Evidence for the Use of Triage, Respiratory Isolation, and Effective Treatment to Reduce the Transmission of Mycobacterium Tuberculosis in Healthcare Settings: A Systematic Review

Autor: Indira Govender, María Calderón, Jane Falconer, Rebecca Harris, Meghann Gregg, Jayne Ellis, David Moore, Katherine Fielding, Hannah E Barton, Aaron S. Karat, Mpho Tlali
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Microbiology (medical)
medicine.medical_specialty
Tuberculosis
Isolation (health care)
hiv seropositivity
infection prophylaxis
Health Personnel
Disease
Review Article
purl.org/pe-repo/ocde/ford#3.03.08 [https]
health personnel
World Health Organization
prevention
healthcare worker
Latent Tuberculosis
Health care
latent tuberculosis
medicine
Infection control
Humans
PICO
guidelines
respiratory isolation
Intensive care medicine
mycobacterium tuberculosis
Infection Control
Latent tuberculosis
business.industry
absolute risk reduction
Absolute risk reduction
Mycobacterium tuberculosis
medicine.disease
Triage
LTBI
infection
Editorial Commentary
Infectious Diseases
AcademicSubjects/MED00290
treatment effectiveness
tuberculosis
occupational health
world health organization
Health Facilities
triage
business
Covid-19
Delivery of Health Care
Zdroj: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
ISSN: 1537-6591
1058-4838
Popis: Evidence is limited for infection prevention and control (IPC) measures reducing Mycobacterium tuberculosis (MTB) transmission in health facilities. This systematic review, 1 of 7 commissioned by the World Health Organization to inform the 2019 update of global tuberculosis (TB) IPC guidelines, asked: do triage and/or isolation and/or effective treatment of TB disease reduce MTB transmission in healthcare settings? Of 25 included articles, 19 reported latent TB infection (LTBI) incidence in healthcare workers (HCWs; absolute risk reductions 1%–21%); 5 reported TB disease incidence in HCWs (no/slight [high TB burden] or moderate [low burden] reduction) and 2 in human immunodeficiency virus-positive in-patients (6%–29% reduction). In total, 23/25 studies implemented multiple IPC measures; effects of individual measures could not be disaggregated. Packages of IPC measures appeared to reduce MTB transmission, but evidence for effectiveness of triage, isolation, or effective treatment, alone or in combination, was indirect and low quality. Harmonizing study designs and reporting frameworks will permit formal data syntheses and facilitate policy making.
Twenty-five articles were found. Most studies showed reduced latent tuberculosis infection or tuberculosis disease incidence after implementation of an intervention package, but evidence was weak for effectiveness of individual interventions. We make recommendations for future research to provide a better evidence base.
Databáze: OpenAIRE
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