Surgical Face Masks Reduce Multidrug-Resistant Tuberculosis Transmission From Patients On A Hospital Ward

Dharmadhikari, Ashwin; Mphahlele, Matsie; Stoltz, Anton; Venter, Kobus; Mathebula, Rirhandzu; Masotla, Thabiso; Jensen, Paul; First, M.W.; Pagano, Marcello; Walt, Martie van der; Nardell, Edward A.

doi:10.1164/ajrccm-conference.2011.183.1_meetingabstracts.a5308

Cited by 3 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Given the lack of data on this potentially useful, commonly recommended, and low-risk method of TB infectious source control (17), we conducted a prospective clinical study to evaluate the efficacy of surgical face masks worn by patients with MDR-TB in reducing transmission. Some of the results of this study have been previously reported in the form of an abstract (18).…”

mentioning

confidence: 78%

Surgical Face Masks Worn by Patients with Multidrug-Resistant Tuberculosis

Dharmadhikari

Mphahlele

Stoltz

et al. 2012

Am J Respir Crit Care Med

Self Cite

164

130

View full text Add to dashboard Cite

Rationale: Drug-resistant tuberculosis transmission in hospitals threatens staff and patient health. Surgical face masks used by patients with tuberculosis (TB) are believed to reduce transmission but have not been rigorously tested. Objectives: We sought to quantify the efficacy of surgical face masks when worn by patients with multidrug-resistant TB (MDR-TB). Methods: Over 3 months, 17 patients with pulmonary MDR-TB occupied an MDR-TB ward in South Africa and wore face masks on alternate days. Ward air was exhausted to two identical chambers, each housing 90 pathogen-free guinea pigs that breathed ward air either when patients wore surgical face masks (intervention group) or when patients did not wear masks (control group). Efficacy was based on differences in guinea pig infections in each chamber. Measurements and Main Results: Sixty-nine of 90 control guinea pigs (76.6%; 95% confidence interval [CI], 68-85%) became infected, compared with 36 of 90 intervention guinea pigs (40%; 95% CI, 31-51%), representing a 56% (95% CI, 33-70.5%) decreased risk of TB transmission when patients used masks. Conclusions: Surgical face masks on patients with MDR-TB significantly reduced transmission and offer an adjunct measure for reducing TB transmission from infectious patients.Keywords: infection control; multidrug-resistant tuberculosis; transmission; surgical maskOf an estimated 9 million new cases of tuberculosis (TB) in 2008 globally (1), 440,000 were multidrug-resistant TB (MDR-TB) (2), and more than half of those are believed to have occurred in previously untreated patients, the result of transmission of already drug-resistant strains (2). Recent reports of infection with highly drug-resistant strains of Mycobacterium tuberculosis among patients and health care workers illustrate the dire consequences of nosocomial transmission, especially in areas where HIV is endemic (3, 4). Although once believed to arise primarily from unsupervised or erratic treatment of drug-susceptible TB, MDR-TB and extensively drug-resistant TB (XDR-TB) are now known to be transmissible and have emerged as important threats to patients who enter hospitals for drug-susceptible TB (reinfection) or other illnesses, to the clinical staff caring for them, and to occupants of other congregate settings, such as correctional facilities and shelters. One study in Russia found that hospitalization, rather than treatment nonadherence, conferred a sixfold greater relative risk for the acquisition of MDR-TB by patients (5), whereas another study in Latvia revealed that previous hospitalization was a highly significant risk factor for MDR-TB (odds ratio, 18.33; P , 0.002) (6). In addition, health care workers in diverse settings have been shown to be disproportionately exposed to and infected with drugsusceptible and drug-resistant TB (4, 7). TB among health care workers erodes the already limited supply of hospital personnel in many resource-constrained settings, both directly through illness and indirectly through fear of working in such high-risk envi...

show abstract

mentioning

confidence: 78%

Surgical Face Masks Worn by Patients with Multidrug-Resistant Tuberculosis

Dharmadhikari

Mphahlele

Stoltz

et al. 2012

Am J Respir Crit Care Med

Self Cite

164

130

View full text Add to dashboard Cite

show abstract

“…Bei an infektiöser Tuberkulose erkrankten Personen ist bereits ein MNS ausreichend, um die beim Husten freigesetzten infektiösen Aerosole auf ein Minimum zu reduzieren. Dies haben auch Studien zur Übertragung von multiresistenter Tuberkulose (MDR-TB) gezeigt 85 86 .…”

Section: Die Umgebungsuntersuchungunclassified

“…Diese Klassifizierung wurde durch eine Studie bestätigt, in der die Kontaktdauer als Einzelfaktor mit einer deutlich höheren Chance eines positiven IGRA-Tests verbunden war, wenn der kumulierte Kontakt mit einer sputumnegativen Indexperson mindestens 40 Stunden betragen hatte, und in welcher sich die Chance einer IGRA-Testpositivität bei Kontakt mit sputumpositiven Indexpersonen ab einer Kontaktzeit von 8 Stunden mehr als verdoppelte 85 .…”

