This document discusses tuberculosis (TB) infection control and prevention. It covers three levels of TB prevention: primary, secondary, and tertiary. It describes how TB can spread from patients to workers, visitors, and other patients. The document outlines a hierarchy of infection control strategies including administrative, environmental, and personal respiratory controls. It emphasizes the importance of contact tracing to identify and screen people exposed to active TB cases.
The document summarizes India's national health budget for 2021, outlining various programmes and initiatives aimed at reducing maternal and infant mortality rates. Key points include:
- The National Health Mission consolidates rural and urban health programmes with a focus on reproductive, maternal, newborn, child and adolescent health.
- Initiatives promote institutional deliveries, maternal and child tracking, immunization drives like Mission Indradhanush, and treatment of pregnancy complications.
- Maternal and Child Health Wings are being established in high-volume facilities to provide emergency obstetric and newborn care.
- Community health workers like ASHAs provide antenatal services, escort women to facilities, and distribute medical supplies.
National health programs related to maternal and child healthSharon Treesa Antony
The document summarizes several key national health programs related to maternal and child health in India, including:
1) The Integrated Child Development Scheme launched in 1975 to provide services to pregnant women, nursing mothers and children under 6 including health checkups, immunizations, supplementary nutrition and education.
2) The National Family Welfare Program launched in 1952 to provide family planning services through rural and urban programs including village health posts and full family planning services at community health centers.
3) The Universal Immunization Program launched in 1978 and expanded in 1985 to provide vaccines to pregnant women, infants and children through a national immunization schedule.
The document discusses the Rashtriya Kishor Swasthya Karyakram (RKSK) or National Adolescent Health Programme in India. It was launched in 2014 to promote the health and well-being of adolescents aged 10-19. The program aims to improve nutrition, sexual and reproductive health, mental health, prevent injuries and violence, address substance misuse, and conditions for non-communicable diseases. It utilizes community-based interventions like peer education, adolescent health days, and iron supplementation, as well as facility-based adolescent friendly health clinics. The program also focuses on convergence between the health sector and other departments to promote adolescent health.
The document discusses teleconsultation, which involves using electronic communications to provide medical expertise to areas without readily available expertise. There are two types: synchronous uses live video conferencing, while asynchronous stores and forwards medical information digitally. Examples provided include telepsychiatry using live video between patient and psychiatrist, and tele radiology where an x-ray is scanned, sent digitally to a radiologist, and diagnosis returned without patient travel. The document also summarizes Malaysia's national teleconsultation network in neurosurgery, radiology, cardiology and dermatology using these techniques.
Tomographic reconstruction in nuclear medicineSUMAN GOWNDER
This document discusses various techniques for tomographic reconstruction in nuclear medicine imaging. It begins with an overview of backprojection and Fourier-based reconstruction techniques like simple backprojection, direct Fourier transform reconstruction, and filtered backprojection. It then discusses multislice imaging, factors that influence image quality, and iterative reconstruction algorithms as an alternative to filtered backprojection. Finally, it covers reconstruction of fan-beam, cone-beam, and pinhole SPECT data that require 3D reconstruction algorithms.
Radiation oncology uses ionizing radiation to treat cancer. Radiation damages DNA directly or indirectly through free radicals, preferentially killing cancer cells. Radiation is produced by linear accelerators and delivered externally by photon beams in conventional fractionated radiotherapy or stereotactically. Newer techniques like IMRT conform doses better to tumors while avoiding normal tissues. Radiation can be delivered internally via brachytherapy sources placed in or near tumors. The goal is definitive cure or palliation; fractionation allows normal tissue recovery between doses. Different cancers have varying radiosensitivities requiring tailored doses and fractionation schemes.
The document discusses the various aspects that affect quality of life for cancer patients, including physical, psychological, social, and spiritual factors. Physically, cancer and its treatments can cause pain, fatigue, sleep issues, nutritional problems, and loss of mobility. Psychologically, patients often experience anxiety, depression, stress, and cognitive impairments. Socially, family/friend support is important, but social roles may change. Spiritually, patients may seek comfort and meaning through faith. Maintaining wellness in these areas can help patients better cope with their cancer diagnosis and treatment.
Bio-statistics for daily needs for a physicianKanhu Charan
The document contains contact information for Dr. Kanhu Charan Patro and the title "Funny & Catchy Statistics for Doctors". It then lists 102 blank slides, suggesting there are no statistics provided in the document beyond the title. The document appears to be an incomplete presentation or list of statistics for doctors that does not contain any actual statistics.
The document summarizes India's national health budget for 2021, outlining various programmes and initiatives aimed at reducing maternal and infant mortality rates. Key points include:
- The National Health Mission consolidates rural and urban health programmes with a focus on reproductive, maternal, newborn, child and adolescent health.
- Initiatives promote institutional deliveries, maternal and child tracking, immunization drives like Mission Indradhanush, and treatment of pregnancy complications.
- Maternal and Child Health Wings are being established in high-volume facilities to provide emergency obstetric and newborn care.
- Community health workers like ASHAs provide antenatal services, escort women to facilities, and distribute medical supplies.
National health programs related to maternal and child healthSharon Treesa Antony
The document summarizes several key national health programs related to maternal and child health in India, including:
1) The Integrated Child Development Scheme launched in 1975 to provide services to pregnant women, nursing mothers and children under 6 including health checkups, immunizations, supplementary nutrition and education.
2) The National Family Welfare Program launched in 1952 to provide family planning services through rural and urban programs including village health posts and full family planning services at community health centers.
3) The Universal Immunization Program launched in 1978 and expanded in 1985 to provide vaccines to pregnant women, infants and children through a national immunization schedule.
The document discusses the Rashtriya Kishor Swasthya Karyakram (RKSK) or National Adolescent Health Programme in India. It was launched in 2014 to promote the health and well-being of adolescents aged 10-19. The program aims to improve nutrition, sexual and reproductive health, mental health, prevent injuries and violence, address substance misuse, and conditions for non-communicable diseases. It utilizes community-based interventions like peer education, adolescent health days, and iron supplementation, as well as facility-based adolescent friendly health clinics. The program also focuses on convergence between the health sector and other departments to promote adolescent health.
The document discusses teleconsultation, which involves using electronic communications to provide medical expertise to areas without readily available expertise. There are two types: synchronous uses live video conferencing, while asynchronous stores and forwards medical information digitally. Examples provided include telepsychiatry using live video between patient and psychiatrist, and tele radiology where an x-ray is scanned, sent digitally to a radiologist, and diagnosis returned without patient travel. The document also summarizes Malaysia's national teleconsultation network in neurosurgery, radiology, cardiology and dermatology using these techniques.
Tomographic reconstruction in nuclear medicineSUMAN GOWNDER
This document discusses various techniques for tomographic reconstruction in nuclear medicine imaging. It begins with an overview of backprojection and Fourier-based reconstruction techniques like simple backprojection, direct Fourier transform reconstruction, and filtered backprojection. It then discusses multislice imaging, factors that influence image quality, and iterative reconstruction algorithms as an alternative to filtered backprojection. Finally, it covers reconstruction of fan-beam, cone-beam, and pinhole SPECT data that require 3D reconstruction algorithms.
Radiation oncology uses ionizing radiation to treat cancer. Radiation damages DNA directly or indirectly through free radicals, preferentially killing cancer cells. Radiation is produced by linear accelerators and delivered externally by photon beams in conventional fractionated radiotherapy or stereotactically. Newer techniques like IMRT conform doses better to tumors while avoiding normal tissues. Radiation can be delivered internally via brachytherapy sources placed in or near tumors. The goal is definitive cure or palliation; fractionation allows normal tissue recovery between doses. Different cancers have varying radiosensitivities requiring tailored doses and fractionation schemes.
