Tuberculosis

The infectivity of a TB patient is directly proportional to the number of TB bacilli present or ejected into the air by the patient. Individuals who expel many bacilli are infectious, and the number of bacilli depends on various factors. First, if a patient has a cough, he/ she is likely to expel more bacilli and thus more infectious. The type of the disease also determines infectiousness. Patients with extrapulmonary TB are less infectious than those with pulmonary TB because bacilli are not expelled into the air from a non-respiratory extrapulmonary site. Additionally, patients who do not cover their mouth when coughing are likely to eject more bacilli (Centers for Disease Control and Prevention [CDC], 2016). The presence of a cavity in the lung increases the infectiousness of TB as cavities are likely to harbor more bacilli, and if a patient with a cavity coughs, he/she is expected to expel more bacilli. Lack of adequate treatment makes a person more infectious because he/she is likely to have more bacilli and display more symptoms. Finally, the presence of acid-fast bacilli on a positive sputum culture increases the infectiousness as it shows that the patient may be expelling many bacilli.
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The key goals of an infection control plan in TB are detection, isolation, and treatment. The health facility staff, public health, and community workers need to be aware of the signs and symptoms of TB, including a persistent cough, weight loss, fever, bloody sputum, and night sweats. Suspects of TB should undergo diagnostics to exclude or confirm TB infection. Isolation includes taking airborne precautions for any person suspected of having TB. If possible, they should be placed in an AII cubicle. In case there is no isolation room, they should be placed in cubicles customized for TB patients only. It is also essential to employ a respiratory protection program to prevent the spread of infection (Lee, 2016). Besides, procedures that generate aerosol and induce a cough should be done using environmental controls. For instance, when the patient is coughing, he/she should be left in the room until the cough subsides. Proper management is required for all confirmed patients with TB infection, preferably through directly observed treatment, to ensure strict adherence to the therapy.
The three stages of TB control are meant to prevent the spread of the disease. The administrative level is an essential level and includes measures aimed at decreasing the possibility of exposure to patients infected with TB. It involves carrying out a risk assessment, designing and implementing a written TB infection plan, ensuring proper sterilization of equipment, testing people at risk of TB, and training, educating, and counseling people on TB. Environmental control is the second stage of control that involves engineering technologies meant to prevent the concentration of droplets in the air. They include ventilation technologies such as mechanical and natural ventilation (CDC, 2016). Additionally, the use of high-efficiency particulate air filters and ultraviolet germicidal irradiation assists in eliminating droplet nuclei from the air. Respiratory protection control involves the use of respiratory protection procedures such as training healthcare professionals on respiratory protection, implementing respiration protection programs, and teaching patients on respiratory hygiene (Washington State Department of Health, 2012).
AII rooms are airborne infection isolation rooms that are meant to confine patients with infectious airborne diseases such as TB, Ebola, and SARS to prevent the spread of these infections in (Lee, 2016). These isolation rooms have negative pressure ventilation. They work to allow clean air to flow into the room from other areas.
Respirators are designed to assist the protection of people and healthcare workers from inhaling droplets with TB nuclei. They