Those at risk include not just health care providers, but any staff, including volunteers and ancillary facility staff, who have contact with persons with TB who have not yet been diagnosed and started on treatment. Workers in correctional institutions and drug rehabilitation centres have also been documented to have higher rates of TB infection and disease than the general population.
"Healthcare and correctional services workers, particularly in resource-limited settings, run the gauntlet every day in terms of an increased risk of TB transmission because of the frequent and prolonged exposure to patients with undiagnosed, untreated and potentially contagious TB disease.
With the drive towards increasing access to HIV counselling and testing, care, and treatment for people living with HIV, more people living with HIV-associated immunosuppression are attending health care and community facilities than ever before. Hence patients and health care workers with HIV-associated immuno-suppression are particularly vulnerable to developing TB disease if they become infected as a result of exposure in these settings," warns Hylton Cowie, commercial director at Technilamp.
"In addition, employees may themselves be immunosuppressed due to HIV-infection which places them at a much higher risk. TB is the most common opportunistic infection and a leading cause of death in persons living with HIV/AIDS," explains Hylton.
Technilamp is a leading supplier to the mining and healthcare industries of Ultraviolet Germicidal Irradiation (UVGI) technology which is currently been deployed as a 'must-have' preventative measure in pro-active facilities and TB clinics across the country and SADC region.
The use of ultraviolet germicidal irradiation (UVGI) measures is proving increasingly effective, particularly in resource-limited settings, to prevent unnecessary morbidity and mortality due to TB transmission.
"A fact of huge concern for health care providers is that micro-organisms responsible for infections are very difficult to eradicate and many have become drug resistant - notably multi-drug resistant Tuberculosis. Infections are spread in two ways, namely contact and inhalation, however conventional preventative methodology has been surface cleaning and hand washing. Currently remedial programs are seriously lacking in reducing the risks from the inhalation of airborne micro-organisms," explains Hylton.
"Addressing the issue of airborne pathogens must be a high priority for healthcare institutions if we are to avoid a potential pandemic situation in our hospitals and clinics. Tuberculosis is transmitted by the airborne route caused by inhalation of infected air-borne droplets produced by infected and undiagnosed individuals while coughing and sneezing. Transmission of TB occurs in situations where infected persons come into close contact with others, such as in hospital and clinic environments, overcrowded living quarters such as in mine hostels, shelters, correctional facilities and so on," explains Hylton.
Exacerbating the problem in southern Africa is the fact that TB acts synergistically with HIV and increases the risk of primary TB infection developing into the active disease by a hundred fold. The seriousness of the situation is compounded by the emergence of new multiple-drug resistant strains of MTB (MDR-TB) with case fatality rates of up to 93% being recorded with MDR-TB. The ever present potential for transmission of MDR-TB to workers is very serious.
Internationally, Ultraviolet germicidal irradiation (UVGI) is a proven and cost effective means of killing off viruses and bacteria and more and more healthcare institutions are investing in the UVGI systems as a means of dramatically reducing the spread of communicable diseases, especially TB," explains Hylton.
In a study by Dr Edward Nardel of the Harvard Medical School comparing the efficacy of fans, filters or rays in the fight against TB, he noted that health care workers live in the corridors of hospitals, which are also important conduits of air and patients. The study concluded that the only technology inexpensive and potentially effective enough to be considered for the purpose of disinfecting air in corridors, waiting areas and emergency rooms, as well as isolation rooms is ultraviolet germicidal irradiation.
"Medical professionals have used ultraviolet irradiation in operating theatres and general wards around the world since 1937. Clinical tests conducted in general wards proved that the overall infection rates declined by more than 78% with the introduction of Ultraviolet Germicidal Irradiation (UVGI). These tests are in accordance with a study recently published which stated that ultraviolet lights could reduce the spread of TB in hospitals and waiting rooms by up to 70%," concludes Hylton.
The latest UVGI technology available from Technilamp includes extensive design enhancements, ensuring that the unit delivers the straightest beam of UV light and thus the highest and most consistent horizontal UV fluence rate versus any other - this is the most important feature of an indoor air sterilisation system and has never been achieved before. Because of the consistent horizontal UV fluence rate, it is safer for health care workers, patients and personnel alike and minimises any risk of UV dispersion. The new system design translates to more efficient indoor air sterilisation with a higher kill rate.
For more information contact Technilamp on +27 (0) 11 839 1837 or visit the website at www.technilamp.co.za.