The document discusses the various aspects that affect quality of life for cancer patients, including physical, psychological, social, and spiritual factors. Physically, cancer and its treatments can cause pain, fatigue, sleep issues, nutritional problems, and loss of mobility. Psychologically, patients often experience anxiety, depression, stress, and cognitive impairments. Socially, family/friend support is important, but social roles may change. Spiritually, patients may seek comfort and meaning through faith. Maintaining wellness in these areas can help patients better cope with their cancer diagnosis and treatment.
Bio-statistics for daily needs for a physicianKanhu Charan
The document contains contact information for Dr. Kanhu Charan Patro and the title "Funny & Catchy Statistics for Doctors". It then lists 102 blank slides, suggesting there are no statistics provided in the document beyond the title. The document appears to be an incomplete presentation or list of statistics for doctors that does not contain any actual statistics.
A care home 'is' someone's home, one day it could be yours too … best practice in end of life care in care homes. Presentation from Eleanor Sherwen, Elaine Owen and Caroline Flynn from England's National End of Life Care Programme as part of the Department of Health's QIPP end of life care workstream seminar series at Healthcare Innovation Expo 2011
1. The document evaluates volumetric modulated arc therapy (VMAT) for craniospinal irradiation (CSI) treatment planning.
2. It aims to standardize and simplify the CSI planning technique while improving dose conformity and homogeneity in the target volume and reducing dose to organs at risk.
3. VMAT plans for 4 patients using 3 isocenters and 2 arcs each achieved good target coverage with a conformity index of 0.99 and homogeneity index of 1.13 on average while sparing organs at risk.
The document outlines the steps to prepare a sub-center microplan for immunization services. It involves estimating the target populations in each village, calculating the number of beneficiaries for each vaccine, and determining the vaccine and logistics requirements on a monthly basis. It also includes preparing an ANM work plan with the immunization session schedule and dates for each village, as well as drawing a map of the sub-center area showing village populations and immunization sites. Additional steps for preparing a PHC microplan are also listed, such as preparing a supervision plan and route chart for vaccine delivery.
Adolescent health and national health programmesDr.Preeti Tiwari
The document discusses several national health programs in India that address adolescent health issues. It describes programs like RKSK that focus on improving nutrition, sexual and reproductive health, and preventing injuries among adolescents. It also outlines other schemes for adolescent girls such as Kishori Shakti Yojana and Nutrition Program for Adolescent Girls that aim to enhance their health, education, and empowerment. The document provides details on services covered under these programs, including weekly iron supplementation, health clinics, peer education, and life skills training.
Palliative care - Advance Nursing PracticeJaice Mary Joy
Palliative care aims to improve the quality of life of patients facing life-threatening illnesses by preventing and relieving suffering through comprehensive care that addresses physical, psychosocial, and spiritual needs. It focuses on symptom management, support for patients and families, and care that affirms life and dying as a normal process. Palliative care teams provide services like pain management, counseling, therapies, and equipment to help patients live as actively as possible.
The document provides an overview of Integrated Counselling and Testing Centres (ICTCs) in India. ICTCs were established in 2006 by integrating Voluntary Counselling and Testing Centres (VCTCs) and facilities providing Prevention of Parent to Child Transmission of HIV/AIDS (PPTCT) services. ICTCs provide HIV counseling, testing, and linkage to care services. They play a key role in HIV prevention, diagnosis, and treatment initiatives like PPTCT. The document outlines the functions, infrastructure, staffing, testing strategies and protocols of ICTCs in India.
This document provides definitions and examples of random and systematic errors that can occur during the radiotherapy treatment process. It discusses various sources of errors including patient setup, organ motion, and target deformation. Methods for managing errors such as offline and online correction techniques, immobilization devices, and image-guidance are presented. The importance of distinguishing between random and systematic errors when establishing appropriate planning target volume margins is also emphasized.
Clinical quality assurance in RadiotherapyBharti Devnani
This document discusses quality assurance requirements and resources for clinical radiotherapy. It outlines the philosophy of radiotherapy quality assurance as improving clinical practice quality, promoting consistency, ensuring accuracy, and validating clinical trial results. It then describes the integrated planning and delivery process and sources of errors. The document provides detailed guidelines for quality assurance procedures during pre-planning, immobilization, simulation/CT, volume determination, treatment planning evaluation, treatment verification and delivery, follow-up, and the importance of audits for quality assurance.
Chapter 6.1 national tobacco control programNilesh Kucha
The National Tobacco Control Programme was launched in India by the Ministry of Health and Family Welfare in 2007-2008 during the 11th five year plan. It aims to increase awareness about the harms of tobacco, facilitate implementation of tobacco control laws, reduce tobacco production and supply, and help people quit tobacco through cessation centers. Currently implemented in 21 states covering 42 districts, it will eventually cover the entire country. The programme monitors implementation of COTPA and provides guidelines on tobacco control activities.
- TB is the 9th leading cause of death worldwide, with India leading the count of cases and deaths.
- WHO's END TB Strategy and UN SDGs aim to end the global TB epidemic by 2035, reducing incidence by 90% and deaths by 95% from 2015 levels.
- India's NSP 2017-2025, aligned with global strategies, aims to eliminate TB in India by 2025 through a framework with 4 pillars - Detect, Treat, Prevent, Build.
- The strategy calls for multi-sectoral participation from all stakeholders to reach the last person with TB and make India TB-free through improved diagnosis, treatment, social support and an enabling policy environment.
Health and wellness center by Dr. Jitender, MD PGIMERYogesh Arora
Health and wellness center is one of the two component of Ayushmann Bharat. HWC ensures comprehensive, quality, and affordable care to be achieved by all.
This document provides an overview of telemedicine, including its origins, definitions, types, equipment, staffing, benefits, and future directions. Telemedicine allows for the delivery of healthcare services via technology where distance is a factor, including video conferencing between patients and doctors, monitoring patient vitals remotely, and transferring medical data between hospitals. It has various applications like tele-radiology, cardiology, and psychiatry. Establishing telemedicine departments requires equipment like telescopes, ECG machines, digital cameras, and IT infrastructure. Staff typically include doctors, technicians, and administrators. Telemedicine provides benefits like increased access to expertise, cost savings, and opportunities for education and research. Its future expansion may include more robotics and remote
The document discusses the process of computed tomography (CT) scanning. It describes the five main stages of CT scanning: 1) scanning and data acquisition, 2) pre-processing of raw data, 3) image reconstruction using filtered back projection, 4) conversion of linear attenuation coefficients to Hounsfield units, and 5) display and recording of images. The scanning phase involves selecting a field of view, dividing it into slices, placing a grid on slices, and scanning slices from multiple projections to acquire data.
CT based Image Guided Radiotherapy - Physics & QASambasivaselli R
This document discusses quality assurance for CT-based image guided radiotherapy. It describes existing technologies like kV CBCT, MV CBCT and XVI imaging. It provides details on the XVI system including its x-ray generator, imaging panel, image acquisition and reconstruction process. The document outlines various quality assurance tests for geometric accuracy, image quality and registration including uniformity, spatial resolution and accuracy tests using phantoms.
The document discusses India's National Tuberculosis Elimination Program (NTEP), formerly known as the Revised National Tuberculosis Control Programme (RNTCP). It outlines the evolution and key components of NTEP, including the adoption of the DOTS strategy, STOP TB and End TB strategies, and the current National Strategic Plan 2017-2025. The summary highlights that NTEP aims to eliminate TB in India by 2025, utilizing active case finding, newer treatment regimens, private sector engagement, and IT-enabled surveillance and support for TB patients.
Palliative care aims to improve quality of life for patients facing life-limiting illnesses through comprehensive pain and symptom management as well as psychosocial and spiritual support. It can be provided alongside curative treatment or as the main focus of care. The goals are to prevent and relieve suffering through early identification of issues, addressing physical, psychological, social and spiritual needs using a multidisciplinary team approach. Palliative care strives to help patients and their families cope with illness and bereavement.
