant tuberculosis among health care workers in KwaZulu-Natal, South Africa.
Strategic Questions
Research programme 3
Strategic objective 3
Project Impact
This is the first study exploring health care workers’ perceptions of XDR-TB and, from health care workers’ perspectives why they are at greater risk of contracting XDR-TB.
The project seeks to provide recommendations on how to improve infection control in hospitals
Collaborators
- Dr Jennifer Zelnick is an Assistant Professor School of Social Work, Salem State College, Salem, MA, USA.
- Dr Max O'Donnell is a senior fellow in the Clinical HIV/AIDS Research Track (BU-CHART) at the Boston University School of Public Health and a senior clinical fellow in Pulmonary Medicine at Boston University School of Medicine, Boston, MA, USA.
- Ms Nesri Padayatchi MBChB, MSc, Centre for AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa, and Department of Community Medicine, School of Public Health, University of KwaZulu-Natal
- Ms Marian Loveday, Senior Scientist, Health Systems Research Unit, Medical Research Council (MRC), Pietermaritzburg, KZN
Key Phases
| Started | Completed | Description |
|---|---|---|
| April 2009 | Ongoing | Background Research |
Outputs and Activities
- A poster presentation, reviewing the literature of why health care workers may be at increased risk of XDR-TB was presented at the 4th Southern African AIDS Conference in Durban in April 2009. It was titled, "XDR-TB Amongst Health Care Workers: Exploring the role of gender, occupational health and stigma." Click here for more information.
Related News
- Dr Max O’Donnell and Dr Jenn Zelnick, collaborators on this project, have recently published data demonstrating that health care workers are 6 to 7 times more likely to have XDR-TB or MDR-TB than the general population. Click here for more information.
- In 2006 Joshi et al published a systematic review of TB in health care workers in low and middle income countries, identifying hospital based transmission of TB as a significant risk. It is freely available here.
- Project collaborators Dr O'Donnell and Dr Padayatchi have just published an article in the International Journal of Tuberculosis and Lung Disease called exploring outcomes of patients with XDR-TB.
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