Section: Die Umgebungsuntersuchungunclassified

Empfehlungen für die Umgebungsuntersuchungen bei Tuberkulose – Update 2023

et al. 2023

View full text Add to dashboard Cite

ZusammenfassungZiel der Umgebungsuntersuchung bei Tuberkulose ist neben der aktiven Fallfindung das Aufdecken von Infektionsketten sowie die Verhütung der Weiterverbreitung der Erkrankung. Dabei ist eine sorgfältige Auswahl der Kontaktpersonen notwendig, die sich nach Art und Dauer des Kontaktes richtet, um möglichst frisch Infizierte zu identifizieren und so den Nutzen einer anschließenden präventiven Therapie zu erhöhen und unnötige Testungen von Personen ohne Ansteckungsrisiko zu vermeiden. Seit der letzten Überarbeitung der Empfehlungen zur Umgebungsuntersuchung hat sich die Datenlage zum Einsatz von Interferon-y release-Assays (IGRAs) bei Kindern weiterhin verbessert. Diese werden bevorzugt in der Umgebungsuntersuchung von erwachsenen Kontaktpersonen eingesetzt. Für Kinder unter 15 Jahren können sowohl IGRAs wie auch weiterhin der Tuberkulin-Hauttest gleichwertig verwendet werden. Als präventive Therapie bei nachgewiesener Infektion werden Rifampicin für 4 Monate, Rifampicin und Isoniazid für 3 Monate oder aber Isoniazid für 9 Monate empfohlen.Ausführlich wird auf die Durchführung der Umgebungsuntersuchung in verschiedenen Altersgruppen sowie rechtliche Rahmenbedingungen und sozialmedizinische Aspekte und Herausforderungen eingegangen. Zusätzlich werden Sonderfälle, wie die Umgebungsuntersuchung in Kitas, Schulen oder in anderen Gemeinschaftseinrichtungen, separat dargestellt.

show abstract

“…Majority of Ethiopian studies on health system delay (8)(9)(10)(11) and a country assessment in 2016 done, as well as according to WHO 2006 report defined, health system delay as the interval from the first visit to the health care provider to initiation of effective treatment and usually used median value to categorize TB patients into delayed and not delayed(12, 13). Delay in diagnosis and treatment cause patients more likely to have advanced disease, complications, mortality and increase on-going person-toperson transmission in the community at large (14)(15)(16)(17)(18). It has been estimated that a patient with untreated smear-positive pulmonary TB may infect on average more than 10 patients annually and over 20 during the natural course of untreated disease until death (4).…”

Section: Introductionmentioning

confidence: 99%

Health system delay in the treatment of tuberculosis patients in Ethiopia: a systematic review and meta-analysis

Tegegne

Wagnew

Belay

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Delay in diagnosis and initiation of effective treatment associated with increase in morbidity, mortality and on-going person-to-person transmission in the community at large. In Ethiopia, several studies have been conducted regarding health system delay among tuberculosis patients. However, studies assessing the health system delay in treatment of tuberculosis patients in Ethiopia had inconsistent and inconclusive findings. Therefore, this systematic review and meta-analysis aimed to determine the pooled median time of the health system delay in the treatment of tuberculosis and its determinants in Ethiopia. Methods: We systematically searched from different databases: Google Scholar, Science Direct, PubMed, Embase, Scopus and Springer link databases for studies published from June 6, 1997 up to December 20, 2020. The quality of the studies was assessed using the Newcastle-Ottawa scale adapted for observational studies. Heterogeneity was evaluated using I squared statistic. We conducted a meta-analysis for the pooled median time of health system delay and its determinants using random-effects model in R version 4.0.3 software(for median estimation) and Stata version 14 (for metan). The pooled estimates with 95% confidence intervals (CI) were presented using forest plots. Results: A total of 14 studies which comprising 6161 patients satisfying a priori set criteria were included. Our meta-analysis showed that, the estimated pooled median time of the health system delay was 15.29(95%CI: 9.94–20.64) days. In the subgroup analysis, studies conducted from 1997 to 2015 the pooled median health system delay was 21.63(95% CI: 14.38-28.88) days, whereas studies conducted after 2015 the pooled median time of 9.33(95% CI: 3.95-14.70) days. Living in rural area (pooled OR: 2.42, 95%CI: 1.16-5.02) was significantly associated with health system delay. Conclusions: In Ethiopia, patients are delayed more-than two weeks in the treatment of tuberculosis. Being from rural residence was more likely to lead prolonged health system delay. Implementing efforts by targeting rural residence may help to shorten the health system delay and important implications for the success of tuberculosis control.

show abstract

Surgical Face Masks Reduce Multidrug-Resistant Tuberculosis Transmission From Patients On A Hospital Ward

Cited by 3 publications

References 0 publications

Surgical Face Masks Worn by Patients with Multidrug-Resistant Tuberculosis

Surgical Face Masks Worn by Patients with Multidrug-Resistant Tuberculosis

Empfehlungen für die Umgebungsuntersuchungen bei Tuberkulose – Update 2023

Health system delay in the treatment of tuberculosis patients in Ethiopia: a systematic review and meta-analysis

Contact Info

Product

Resources

About