Revised national tuberculosis control programmeRavi Rohilla
This document provides an overview of tuberculosis (TB) control in India. It discusses the background and epidemiology of TB globally and in India. It describes India's National TB Control Programme established in 1962 and the Revised National TB Control Programme (RNTCP) launched in 1997, which applies the WHO-recommended DOTS strategy. The RNTCP aims to achieve 85% treatment success among new sputum-positive TB patients and detect at least 70% of estimated cases. It emphasizes standardized treatment regimens, quality-assured diagnosis, and direct observation of treatment.
ndia is one of the developing countries who have national cancer control programme (NCCP). We started way back in 1975 and the plan has been revised three times. The first revision was in 1984, second one in 1991 and third one 2004.
Prospective Assessment of Deep Inspiration Breath Hold to Prevent Radiation-I...SGRT Community
Timothy M. Zagar MD, Assistant Professor at the University of North Carolina, presents on Deep Inspiration Breath Hold (DIBH) with AlignRT at ASTRO 2015.
India is the highest TB burden country in the world & accounts for nearly 1/5th (20 per cent) of global burden of tuberculosis, 2/3rd of cases in SEAR. Every year approximately 1.8 million persons develop tuberculosis, of which about 0.8 million are new smear positive highly'- infectious cases.Annual risk of becoming infected with TB is 1.5 % and once infected there is 10 % life-time risk of developing TB disease
1. The document discusses various enteral feeding methods including nasogastric tubes, nasojejunal tubes, percutaneous endoscopic gastrostomy (PEG) tubes, radiologically placed gastrostomy tubes, and jejunostomy tubes.
2. It describes the indications, contraindications, techniques, advantages, and complications of each method. PEG tubes are the most common method for long-term enteral access beyond 4-6 weeks while NG and NJ tubes are used for short-term feedings.
3. Access methods are chosen based on factors like the patient's condition, prognosis, ability to tolerate different sites of feeding, and risk of complications. Overall the document provides an overview
A care home 'is' someone's home, one day it could be yours too … best practice in end of life care in care homes. Presentation from Eleanor Sherwen, Elaine Owen and Caroline Flynn from England's National End of Life Care Programme as part of the Department of Health's QIPP end of life care workstream seminar series at Healthcare Innovation Expo 2011
1. The document evaluates volumetric modulated arc therapy (VMAT) for craniospinal irradiation (CSI) treatment planning.
2. It aims to standardize and simplify the CSI planning technique while improving dose conformity and homogeneity in the target volume and reducing dose to organs at risk.
3. VMAT plans for 4 patients using 3 isocenters and 2 arcs each achieved good target coverage with a conformity index of 0.99 and homogeneity index of 1.13 on average while sparing organs at risk.
The document outlines the steps to prepare a sub-center microplan for immunization services. It involves estimating the target populations in each village, calculating the number of beneficiaries for each vaccine, and determining the vaccine and logistics requirements on a monthly basis. It also includes preparing an ANM work plan with the immunization session schedule and dates for each village, as well as drawing a map of the sub-center area showing village populations and immunization sites. Additional steps for preparing a PHC microplan are also listed, such as preparing a supervision plan and route chart for vaccine delivery.
Adolescent health and national health programmesDr.Preeti Tiwari
The document discusses several national health programs in India that address adolescent health issues. It describes programs like RKSK that focus on improving nutrition, sexual and reproductive health, and preventing injuries among adolescents. It also outlines other schemes for adolescent girls such as Kishori Shakti Yojana and Nutrition Program for Adolescent Girls that aim to enhance their health, education, and empowerment. The document provides details on services covered under these programs, including weekly iron supplementation, health clinics, peer education, and life skills training.
Palliative care - Advance Nursing PracticeJaice Mary Joy
Palliative care aims to improve the quality of life of patients facing life-threatening illnesses by preventing and relieving suffering through comprehensive care that addresses physical, psychosocial, and spiritual needs. It focuses on symptom management, support for patients and families, and care that affirms life and dying as a normal process. Palliative care teams provide services like pain management, counseling, therapies, and equipment to help patients live as actively as possible.
The document provides an overview of Integrated Counselling and Testing Centres (ICTCs) in India. ICTCs were established in 2006 by integrating Voluntary Counselling and Testing Centres (VCTCs) and facilities providing Prevention of Parent to Child Transmission of HIV/AIDS (PPTCT) services. ICTCs provide HIV counseling, testing, and linkage to care services. They play a key role in HIV prevention, diagnosis, and treatment initiatives like PPTCT. The document outlines the functions, infrastructure, staffing, testing strategies and protocols of ICTCs in India.
This document provides definitions and examples of random and systematic errors that can occur during the radiotherapy treatment process. It discusses various sources of errors including patient setup, organ motion, and target deformation. Methods for managing errors such as offline and online correction techniques, immobilization devices, and image-guidance are presented. The importance of distinguishing between random and systematic errors when establishing appropriate planning target volume margins is also emphasized.
Clinical quality assurance in RadiotherapyBharti Devnani
This document discusses quality assurance requirements and resources for clinical radiotherapy. It outlines the philosophy of radiotherapy quality assurance as improving clinical practice quality, promoting consistency, ensuring accuracy, and validating clinical trial results. It then describes the integrated planning and delivery process and sources of errors. The document provides detailed guidelines for quality assurance procedures during pre-planning, immobilization, simulation/CT, volume determination, treatment planning evaluation, treatment verification and delivery, follow-up, and the importance of audits for quality assurance.
Chapter 6.1 national tobacco control programNilesh Kucha
The National Tobacco Control Programme was launched in India by the Ministry of Health and Family Welfare in 2007-2008 during the 11th five year plan. It aims to increase awareness about the harms of tobacco, facilitate implementation of tobacco control laws, reduce tobacco production and supply, and help people quit tobacco through cessation centers. Currently implemented in 21 states covering 42 districts, it will eventually cover the entire country. The programme monitors implementation of COTPA and provides guidelines on tobacco control activities.
- TB is the 9th leading cause of death worldwide, with India leading the count of cases and deaths.
- WHO's END TB Strategy and UN SDGs aim to end the global TB epidemic by 2035, reducing incidence by 90% and deaths by 95% from 2015 levels.
- India's NSP 2017-2025, aligned with global strategies, aims to eliminate TB in India by 2025 through a framework with 4 pillars - Detect, Treat, Prevent, Build.
- The strategy calls for multi-sectoral participation from all stakeholders to reach the last person with TB and make India TB-free through improved diagnosis, treatment, social support and an enabling policy environment.
Health and wellness center by Dr. Jitender, MD PGIMERYogesh Arora
Health and wellness center is one of the two component of Ayushmann Bharat. HWC ensures comprehensive, quality, and affordable care to be achieved by all.
This document provides an overview of telemedicine, including its origins, definitions, types, equipment, staffing, benefits, and future directions. Telemedicine allows for the delivery of healthcare services via technology where distance is a factor, including video conferencing between patients and doctors, monitoring patient vitals remotely, and transferring medical data between hospitals. It has various applications like tele-radiology, cardiology, and psychiatry. Establishing telemedicine departments requires equipment like telescopes, ECG machines, digital cameras, and IT infrastructure. Staff typically include doctors, technicians, and administrators. Telemedicine provides benefits like increased access to expertise, cost savings, and opportunities for education and research. Its future expansion may include more robotics and remote
The document discusses the process of computed tomography (CT) scanning. It describes the five main stages of CT scanning: 1) scanning and data acquisition, 2) pre-processing of raw data, 3) image reconstruction using filtered back projection, 4) conversion of linear attenuation coefficients to Hounsfield units, and 5) display and recording of images. The scanning phase involves selecting a field of view, dividing it into slices, placing a grid on slices, and scanning slices from multiple projections to acquire data.
