University researchers take an innovative approach to tackling the transmission of drug-resistant tuberculosis (DR-TB) within health facilities in South Africa
The Institute for Global Health & Development at Queen Margaret University is a leading partner on a major new grant awarded £1.7 million under the Cross Research Council Tackling AMR Initiative.
South Africa has one of the highest burdens of drug-resistant tuberculosis (DR-TB) in the world, with more than 20,000 people diagnosed with DR-TB in 2015. Transmission of DR-TB occurs within hospitals and clinics, but it is not known how much exposure in clinics contributes to DR-TB transmission overall. Guidelines for airborne infection prevention and control (IPC) in health facilities are variably implemented; clinic design, climatic conditions and health workers’ practices and risk perceptions may contribute to this gap.
The project adopts a ‘whole systems’ approach to propose novel inter-disciplinary solutions. Researchers will examine the epidemiology of DR-TB transmission in clinics and communities, and current policies for IPC. They will also investigate health workers’ and patients’ perceptions of infection risk and responsibility for IPC measures. These data will help inform the design of a health systems intervention package to reduce the transmission of DR-TB within health care clinics in South Africa.
The 3-year project is led by Professor Alison Grant of the London School of Hygiene and Tropical Medicine (LSHTM), with Co-Principal Investigator, Dr Karina Kielmann (QMU) overseeing the social science components of the project.
Dr Kielmann said: “In addition to gaining better understanding of the epidemiological aspects of transmission of DR-TB within clinics, and the wider benefits of reducing transmission within clinics, the whole systems approach allows us to look at current policy and working practices for TB-related infection prevention and control. These are the kind of data needed to strengthen advocacy for IPC as a critical occupational health issue.”
This grant is funded by Economic and Social Research Council in partnership with the Department of Health, and awarded under the GCRF Tackling Antimicrobial Resistance: Behaviour Within and Beyond the Healthcare Setting call. Partners include the Africa Health Research Institute, South Africa; the Institute of Development Studies, Sussex; the Universities of Cape Town and KwaZulu-Natal, South Africa; and University College London.
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