title: Infection control in households of drug-resistant tuberculosis patients co-infected with HIV in Mumbai, India.
abstract: BACKGROUND
  Mumbai has a population of 21 million, and an increasingly recognised epidemic of drug-resistant tuberculosis (DR-TB).
  
  
  OBJECTIVE
  To describe TB infection control (IC) measures implemented in households of DR-TB patients co-infected with the human immunodeficiency virus (HIV) under a Médecins Sans Frontières programme.
  
  
  METHODS
  IC assessments were carried out in patient households between May 2012 and March 2013. A simplified, standardised assessment tool was utilised to assess the risk of TB transmission and guide interventions. Administrative, environmental and personal protective measures were tailored to patient needs.
  
  
  RESULTS
  IC assessments were carried out in 29 houses. Measures included health education, segregating sleeping areas of patients, improving natural ventilation by opening windows, removing curtains and obstacles to air flow, installing fans and air extractors and providing surgical masks to patients for limited periods. Environmental interventions were carried out in 22 houses.
  
  
  CONCLUSIONS
  TB IC could be a beneficial component of a comprehensive TB and HIV care programme in households and communities. Although particularly challenging in slum settings, IC measures that are feasible, affordable and acceptable can be implemented in such settings using simplified and standardised tools. Appropriate IC interventions at household level may prevent new cases of DR-TB, especially in households of patients with a lower chance of cure.
authors.affiliation: Médecins Sans Frontières, Mumbai, India.
authors.forename: T
authors.initials: T
authors.lastname: Albuquerque
authors.affiliation: Médecins Sans Frontières, Mumbai, India.
authors.forename: P
authors.initials: P
authors.lastname: Isaakidis
authors.affiliation: Médecins Sans Frontières, Mumbai, India.
authors.forename: M
authors.initials: M
authors.lastname: Das
authors.affiliation: Southern Africa Medical Unit, Médecins Sans Frontières, Cape Town, South Africa.
authors.forename: P
authors.initials: P
authors.lastname: Saranchuk
authors.affiliation: Médecins Sans Frontières, Mumbai, India.
authors.forename: A
authors.initials: A
authors.lastname: Andries
authors.affiliation: School of Health System Studies, Tata Institute of Social Sciences, Mumbai, India.
authors.forename: D P
authors.initials: DP
authors.lastname: Misquita
authors.affiliation: Médecins Sans Frontières, Mumbai, India.
authors.forename: S
authors.initials: S
authors.lastname: Khan
authors.affiliation: Médecins Sans Frontières, Mumbai, India.
authors.forename: S
authors.initials: S
authors.lastname: Dubois
authors.affiliation: Médecins Sans Frontières, Mumbai, India.
authors.forename: C
authors.initials: C
authors.lastname: Peskett
authors.affiliation: Southern Africa Medical Unit, Médecins Sans Frontières, Cape Town, South Africa.
authors.forename: M
authors.initials: M
authors.lastname: Browne
keywords: HIV; Mumbai; drug-resistant tuberculosis; infection control; slums