CT based Image Guided Radiotherapy - Physics & QASambasivaselli R
This document discusses quality assurance for CT-based image guided radiotherapy. It describes existing technologies like kV CBCT, MV CBCT and XVI imaging. It provides details on the XVI system including its x-ray generator, imaging panel, image acquisition and reconstruction process. The document outlines various quality assurance tests for geometric accuracy, image quality and registration including uniformity, spatial resolution and accuracy tests using phantoms.
The document discusses India's National Tuberculosis Elimination Program (NTEP), formerly known as the Revised National Tuberculosis Control Programme (RNTCP). It outlines the evolution and key components of NTEP, including the adoption of the DOTS strategy, STOP TB and End TB strategies, and the current National Strategic Plan 2017-2025. The summary highlights that NTEP aims to eliminate TB in India by 2025, utilizing active case finding, newer treatment regimens, private sector engagement, and IT-enabled surveillance and support for TB patients.
Palliative care aims to improve quality of life for patients facing life-limiting illnesses through comprehensive pain and symptom management as well as psychosocial and spiritual support. It can be provided alongside curative treatment or as the main focus of care. The goals are to prevent and relieve suffering through early identification of issues, addressing physical, psychological, social and spiritual needs using a multidisciplinary team approach. Palliative care strives to help patients and their families cope with illness and bereavement.
Revised national tuberculosis control programmeRavi Rohilla
This document provides an overview of tuberculosis (TB) control in India. It discusses the background and epidemiology of TB globally and in India. It describes India's National TB Control Programme established in 1962 and the Revised National TB Control Programme (RNTCP) launched in 1997, which applies the WHO-recommended DOTS strategy. The RNTCP aims to achieve 85% treatment success among new sputum-positive TB patients and detect at least 70% of estimated cases. It emphasizes standardized treatment regimens, quality-assured diagnosis, and direct observation of treatment.
ndia is one of the developing countries who have national cancer control programme (NCCP). We started way back in 1975 and the plan has been revised three times. The first revision was in 1984, second one in 1991 and third one 2004.
Prospective Assessment of Deep Inspiration Breath Hold to Prevent Radiation-I...SGRT Community
Timothy M. Zagar MD, Assistant Professor at the University of North Carolina, presents on Deep Inspiration Breath Hold (DIBH) with AlignRT at ASTRO 2015.
India is the highest TB burden country in the world & accounts for nearly 1/5th (20 per cent) of global burden of tuberculosis, 2/3rd of cases in SEAR. Every year approximately 1.8 million persons develop tuberculosis, of which about 0.8 million are new smear positive highly'- infectious cases.Annual risk of becoming infected with TB is 1.5 % and once infected there is 10 % life-time risk of developing TB disease
1. The document discusses various enteral feeding methods including nasogastric tubes, nasojejunal tubes, percutaneous endoscopic gastrostomy (PEG) tubes, radiologically placed gastrostomy tubes, and jejunostomy tubes.
2. It describes the indications, contraindications, techniques, advantages, and complications of each method. PEG tubes are the most common method for long-term enteral access beyond 4-6 weeks while NG and NJ tubes are used for short-term feedings.
3. Access methods are chosen based on factors like the patient's condition, prognosis, ability to tolerate different sites of feeding, and risk of complications. Overall the document provides an overview
Tuberculosis infection control program - CDC guidelinesAman Tong
Administrative Controls
Environmental Controls
Respiratory-protection
Controls
care units (ICUs)
1. The document outlines the key components of a TB infection control (TB-IC) program, including assigning responsibility, conducting risk assessments, developing written TB-IC plans, implementing administrative, environmental and respiratory controls, and managing TB patients with considerations for special settings like emergency departments.
2. It describes conducting prompt triage of TB patients, initiating airborne precautions, using airborne infection isolation rooms, discontinuing precautions based on diagnostic testing, and managing infectious patients.
3. Recommendations are provided for a variety of healthcare settings depending on the expected risk of encount
Every year, many lives are lost due to the spread of infections in hospitals. Health care workers can take steps to prevent the spread of infectious diseases. Identifying hazards that could potentially compromise patient care and implementing proper controls to reduce risk and minimize the impact of hazards created by renovation, demolition and new construction activities. Those projects could impact infection control, air or water quality, utility and equipment requirements, noise and vibration.
Healthcare workers are occupationally exposed to many infectious diseases during the performance of their normal duties. The delivery of healthcare services requires a broad range of workers, such as physicians, nurses, technicians, and clinical laboratory workers, first responders, building maintenance, security and administrative personnel. Since, healthcare workers have many different tasks or work in different parts of the facility each employee will be exposed to different infectious agents and in different amounts.
Tuberculosis infection control policy - WHO guidelinesAman Tong
This document outlines recommendations for tuberculosis (TB) infection control at national, health facility, and household levels. At the national level, it recommends identifying a coordinating body, developing comprehensive TB infection control plans, ensuring appropriate health facility design, and conducting surveillance. In health facilities, it recommends administrative controls like separating infectious patients, environmental controls like ventilation systems, and personal protective equipment. For households, it recommends educating families of TB patients on cough etiquette and increasing ventilation, with additional precautions for multi-drug resistant TB patients. The goal is to minimize TB transmission through a combination of managerial, administrative, environmental and personal protective measures.
Basic facts of tuberculosis and malaria [compatibility mode]Emmanuel Olashore
Tuberculosis (TB) is an infectious disease caused by a microorganism called Mycobacterium tuberculosis. While Malaria is a disease caused by little germs in the body called “Plasmodium”
This document discusses universal precautions and current infection control practices in dental healthcare settings. It defines infection and explains why infection control is important in dentistry due to contact with blood, saliva and equipment. The aims of infection control are to prevent patient-to-patient, patient-to-practitioner and practitioner-to-patient transmission. Modes of transmission include direct contact, indirect contact and inhalation. Standard precautions including hand hygiene, PPE and sterilization of instruments are described.
Tuberculosis Infection Control Symposia, presented at Hôpital Sacré Coeur in Milot, Haiti, 2011.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
This document provides instructions for collecting a sputum sample to test for acid fast bacillus (AFB) and diagnose tuberculosis (TB). Sputum samples should be collected upon waking to detect mycobacterial infections like pulmonary TB. Precautions like shielding samples from sunlight must be taken to preserve the TB bacteria. Patients are instructed to take deep breaths and cough hard into a collection container, avoiding contamination. Proper collection and handling of samples enables timely diagnosis and treatment monitoring of TB infections.
All you need to know about Tuberculosis (TB)GLRA India
The core activity of GLRA is to cure people affected by leprosy, tuberculosis and to address physical disabilities.
In this presentation, GLRA describes
WHAT WE NEED TO KNOW ABOUT TUBERCULOSIS?
The document discusses infection control and prevention of disease transmission. It covers topics such as sources of infection, universal precautions including proper hand washing techniques and use of personal protective equipment, handling of wastes and linens, safe disposal of medical sharps, cleaning and disinfection procedures, bloodborne pathogens like HIV and hepatitis, and screening and prevention of tuberculosis. The overall message is on reducing the spread of germs and diseases through basic hygiene practices and following standard infection control protocols.
The document discusses Malaysia's intensified case finding (ICF) program for tuberculosis (TB) detection. It provides an overview of the 3 main components of ICF: intensified case finding, isoniazid preventive therapy, and infection control. It emphasizes finding TB cases early through screening high-risk groups like people living with HIV and in institutional settings like prisons. The goal is to reduce TB transmission in communities and improve TB treatment outcomes.
