Time to change the way we think about tuberculosis infection prevention and control in health facilities: insights from recent research

Abstract In clinical settings where airborne pathogens, such as Mycobacterium tuberculosis, are prevalent, they constitute an important threat to health workers and people accessing healthcare. We report key insights from a 3-year project conducted in primary healthcare clinics South Africa, alongside other recent tuberculosis infection prevention control (TB-IPC) research. discuss the fragmentation of TB-IPC policies budgets; characteristics individuals attending with prevalent pulmonary tuberculosis; clinic congestion patient flow; design natural ventilation; facility-level determinants implementation (or not) interventions. present modeling studies that describe contribution M. transmission community burden economic evaluations showing interventions highly cost-effective. argue for set changes TB-IPC, including better coordination policymaking, decongestion, building regulations, budgeting enablers sustain Additional research is needed find most effective means improving interventions; develop approaches screening do not rely on symptoms; identify groups patients can be seen less frequently.