EVALUATION OF INFECTION CONTROL MEASURES FOR TUBERCULOSIS IN TUBERCULOSIS HEALTHCARE FACILITIES IN MOGADISHU, SOMALIA

Abstract

Intro: Tuberculosis infection control (TBIC) is one of the main pillars of tuberculosis control programs. The objectives of this study were to evaluate the implementation of TBIC and identify the barriers hindering the implementation of TBIC in TB healthcare facilities in Mogadishu, Somalia. Methods: A cross-sectional study with direct observations using the WHO Checklist for Periodic Evaluation of TBIC in TB Health-Care Facilities was conducted between April 2021 and July 2022 in 10/12 TB health facilities in Mogadishu, Somalia. 1/10 (10%) private and 9/10 (90%) public TB health facilities participated in this study. Findings: Managerial infection control measures: only 4/10 (40%) facilities demonstrated available TBIC guidelines. All facilities 10/10 (100%) were unable to demonstrate a designated TBIC focal-person or committee; budget allocation and documented training on TBIC for clinical staff. Administrative infection control measures: all facilities 10/10 (100%) provided cough guidance and sufficient TB transmission and prevention information for patients. Environmental infection control measures: all facilities 10/10 (100%) had a well- ventilated waiting area; patients were not overcrowded, and Sputum samples were collected in a well-ventilated area. Only 3/10 (30%) and 4/10 (40%) of the facilities had the capacity to group patients according to their drug sensitivity status or had a properly designed facility respectively. All facilities, 10/10 (100%) had sufficient Personal Protective Equipment (PPE) including N95 respirators, and their staff was trained on proper usage of PPE. Regarding the barriers to implementation of TBIC, 10/10 (100%) and 8/10 (80%) of the facilities identified lack of funding or lack of training, enforcement, and motivation respectively as barriers to TBIC in their facilities. Discussion: Proper implementation of TBIC measures in the TB facilities in Mogadishu was low. Conclusion: We recommend a similar country-level study in Somalia; the rollout and training of TB staff on Somalia's national TBIC guidelines and allocation of funds and resources for TBIC implementation.