Structure of the epidemiological processJasmine John
This document outlines basic principles for preventing infectious diseases, including measures targeting the source of infection, transmission mechanisms, and population susceptibility. It discusses eliminating or decontaminating sources through measures like exterminating infected animals or isolating sick individuals. It covers stopping transmission by improving sanitation, ventilation, and health education. It also addresses stimulating population immunity through vaccines, immunization programs, and developing herd immunity. The three approaches work best together to effectively fight infectious diseases according to their specific characteristics and the situation.
The document summarizes guidelines from the Healthcare Infection Control Practices Advisory Committee from 2007 on preventing the transmission of infectious agents in healthcare settings. It outlines two tiers of precautions: standard precautions that should be used for all patient contact, and transmission-based precautions that are used in addition for certain infectious diseases. Standard precautions include hand hygiene and the use of personal protective equipment. Transmission-based precautions include contact, droplet, and airborne precautions used for diseases spread by direct contact, large respiratory droplets, or airborne transmission, respectively.
The document provides information about primary tuberculosis (TB), including:
1) Primary TB most commonly involves the lungs where the initial lesion forms along with draining lymph nodes, known as the primary complex.
2) Without treatment, 50% of pulmonary TB patients will die within 5 years, while 25% will self-cure and 25% will develop chronic, infectious TB.
3) The pathology of primary TB progresses from initial inhalation of droplet nuclei, formation of the primary lesion/complex, potential hematogenous spread, and development of tubercles that can cavitate and spread TB in the lungs.
HIV destroys CD4 cells, weakening the immune system and leading to AIDS. AIDS occurs when the immune system is severely damaged, leaving the body vulnerable to infections and cancers. HIV is transmitted via sexual contact, needle sharing, transfusions, and from mother to child during birth or breastfeeding. While treatment can slow the progression of HIV, there is no vaccine and prevention through safe practices is critical to stemming the tide of the epidemic.
Dokumen ini membahas program kawalan infeksi di fasilitas kesehatan primer di Jabatan Kesehatan Negeri Pahang, Malaysia. Program ini penting untuk menjaga kesehatan tenaga kesehatan dan mencegah penularan penyakit. Standar kawalan infeksi perlu diterapkan untuk mengurangi risiko penularan, dan pelatihan telah dilakukan untuk 52% tenaga kesehatan. Audit berkala dilakukan untuk memantau kepatuhan dan mengidentifikasi area
The document provides information about infection control and preventing the spread of infectious diseases. It discusses the goal of infection control as preventing the spread of diseases by maintaining a safe environment and following procedures to prevent transmission between patients and staff. It explains the chain of infection and how breaking the links in the chain can stop the spread by decreasing sources of pathogens, preventing transmission, and strengthening a person's resistance.
HIV/AIDS refers to acquired immunodeficiency syndrome (AIDS) caused by the human immunodeficiency virus (HIV). HIV attacks the immune system, leaving individuals susceptible to infections over time. The document discusses the definition of HIV/AIDS, how HIV is transmitted, signs and symptoms of infection, worldwide impact of AIDS, and strategies for prevention through risk avoidance and reduction.
To reduce the risk of tuberculosis (TB) transmission in healthcare settings, facilities should implement infection control measures. Administrative controls include developing written TB policies, isolating suspected TB patients, and educating healthcare workers. Engineering controls like ventilation systems and HEPA filters work to reduce infectious droplets. Personal protective equipment like respirators protects workers during high-risk procedures. Facilities should screen patients and workers for TB symptoms and use simple measures until diagnostic results, such as providing masks to suspected TB patients and opening windows. Prompt evaluation and treatment are also important to control the spread of TB.
Tuberculosis (TB) is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs. Tuberculosis is curable and preventable.
TB is spread from person to person through the air. When people with lung TB cough, sneeze or spit, they propel the TB germs into the air. A person needs to inhale only a few of these germs to become infected.
The causative agent is Mycobacterium tuberculosis (also known as the tubercle bacillus).
Tuberculosis (TB) is an infectious disease that primarily affects the lung parenchyma. The primary infection usually involves the middle or lower lung area.
It is also may be transmitted to other parts of the body, including the Meninges, kidneys, bone, joints, pericardium, GI tract and lymph nodes And this condition known as Extra pulmonary TB.
The disease also can affects animals such as cattle, this is known as “bovine tuberculosis” which may sometimes be transmitted to man.The primary infectious agent, “ M.Tuberculosis”, is an acid – fast aerobic (AFB) rod that grows slowly and is sensitive to heat and ultraviolet light.
Tuberculosis is caused by mycobacterium tuberculosis and usually affects the lungs. It spreads through the air when infected people cough or sneeze. Symptoms include coughing for 3+ weeks, weight loss, coughing up blood or mucus, and night sweats. Treatment involves isolating infected patients and starting antibiotic therapy. Leprosy is caused by mycobacterium leprae and affects the skin and nerves, causing disfigurement. It spreads through prolonged contact with infected individuals and has a long incubation period. Malaria is transmitted through the bites of infected anopheles mosquitoes and causes cycles of chills, fever and sweating. Control methods for these diseases include treatment, isolation, vector control
An outbreak of infection in a hospital is defined as two or more epidemiologically linked cases occurring in the same setting. Common hospital outbreaks include gastroenteritis, C. difficile, MRSA, and influenza. An outbreak may be suspected based on an increase in cases on a ward or positive specimens identified by the laboratory. Initial control measures include isolation, cohorting, hand hygiene, and environmental cleaning. A thorough investigation is then conducted including case verification, developing an epidemic curve, formulating a hypothesis, and implementing specific control measures once the cause is identified. The efficacy of control measures is evaluated through ongoing monitoring and documentation of the outbreak.
This document discusses tuberculosis (TB), which remains a major global health issue. It provides statistics on TB prevalence, mortality rates, and discusses populations most at risk. It then summarizes the aims and topics of the 7th South African TB Conference, including discussions on pathogenesis, vaccines/drugs/diagnostics, health systems implementation, and social aspects of TB control. The document concludes that achieving the goal of ending TB will require a comprehensive multisectoral approach that is patient-centered and community-focused.
The document provides an overview of the steps involved in investigating disease outbreaks. It describes 8 main steps: 1) verifying the diagnosis and confirming the outbreak; 2) defining cases and conducting case finding; 3) tabulating and orienting data by time, place and person; 4) taking immediate control measures; 5) formulating and testing hypotheses; 6) planning and executing additional studies; 7) implementing and evaluating control measures; and 8) communicating findings. The goals of an outbreak investigation are to identify the source of illness and guide public health intervention. Preparedness activities are also important for preventing and controlling future outbreaks.
This document discusses pulmonary tuberculosis (PTB). PTB is caused by the bacterium Mycobacterium tuberculosis and is an airborne infectious disease. The document defines PTB and outlines learning outcomes which include describing the etiology, pathophysiology, clinical manifestations, diagnostic procedures, and management of PTB. Risk factors, symptoms, diagnostic tests, treatment which involves medication administration and directly observed therapy, and nursing management are all discussed in relation to PTB.
This document provides an overview of infection prevention policies and practices for outpatient hemodialysis facilities. It recommends that all staff and patients receive annual influenza and hepatitis B vaccines. It also outlines precautions such as dedicating equipment, disinfecting surfaces, and proper hand hygiene to prevent the spread of infections between patients. Facilities should have policies to separate patients with active infections and conduct routine testing for hepatitis B and C.
Prevention of mycobateria tuberculosis in healthcare settingsMoustapha Ramadan
This document discusses the prevention of Mycobacterium tuberculosis (MTB) in healthcare settings. It begins with an introduction to mycobacteria and the diseases they cause like tuberculosis, leprosy, and atypical mycobacterial infections. It then provides facts about MTB globally and its symptoms. The remainder of the document outlines administrative, environmental, and respiratory precautions that can be taken to prevent MTB transmission in healthcare settings, including proper patient management, cleaning/disinfection, staff training/surveillance, and use of airborne isolation rooms and respiratory protection equipment.
