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An evaluation of the compliance to the ventilation aspects of airborne infectious disease control in Cape Town, South Africa

Background: Tuberculosis (TB) is a major healthcare problem worldwide and is endemic to Cape Town, South Africa. Health Care Workers in Emergency Centers (ECs) are at high risk of nosocomial TB infection. The aim of this study was to determine whether the isolation rooms (IRs)in emergency centers, f...

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Main Author: Groenewald, Coenraad
Other Authors: Morrow, Brenda M
Format: Thesis
Language:English
Published: Division of Emergency Medicine 2017
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access_status_str Open Access
author Groenewald, Coenraad
author2 Morrow, Brenda M
author_browse Groenewald, Coenraad
Morrow, Brenda M
author_facet Morrow, Brenda M
Groenewald, Coenraad
author_sort Groenewald, Coenraad
collection Thesis
description Background: Tuberculosis (TB) is a major healthcare problem worldwide and is endemic to Cape Town, South Africa. Health Care Workers in Emergency Centers (ECs) are at high risk of nosocomial TB infection. The aim of this study was to determine whether the isolation rooms (IRs)in emergency centers, for patients with diagnosed or suspected TB, comply with set National Core Standards. Methods: This was a cross-sectional descriptive study of ECs in the Cape Town Metropolitan area. .The characteristics of IRs with regards to air changes per hour (ACH), negative pressure ventilation with relation to the surrounding areas and appropriate discharge of air outdoors or via filters before recirculation was measured using standard objective engineering methods. Results: 19 IRs in 8 ECs were evaluated, none of which complied with the National Core Standard's ideal requirements for IRs. Five complied with minimal requirements . Eleven (57,9%) IRs were designed to have negative pressure; and 8 (42,1%) rooms were not designed for isolation purposes, . IR volumes ranged from 15,5 m³ to 67,2 m³ (median 35,6 m³). Five (26,3%) IRs were under negative pressure; 7 (36,8%) had erratic air flow; and 7 (36,8%) showed positive airflow from the IR into adjacent clinical areas. Fifteen (78,9%) IRs had central provision of air via a ventilation system; 6 (31,6%) had central air extraction; 6 (31,6%) had local extraction; and 7 (36,8%) used natural ventilation only. Four local extraction units had zero flow rate. Airflow in naturally ventilated IRs was significantly lower than flow with other systems (p = 0,0002). The ACH ranged from 0 (n=4) to 112.37 (median 11,9); and was significantly greater in rooms ventilated with central extraction compared to other systems (p = 0,00002). Discussion: The ventilation aspects of airborne infectious disease control are generally poorly implemented. This may contribute to, and fail to mitigate, the high risk of nosocomial transmission of airborne infectious diseases to staff and other patients utilising emergency facilities in the TB endemic areas of Cape Town. Conclusion: Existing ECs should improve adherence to standards of airborne infectious disease transmission prevention in order to protect patients and staff from nosocomial airborne transmitted diseases, such as TB. New Hospitals should place a high priority on the amount, positioning and maintenance of IRs when planning their facility.
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institution University of Cape Town (South Africa)
language eng
last_indexed 2026-06-10T12:50:20.107Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2017
publishDateRange 2017
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publisher Division of Emergency Medicine
publisherStr Division of Emergency Medicine
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spelling oai:open.uct.ac.za:11427/23398 An evaluation of the compliance to the ventilation aspects of airborne infectious disease control in Cape Town, South Africa Groenewald, Coenraad Morrow, Brenda M Meintjes, Jack Emergency Medicine Background: Tuberculosis (TB) is a major healthcare problem worldwide and is endemic to Cape Town, South Africa. Health Care Workers in Emergency Centers (ECs) are at high risk of nosocomial TB infection. The aim of this study was to determine whether the isolation rooms (IRs)in emergency centers, for patients with diagnosed or suspected TB, comply with set National Core Standards. Methods: This was a cross-sectional descriptive study of ECs in the Cape Town Metropolitan area. .The characteristics of IRs with regards to air changes per hour (ACH), negative pressure ventilation with relation to the surrounding areas and appropriate discharge of air outdoors or via filters before recirculation was measured using standard objective engineering methods. Results: 19 IRs in 8 ECs were evaluated, none of which complied with the National Core Standard's ideal requirements for IRs. Five complied with minimal requirements . Eleven (57,9%) IRs were designed to have negative pressure; and 8 (42,1%) rooms were not designed for isolation purposes, . IR volumes ranged from 15,5 m³ to 67,2 m³ (median 35,6 m³). Five (26,3%) IRs were under negative pressure; 7 (36,8%) had erratic air flow; and 7 (36,8%) showed positive airflow from the IR into adjacent clinical areas. Fifteen (78,9%) IRs had central provision of air via a ventilation system; 6 (31,6%) had central air extraction; 6 (31,6%) had local extraction; and 7 (36,8%) used natural ventilation only. Four local extraction units had zero flow rate. Airflow in naturally ventilated IRs was significantly lower than flow with other systems (p = 0,0002). The ACH ranged from 0 (n=4) to 112.37 (median 11,9); and was significantly greater in rooms ventilated with central extraction compared to other systems (p = 0,00002). Discussion: The ventilation aspects of airborne infectious disease control are generally poorly implemented. This may contribute to, and fail to mitigate, the high risk of nosocomial transmission of airborne infectious diseases to staff and other patients utilising emergency facilities in the TB endemic areas of Cape Town. Conclusion: Existing ECs should improve adherence to standards of airborne infectious disease transmission prevention in order to protect patients and staff from nosocomial airborne transmitted diseases, such as TB. New Hospitals should place a high priority on the amount, positioning and maintenance of IRs when planning their facility. 2017-01-26T13:34:13Z 2017-01-26T13:34:13Z 2016 Master Thesis Masters MMed http://hdl.handle.net/11427/23398 eng application/pdf Division of Emergency Medicine Faculty of Health Sciences University of Cape Town
spellingShingle Emergency Medicine
Groenewald, Coenraad
An evaluation of the compliance to the ventilation aspects of airborne infectious disease control in Cape Town, South Africa
thesis_degree_str Master's
title An evaluation of the compliance to the ventilation aspects of airborne infectious disease control in Cape Town, South Africa
title_full An evaluation of the compliance to the ventilation aspects of airborne infectious disease control in Cape Town, South Africa
title_fullStr An evaluation of the compliance to the ventilation aspects of airborne infectious disease control in Cape Town, South Africa
title_full_unstemmed An evaluation of the compliance to the ventilation aspects of airborne infectious disease control in Cape Town, South Africa
title_short An evaluation of the compliance to the ventilation aspects of airborne infectious disease control in Cape Town, South Africa
title_sort evaluation of the compliance to the ventilation aspects of airborne infectious disease control in cape town south africa
topic Emergency Medicine
url http://hdl.handle.net/11427/23398
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