title: Tuberculosis infection control in primary health clinics in eThekwini, KwaZulu-Natal, South Africa.
abstract: METHODS
  Primary health clinics in KwaZulu-Natal, South Africa.
  
  
  OBJECTIVE
  To assess and describe current practices in infection control at local government primary health clinics.
  
  
  METHODS
  A descriptive study using a standardised tool to assess adherence to recommended infection  control policies in 51 primary health clinics in 2009-2010. Administrative policies, engineering controls and personal respiratory protection were assessed by observations and interviews at the clinics.
  
  
  RESULTS
  Of 51 clinics, 11 (22%) had infection control policies, 13 (26%) triaged  coughing patients and 16 (31%) had a dedicated nurse and a dedicated consulting room for treating tuberculosis (TB) patients. Study clinics treated a median of 99 patients (range 3-331) daily and a median of 15 TB patients (range 2-73) monthly. Of the rooms in the clinics, all  of which rely on natural ventilation, half (149/284) had ≤12 air changes per hour. Eleven (22%) of 51 clinics had N95 masks available for staff use.
  
  
  CONCLUSIONS
  Limited infection control practices exist in clinics in a high TB burden setting in KwaZulu-Natal, South Africa. These practices  need to be implemented more widely to minimise the spread of TB to non-infected patients and health care workers in primary health clinics.
authors.affiliation: Discipline of Occupational and Environmental Health, School of Nursing and Public Health, University of KwaZulu-Natal, Congella, KwaZulu-Natal, South Africa. naidoos71@ukzn.ac.za
authors.forename: S
authors.initials: S
authors.lastname: Naidoo
authors.forename: K
authors.initials: K
authors.lastname: Seevnarain
authors.forename: D L
authors.initials: DL
authors.lastname: Nordstrom
mesh_terms: D005160:Facility Design and Construction; D019983:Guideline Adherence; D019538:Health Care Surveys; D006268:Health Facilities; D006282:Health Personnel; D006801:Humans; D017053:Infection Control / Q000379:methods* / Q000592:standards; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D016273:Occupational Exposure; D016272:Occupational Health / Q000592:standards; D010356:Patient Isolation; D017410:Practice Guidelines as Topic; D011320:Primary Health Care; D019984:Quality Indicators, Health Care / Q000592:standards; D012134:Respiratory Protective Devices; D013019:South Africa / Q000453:epidemiology; D014218:Triage; D014376:Tuberculosis / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission; D014691:Ventilation; D000078329:Workforce; D016526:Workload