This document provides an overview of an online continuing education course for dialysis healthcare workers on infection prevention. The course covers infections patients can get from dialysis like hepatitis B and C and bloodstream infections. It reviews standard precautions like hand hygiene, personal protective equipment, and safe injection practices. It also provides specific recommendations for dialysis settings including promoting vascular access safety, separating clean and contaminated areas, and safely handling medications and dialyzers. The document outlines policies around vaccinating staff and patients and preventing the spread of infections.
This document provides an overview of pulmonary tuberculosis (TB). It defines TB as an infectious disease caused by the bacterium Mycobacterium tuberculosis, which primarily affects the lungs. TB is spread through airborne droplets when an infected person coughs or sneezes. The document discusses the pathogenesis, stages, risk factors, signs and symptoms, diagnostic tests, medical management including drug therapy, and nursing care of patients with pulmonary TB. It also covers complications, education on respiratory hygiene and home care considerations for patients.
Corna virus detail And corona virus in pakistanEmaan Uppal
The 2019–20 coronavirus pandemic is a pandemic of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease was first identified in Wuhan, Hubei, China in December 2019Avoiding close contact with sick individuals; frequently washing hands with soap and water; not touching the eyes, nose, or mouth with unwashed hands; and practicing good respiratory hygiene.
The document provides an orientation for community health workers (CHWs) on their role in responding to COVID-19. It outlines a two-day training which will cover: [1] learning about COVID-19, community-based surveillance, and how to work safely; and [2] CHW work in the COVID-19 response including detecting cases, contact tracing, and community engagement. The training aims to equip CHWs to support the prevention and control of COVID-19 in their communities.
This document provides information on a continuing education webinar for pharmacy technicians on COVID-19 presented by Mike Johnston, CPhT. The webinar is 1 hour and offers 1.0 continuing education credit. It reviews key terminology, clinical information, and treatment recommendations regarding COVID-19. It also outlines guidelines from organizations like the FIP, WHO, and CDC for pharmacy staff on prevention, disinfection, and optimizing PPE during the pandemic. Several medications being investigated for treating COVID-19 are discussed, including chloroquine, hydroxychloroquine, and remdesivir. Common patient questions on the virus are also addressed.
Over 1.4 million people each year worldwide suffer from hospital acquired infections. We can follow simple steps and protocols to prevent many of these cases.
Hospital acquired infections: The different common sources of infection, their routes of spread and the growing antimicrobial resistance. Also includes a discussion on hospital Infection prevention and control guidelines and the universal and standard precautions.
this presentation is based on national health program in india in relation to tuberculosis and malaria as these are mostly occuring disease in india so national program are organised to irradicate the spread of vector borne disease by various methods like controlling the vector (mosquitos) from spreading
role of community pharmacist in educating and monitoring of patients for infection and counselling and educating them regarding the control of malaria and tb.
This document provides information on tuberculosis (TB) including:
1. TB epidemiology statistics for Pakistan which has a high burden of TB with an estimated 250,000 new cases and 64,000 deaths per year.
2. Definitions of key TB terms such as prevalence, incidence, drug resistant cases, and treatment outcomes.
3. Descriptions of diagnostic tests for TB including the tuberculin skin test and its limitations, as well as the QuantiFERON blood test.
4. Overviews of the WHO recommended DOTS strategy for TB control, which involves direct observation of treatment, and the five elements of effective TB programs.
This document provides information on tuberculosis (TB) including:
1. TB epidemiology statistics for Pakistan which has a high burden of TB with an estimated 250,000 new cases and 64,000 deaths per year.
2. Definitions of key TB terms like prevalence, incidence, drug resistant cases, and treatment outcomes.
3. Descriptions of diagnostic tests for TB like the tuberculin skin test and Quantiferon blood test which can have false negative or positive results.
4. Overviews of the WHO recommended DOTS strategy for TB control, which has 5 elements including government commitment, quality case detection and treatment supervision.
1. Unit 4: InfectionUnit 4: Infection Control andControl and
Prevention of TuberculosisPrevention of Tuberculosis
Botswana National Tuberculosis Programme
Manual Training for Medical Officers
2. Slide 4-2Unit 4: Infection Control and Prevention of Tuberculosis
ObjectivesObjectives
At the end of this unit, participants will be able to:
• Identify the goals of infection prevention
• Identify 3 levels of prevention
• Identify infection control strategies to prevent
the transmission of TB in the healthcare setting
• Explain the importance of contact tracing
3. Slide 4-3Unit 4: Infection Control and Prevention of Tuberculosis
Levels of Prevention and Their GoalsLevels of Prevention and Their Goals
Prevention efforts focus on the following three
goals:
• Primary prevention – preventing TB infection
• Secondary prevention – preventing TB disease
• Tertiary prevention – preventing TB morbidity and
mortality
4. Slide 4-4Unit 4: Infection Control and Prevention of Tuberculosis
The TransmissionThe Transmission
of TB Knows No Boundariesof TB Knows No Boundaries
Patient to:
Worker
Visitor
Patient
Worker to:
Worker
Visitor
Patient
Visitor to:
Worker
Visitor
Patient
5. Slide 4-5Unit 4: Infection Control and Prevention of Tuberculosis
Hierarchy ofHierarchy of
Infection Prevention & ControlInfection Prevention & Control
• Administrative controls
• Reduce risk of exposure, infection and disease
thru policy and practice
• Environmental (engineering) controls
• Reduce concentration of infectious bacilli in air in
areas where air contamination is likely
• Personal respiratory protection
• Protect personnel who must work in environments
with contaminated air
6. Slide 4-6Unit 4: Infection Control and Prevention of Tuberculosis
ActivityActivity
• Discuss the following in small groups:
• What infection control methods are being done
currently in your facilities?
• What are some things you could change?
• Are there any potential barriers to implementing
those changes?
• Report back to the larger group and other
groups should give feedback/discuss solutions
to any possible barriers identified
7. Slide 4-7Unit 4: Infection Control and Prevention of Tuberculosis
Administrative ControlsAdministrative Controls
• Develop and implement written policies and
protocols to ensure:
• Rapid identification of TB cases (e.g., improving the turn-
around time for obtaining sputum results)
• Isolation of patients with PTB
• Rapid diagnostic evaluation
• Rapid initiation treatment
• Educate, train, and counsel HCWs about TB
• To the extent possible, avoid mixing TB patients and
HIV patients in the hospital or clinic setting
8. Slide 4-8Unit 4: Infection Control and Prevention of Tuberculosis
Environmental Controls:Environmental Controls:
Ventilation and Air FlowVentilation and Air Flow
• Ventilation is the movement of air
• Should be done in a controlled manner
• Types
• Natural
• Local
• General
• Simple measures can be effective
9. Slide 4-9Unit 4: Infection Control and Prevention of Tuberculosis
Evidence from PeruEvidence from Peru
• Open windows and doors produced 6x greater air
exchanges than mechanical ventilation and 20x
great air changes per hour than with windows closed
• Natural ventilation in “old-style” hospitals and clinics
resulted in much better ventilation and much lower
calculated TB risk, despite similar patient crowding
• More likely to have larger, higher ceilings; larger
windows; windows on opposite walls allowing
through-flow of air
Source: Escombe, et al. PLoS Medicine, 2007.
10. Slide 4-10Unit 4: Infection Control and Prevention of Tuberculosis
Estimated Risk ofEstimated Risk of
Airborne TB InfectionAirborne TB Infection
• Naturally ventilated, windows closed - 97%
• Mechanically ventilated with neg pressure
(ACH 12) - 39%
• Naturally ventilation, windows and doors
fully open:
• Modern (1970-1990) - 33%
• Old-fashioned (pre-1950) - 11%
Source: Escombe, et al. PLoS Medicine, 2007.
