Last data update: Sep 16, 2024. (Total: 47680 publications since 2009)
Records 1-6 (of 6 Records) |
Query Trace: Lipke V [original query] |
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Highlighting the need for more infection control practitioners in low- and middle-income countries
Lipke V , Emerson C , McCarthy C , Briggs-Hagen M , Farley J , Verani AR , Riley PL . Public Health Action 2016 6 (3) 160-163 Background: Many low- and middle-income countries struggle to implement, monitor and evaluate the efficacy of infection control (IC) measures within health care facilities. This hampers their ability to prevent nosocomial infections, identify emerging pathogens and rapidly alert officials to possible outbreaks. The lack of dedicated and trained IC practitioners (ICPs) is a serious deficit in the health care workforce, and is worsened by the lack of institutions that offer IC training. Discussion: While no single individual can entirely eliminate the risk of nosocomial transmission, there is literature to support the value of designated IC persons. Recommendations from the World Health Organization in 2008 and 2009 describe the need for this specialized cadre of workers, but many countries lack the national regulations to authorize, train and manage such professionals at the national or local level. This article provides an overview of how ICPs are trained and credentialed in several countries, and discusses approaches countries can use to train ICPs. Conclusion: Trained ICPs can help prevent future outbreaks and control nosocomial transmission of diseases in health care facilities. For this to occur, supportive national policies, availability of training institutions and local administrative support will be required. |
Evaluation of a TB infection control implementation initiative in out-patient HIV clinics in Zambia and Botswana
Emerson C , Lipke V , Kapata N , Mwananyambe N , Mwinga A , Garekwe M , Lanje S , Moshe Y , Pals SL , Nakashima AK , Miller B . Int J Tuberc Lung Dis 2016 20 (7) 941-7 SETTING: Out-patient human immunodeficiency virus (HIV) care and treatment clinics in Zambia and Botswana, countries with a high burden of HIV and TB infection. OBJECTIVE: To develop a tuberculosis infection control (TB IC) training and implementation package and evaluate the implementation of TB IC activities in facilities implementing the package. DESIGN: Prospective program evaluation of a TB IC training and implementation package using a standardized facility risk assessment tool, qualitative interviews with facility health care workers and measures of pre- and post-test performance. RESULTS: A composite measure of facility performance in TB IC improved from 32% at baseline to 50% at 1 year among eight facilities in Zambia, and from 27% to 80% at 6 months among 10 facilities in Botswana. Although there was marked improvement in indicators of managerial, administrative and environmental controls, key ongoing challenges remained in ensuring access to personal protective equipment and implementing TB screening in health care workers. CONCLUSION: TB IC activities at out-patient HIV clinics in Zambia and Botswana improved after training using the implementation package. Continued infrastructure support, as well as monitoring and evaluation, are needed to support the scale-up and sustainability of TB IC programs in facilities in low-resource countries. |
The role of the law in reducing tuberculosis transmission in Botswana, South Africa and Zambia
Verani AR , Emerson CN , Lederer P , Lipke G , Kapata N , Lanje S , Peters AC , Zulu I , Marston BJ , Miller B . Bull World Health Organ 2016 94 (6) 415-23 OBJECTIVE: To determine whether laws and regulations in Botswana, South Africa and Zambia - three countries with a high tuberculosis and HIV infection burden - address elements of the World Health Organization (WHO) policy on tuberculosis infection control. METHODS: An online desk review of laws and regulations that address six selected elements of the WHO policy on tuberculosis infection control in the three countries was conducted in November 2015 using publicly available domestic legal databases. The six elements covered: (i) national policy and legal framework; (ii) health facility design, construction and use; (iii) tuberculosis disease surveillance among health workers; (iv) patients' and health workers' rights; (v) monitoring of infection control measures; and (vi) relevant research. FINDINGS: The six elements were found to be adequately addressed in the three countries' laws and regulations. In all three, tuberculosis case-reporting is required, as is tuberculosis surveillance among health workers. Each country's legal and regulatory framework also addresses the need to respect individuals' rights and privacy while safeguarding public health. These laws and regulations create a strong foundation for tuberculosis infection control. Although the legal and regulatory frameworks thoroughly address tuberculosis infection control, their dissemination, implementation and enforcement were not assessed, nor was their impact on public health. CONCLUSION: Laws and regulations in Botswana, South Africa and Zambia address all six selected elements of the WHO policy on tuberculosis infection control. However, the lack of data on their implementation is a limitation. Future research should assess the implementation and public health impact of laws and regulations. |
