Tuberculosis infection control in primary health clinics in eThekwini, KwaZulu-Natal, South Africa

Setting Primary health clinics in KwaZulu-Natal, South Africa. Objective To assess and describe current practices in infection control at local government primary health clinics. Design A descriptive study using a standardised tool to assess adherence to recommended infection control policies in 51 primary health clinics in 2009-2010. Administrative policies, engineering controls and personal respiratory protection were assessed by observations and interviews at the clinics. Results Of 51 clinics, 11 (22%) had infection control policies, 13 (26%) triaged coughing patients and 16 (31%) had a dedicated nurse and a dedicated consulting room for treating tuberculosis (TB) patients. Study clinics treated a median of 99 patients (range 3-331) daily and a median of 15 TB patients (range 2-73) monthly. Of the rooms in the clinics, all of which rely on natural ventilation, half (149/284) had ≤12 air changes per hour. Eleven (22%) of 51 clinics had N95 masks available for staff use. Conclusion Limited infection control practices exist in clinics in a high TB burden setting in KwaZulu-Natal, South Africa. These practices need to be implemented more widely to minimise the spread of TB to non-infected patients and health care workers in primary health clinics.