11. Slide 4-11Unit 4: Infection Control and Prevention of Tuberculosis
Direction of Natural Ventilation andDirection of Natural Ventilation and
Correct Working Locations (1)Correct Working Locations (1)
Source: CDC, 2007
12. Slide 4-12Unit 4: Infection Control and Prevention of Tuberculosis
Direction of Natural Ventilation andDirection of Natural Ventilation and
Correct Working Locations (2)Correct Working Locations (2)
Source: CDC, 2007
13. Slide 4-13Unit 4: Infection Control and Prevention of Tuberculosis
Direction of Natural Ventilation andDirection of Natural Ventilation and
Correct Working Locations (3)Correct Working Locations (3)
Source: CDC, 2007
14. Slide 4-14Unit 4: Infection Control and Prevention of Tuberculosis
Direction of Natural Ventilation andDirection of Natural Ventilation and
Correct Working Locations (4)Correct Working Locations (4)
Source: CDC, 2007
15. Slide 4-15Unit 4: Infection Control and Prevention of Tuberculosis
Environmental Controls (2)Environmental Controls (2)
Ultraviolet Light HEPA (high efficiency
particulate air) filters
Source: iStockphoto, 2008.
Source: MedlinePlus, 2008.
16. Slide 4-16Unit 4: Infection Control and Prevention of Tuberculosis
Personal Respiratory ProtectionPersonal Respiratory Protection
• Respirators:
• Can protect HCWs
• Should be encouraged in high-risk settings
• May be unavailable in low-resource settings
• Face/surgical masks:
• Act as a barrier to prevent infectious patients from
expelling droplets
• Do not protect against inhalation of microscopic
TB particles
17. Slide 4-17Unit 4: Infection Control and Prevention of Tuberculosis
N95 Respirator Dos and Don’tsN95 Respirator Dos and Don’ts
Source: CDC, 2007
18. Slide 4-18Unit 4: Infection Control and Prevention of Tuberculosis
DoDo
Be sure your
respirator is
properly fitted!
It should fit snugly
at nose and chin
Source: CDC, 2007
19. Slide 4-19Unit 4: Infection Control and Prevention of Tuberculosis
Note poor fit at the
bridge of nose
Note poor fit at the
chin
Respirator should
cover chin and
create a seal
Source: CDC, 2007
20. Slide 4-20Unit 4: Infection Control and Prevention of Tuberculosis
Don’t Forget to WEAR It!Don’t Forget to WEAR It!
Source: CDC, 2007
21. Slide 4-21Unit 4: Infection Control and Prevention of Tuberculosis
TB Prevention & ControlTB Prevention & Control
in the Community: MO Rolein the Community: MO Role
• Begin TB treatment as soon as possible
• Screen other people in the household
• Ensure that TB patients complete treatment
• Minimise crowding in congregate settings
22. Slide 4-22Unit 4: Infection Control and Prevention of Tuberculosis
TB Prevention & Control in theTB Prevention & Control in the
Community: Community RoleCommunity: Community Role
Teach members of the community to:
• Recognize the early symptoms of TB
• Minimise crowded living conditions
• Allow natural light into buildings and rooms as
ultra-violet rays quickly kill TB bacilli
• Open windows to air out rooms to dilute the
load of infectious TB bacilli
23. Slide 4-23Unit 4: Infection Control and Prevention of Tuberculosis
TB Prevention & Control in theTB Prevention & Control in the
Community: Patient RoleCommunity: Patient Role
• Patient should maintain a well-balanced diet
to keep the immune system strong
• Patient should TB patient to stop smoking
and minimize intake of alcohol
• Patient should hold a cloth or handkerchief
over mouth when coughing
• Patient should not spit on the floor but in a
container (preferably disposable) and dispose
of properly
24. Slide 4-24Unit 4: Infection Control and Prevention of Tuberculosis
TB Prevention & Control AmongTB Prevention & Control Among
HIV+ Patients and HCWsHIV+ Patients and HCWs
• Immunosuppressed persons are much more
susceptible to TB and therefore should not be
housed with inpatients who have undiagnosed
cough or untreated TB
• Encourage patients and HCWs to know their
HIV status so they can reduce their exposure
to TB infection
25. Slide 4-25Unit 4: Infection Control and Prevention of Tuberculosis
Infection Prevention &Infection Prevention &
Control in the WorkplaceControl in the Workplace
• Provide a well-ventilated, sun-lit environment
• Educate all staff on TB transmission &
prevention
• Implement HIV/AIDS workplace policy
• Link with health facilities for treatment &
support
26. Slide 4-26Unit 4: Infection Control and Prevention of Tuberculosis
TB Prevention in Special SettingsTB Prevention in Special Settings
Prisons and Police Holding Cells
• Screen all prisoners
• Treat & isolate
• Implement strict DOT during entire
treatment
• Refer all released prisoners under
treatment to nearest healthcare facility
27. Slide 4-27Unit 4: Infection Control and Prevention of Tuberculosis
TB Prevention in Special SettingsTB Prevention in Special Settings
Barracks
• Educate all personnel
• Screen all recruits
• Start treatment & organise workplace
DOT
• Identify & screen all close contacts
• Advise TB patients to have an HIV test
29. Slide 4-29Unit 4: Infection Control and Prevention of Tuberculosis
Contact Tracing (1)Contact Tracing (1)
The identification and diagnosis of persons
who may have come into contact with an
infected person
An important element to infection prevention
and control
30. Slide 4-30Unit 4: Infection Control and Prevention of Tuberculosis
Contact Tracing (2)Contact Tracing (2)
• Identify and evaluate contacts of persons with smear
positive pulmonary TB within 3 days of new case
discovery
• All close contacts should be evaluated
• Particular attention give to children under 5
• If index case is a child, source of disease will be a person
with PTB
• If source unknown, ask household contacts for symptoms
and investigate any contact with symptoms of PTB
31. Slide 4-31Unit 4: Infection Control and Prevention of Tuberculosis
Contact Tracing (3)Contact Tracing (3)
• Generally done by FWE or nurse
• Not necessary for smear-negative PTB or
EPTB, unless index case is a child
• Contact examination form completed for each
confirmed case’s contacts
• Suspects should be entered into the “Suspect
and Sputum Dispatch Register” and evaluate
appropriately
32. Slide 4-32Unit 4: Infection Control and Prevention of Tuberculosis
Contact Tracing: ChildrenContact Tracing: Children
• Nurses can give INH to child contacts <5 who
have been screened and are asymptomatic
• Treatment lasts 6 months, but a monthly
supply is handed out
• Pyridoxine is not routinely indicated for
children
33. Slide 4-33Unit 4: Infection Control and Prevention of Tuberculosis
TB Screening Among ContactsTB Screening Among Contacts
• Basic screening for TB done in home by FWE
or nurse
• Refer the following individuals to clinic for
further evaluation and follow-up (evaluation for
active TB and evaluation for INH prophylaxis
or IPT):
• Children in household < 5 years old
• Persons in household who are HIV+
• Persons in household who are ill
34. Slide 4-34Unit 4: Infection Control and Prevention of Tuberculosis
Large Group DiscussionLarge Group Discussion
• Who here works in a facility that does contact
tracing?
• Why is it important?
• What are some strategies you use at your
facility to make contact tracing successful?
• What are some challenges/barriers you have
encountered in the process?