Building and strengthening infection control strategies to prevent tuberculosis - Nigeria, 2015
Dokubo EK , Odume B , Lipke V , Muianga C , Onu E , Olutola A , Ukachukwu L , Igweike P , Chukwura N , Ubochioma E , Aniaku E , Ezeudu C , Agboeze J , Iroh G , Orji E , Godwin O , Raji HB , Aboje SA , Osakwe C , Debem H , Bello M , Onotu D , Maloney S . MMWR Morb Mortal Wkly Rep 2016 65 (10) 263-266 Tuberculosis (TB) is the leading cause of infectious disease mortality worldwide, accounting for more than 1.5 million deaths in 2014, and is the leading cause of death among persons living with human immunodeficiency virus (HIV) infection (1). Nigeria has the fourth highest annual number of TB cases among countries, with an estimated incidence of 322 per 100,000 population (1), and the second highest prevalence of HIV infection, with 3.4 million infected persons (2). In 2014, 100,000 incident TB cases and 78,000 TB deaths occurred among persons living with HIV infection in Nigeria (1). Nosocomial transmission is a significant source of TB infection in resource-limited settings (3), and persons with HIV infection and health care workers are at increased risk for TB infection because of their routine exposure to patients with TB in health care facilities (3-5). A lack of TB infection control in health care settings has resulted in outbreaks of TB and drug-resistant TB among patients and health care workers, leading to excess morbidity and mortality. In March 2015, in collaboration with the Nigeria Ministry of Health (MoH), CDC implemented a pilot initiative, aimed at increasing health care worker knowledge about TB infection control, assessing infection control measures in health facilities, and developing plans to address identified gaps. The approach resulted in substantial improvements in TB infection control practices at seven selected facilities, and scale-up of these measures across other facilities might lead to a reduction in TB transmission in Nigeria and globally. |
Tuberculosis and latent tuberculosis infection among health care workers in Kisumu, Kenya
Agaya J , Nnadi CD , Odhiambo J , Obonyo C , Obiero V , Lipke V , Okeyo E , Cain K , Oeltmann JE . Trop Med Int Health 2015 20 (12) 1797-804 OBJECTIVE: To assess prevalence and occupational risk factors of latent TB infection and history of TB disease ascribed to work in a health care setting in western Kenya. METHODS: We conducted a cross-sectional survey among health care workers in western Kenya in 2013. They were recruited from dispensaries, health centers, and hospitals that offer both TB and HIV services. School workers from the health facilities' catchment communities were randomly selected to serve as the community comparison group. Latent TB infection was diagnosed by tuberculin skin testing. HIV status of participants was assessed. Using a logistic regression model, we determined the adjusted odds of latent TB infection among health care workers compared to school workers; and among health care workers only, we assessed work-related risk factors for latent TB infection. RESULTS: We enrolled 1,005 health care workers and 411 school workers. Approximately 60% of both groups were female. 22% of 958 health care workers and 12% of 392 school workers tested HIV positive. Prevalence of self-reported history of TB disease was 7.4% among health care workers and 3.6% among school workers. Prevalence of latent TB infection was 60% among health care workers and 48% among school workers. Adjusted odds of latent TB infection were 1.5 times higher among health care workers than school workers (95% confidence interval 1.2-2.0). Health care workers at all three facility types had similar prevalence of latent TB infection, (p=0.72), but increasing years of employment was associated with increased odds of LTBI (p<0.01). CONCLUSION: Health care workers at facilities in western Kenya which offer TB and HIV services are at increased risk of latent TB infection, and the risk is similar across facility types. The WHO-recommended TB infection control measures are urgently needed in health facilities to protect health care workers. This article is protected by copyright. All rights reserved. |
Optimizing the protection of research participants and personnel in HIV-related research where TB is prevalent: practical solutions for improving infection control
Farley JE , Landers TF , Godfrey C , Lipke V , Sugarman J . J Acquir Immune Defic Syndr 2014 65 Suppl 1 S19-23 Tuberculosis (TB) is a leading cause of death among persons with HIV globally. HIV-related research in TB endemic areas raises some unique and important ethical issues in infection control related to protecting both research participants and personnel. To address such concerns, this article provides practical guidance to help research teams develop strategies to prevent TB transmission in studies involving persons with HIV in TB endemic settings. |
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