35. Slide 4-35Unit 4: Infection Control and Prevention of Tuberculosis
Key PointsKey Points
• Prevention efforts should focus on primary,
secondary, and tertiary prevention
• Attention to the potential spread of infection
and disease among special populations,
including among those who are HIV+ is crucial
• Contact tracing is an important component of
TB control in the community
Editor's Notes
All three of these goals are important in the prevention of TB. Use the following examples to explain the levels of prevention
Primary prevention:
Using infection control measures in healthcare settings can prevent TB among patients and staff – i.e., wearing masks, appropriate ventilation
Offering INH-preventive therapy to infants living with adults with infectious TB
Secondary prevention
INH is used to prevent the progression to TB disease
Persons who benefit the most from secondary prevention are those most likely to develop severe forms of active TB (such as contacts less than 5 years old and immunosuppresed persons)
Early diagnosis and treatment
Tertiary prevention
BCG vaccination does not prevent infection with TB but it does prevent severe forms of childhood TB and thus can be considered tertiary prevention
The more commonly used interpretation of tertiary prevention is the early diagnosis of TB before complications have developed and that will be discussed in subsequent units
Emphasise that transmission is not one-way and does not discriminate!
Patients can transmit to workers, visitors and other patients and vice versa. Any infectious person puts everyone in his/her immediate surroundings at risk!
Infection prevention and control is the PREVENTION of transmission from individual to individual (as above) through administrative, environmental, and personal protection equipment
Infection control is divided into three different control measures
First two levels are the most important
Use of personal respiratory protection cannot compensate fully for missing administrative and environmental controls
Have the participants break into small groups and discuss the questions, 3 minutes for each question. They should then report back as a large group quickly
After the small groups have discussed as a large group, present slides 7-27 to summarize what participants have just discussed and add some additional information
Administrative controls refer to policies and procedures that reduce the risk of exposing uninfected persons to infectious TB
Ask participants what administrative measures they can think of to accomplish this goal
Ask participants to discuss specific advice for HIV+ healthcare workers
Natural ventilation refers to open windows and doors to capture wind
Local ventilation refers to strategically placed fans
General ventilation refers to a centralised air conditioning system that does not allow air from rooms of patients with infectious TB to be re-circulated
Some simple measures to increase ventilation and air flow include different types of fans (standing, window, ceiling, etc.)
Source: Escombe AR, Oeser CC, Gilman RH, et al. Natural Ventilation for the Prevention of Airborne Contagion. PLoS Medicine. 2007; 4(2):e68
These are the percent of susceptible individuals who were infected after 24 hours of exposure in each of the settings listed
Source: Escombe AR, Oeser CC, Gilman RH, et al. Natural Ventilation for the Prevention of Airborne Contagion. PLoS Medicine. 2007; 4(2):e68
Explain that this and the following 3 slides are examples of methods that could be used to take advantage of natural ventilation as an infection control measure. Emphasise that the point of these graphics are not necessarily to show exact placement, rather to demonstrate examples and how wind can be used in a variety of ways
Emphasize also that it is the patient TB-infected patient is the one that would be transmitting TB to the HCW
When increasing ventilation and air flow, care should be taken as to the appropriate positioning of the windows, doors, the patient and the HCW to control infection
Remember, the patient is the one that is infected and might pass on TB to the HCW.
Both indirect ultraviolet irradiation of air and HEPA filters have been used in some high-risk settings to reduce the concentration of infectious TB particles in the ambient air
Image source (sun): iStockphoto. [database on the Internet]. iStock International, Inc. 2008 [cited 2008 Feb 4]. Image # 3025335. Available from: istockphoto.com
Image source (HEPA): MedlinePlus [database on the Internet]. Bethesda (MD): National Library of Medicine and National Institutes of Health; 2008 Jan 2 [cited 2008 Jan 23]. Medical Encyclopedia: HEPA Air Filter; Available from: http://www.nlm.nih.gov/medlineplus/ency/imagepages/19338.htm
High-risk setting in which respirators should be encouraged include:
Rooms where cough-inducing procedures are done (i.e., bronchoscopy suites)
When collecting sputum specimens from patients
TB “isolation” rooms
Referral centers or homes of infectious TB patients
CDC/NIOSH-certfied N95 (or greater) respirator should be used
Respiratory protection is effective only if:
The correct respirator is used
It&apos;s available when you need it
You know when and how to put it on and take it off
You have stored it and kept it in working order in accordance with the manufacturer&apos;s instructions
How it works: The patient coughs out droplets, therefore the surgical mask is protective as it will collect the droplets and not allow them to spread. The droplet evaporates, leaving the organism in microbe form in the air. The HCW must wear the N95 mask as he/she is breathing in microbes, which are much smaller than the droplet the patient has coughed out
Some clinics may not have access to CDC/NIOSH-certified N95 (or greater) respirators. The MoH and government are making every effort to make these masks widely available. HCWs may be able to access respirators from CMS through special order. One person can use the same respirator for one month
It’s also important to note that these respirators are for healthcare providers and the surgical masks may be given to patients to wear
The mask used in this picture is one of many N95 respirator masks. This and the following slides are used to show correct usage and placement of the mask on the face
Show the green mask made by 3M to participants, as this is the mask used in Botswana
Either demonstrate correct usage with mask in hand, or use the images in next few slides
Remember, respirators and masks don’t do you any good if kept in your pocket or purse!
Most TB patients will no longer be able to spread the bacteria after two weeks of treatment. Therefore, it is very important that a person starts on treatment as soon as possible to avoid spreading the bacteria to others
It is our job as HCW to teach the patients these things!
It is very important that the TB patient maintain a healthy lifestyle to keep their immune system strong. This includes maintaining a good diet and not drinking or smoking
Smoking damages the lungs and will continue to weaken the lungs while they are trying to heal. Drinking alcohol can also be dangerous for a patient on TB treatment
Both alcohol and the TB medication are processed by the liver. If the liver has too much work to do, it can become damaged and no longer function properly
The issue of keeping HIV infected health care workers away from TB patients is complex
It may be difficult for an HIV+ health care worker to avoid TB exposure, since there are so many patients with TB in Botswana
It is still useful to understand that there is an increased risk for HIV+ health care workers who are exposed to TB
Ask participants if they have an HIV/AIDS workplace policy
A rapid assessment of TB in Botswana in 2002 showed the prevalence of TB among prisoners was 3,797 cases per 100,000, equivalent to 5x higher than the general population. On the basis of this survey several recommendations were made:
Screening for TB at prison entry or transfer and periodically thereafter (e.g, annually) using a symptom-based questionnaire
Contact investigations of newly identified smear-positive cases
Assessment of administrative and environmental measures to reduce ongoing transmission within the prison
Implementation of isoniazid preventive therapy among HIV-infected prisoners and guards according to existing MOH guidelines
Source: Centers for Disease Control and Prevention. Rapid Assessment of Tuberculosis in a Large Prison System --- Botswana, 2002. MMWR Weekly [serial on the Internet]. 2003 March 28 [reviewed 2003 March 27; cited 2008 Jan 23]; 52(12):250-252. Available from: http://www.cdc.gov/mmwR/preview/mmwrhtml/mm5212a3.htm
Some police officers won’t give ARVs and TB meds to inmates in the police holding cells. Inmates could be there 6 months – 1 year before going to trial
Make sure prisons in your district/region have a referral policy for inmates with tuberculosis who will be released
Explain that police officers need to be trained as DOT supporters
The next few slides will deal with contact tracing. These questions will be answered in the next few slides and will be discussed in small groups at the end of the section.
Open the Botswana National Tuberculosis Programme Manual to Annex 11, Form 7
As capacity in Botswana grows, the effort devoted to screening and follow-up of TB contacts will increase
Refer to The Tuberculosis Contact Examination Form (MH 2035) in the Botswana National Tuberculosis Programme Manual, Annex 11, form 7
Document INH prophylaxis in child’s clinic card– there is no register for children who are given preventive IN after exposure
The IPT register should NOT be used
Case finding in households is important for control of TB in the community
Large group discussion:
Allow ~3-5 minutes for discussion of each question above, allowing participants to engage in reciprocal discussion about their experiences with contact tracing
If few people have experience with it, encourage them to brainstorm keys to success and potential barriers in their own work settings, based on what they have just learned