Tuberculosis infection prevention and control measures in DOTS centres in Lagos State, Nigeria

SETTING Nigeria is a high tuberculosis (TB) burden country. However, there is limited evidence on implementation of tuberculous infection prevention and control (TBIC) practices in Nigeria. OBJECTIVE To assess TBIC practices, and barriers to their implementation, in TB-DOTS centres in Lagos State, Nigeria. DESIGN A descriptive cross-sectional study was used to assess 112 TB-DOTS centres in primary and secondary health facilities in Lagos State using mixed methods. Quantitative data comprised a survey and measurement of the air exchange rate in a subsample of centres. The qualitative aspect comprised focus-group discussions to highlight health care workers' (HCWs') perceptions of TBIC guidelines and barriers to their implementation. RESULTS The majority of the DOTS centres had a dedicated TBIC officer, while a fifth (21%) had documented TBIC plans. About 57% of DOTS centres had staff that had been trained on TBIC and 37% provided some form of personal respiratory protection (face masks/tissue papers) for staff or patients. The air exchange rate was adequate in 21% of centres. The HCWs' perception of being at risk of contracting TB was reported to affect the way they relate to TB patients. The key barrier to implementing TBIC was the design of DOTS centres. CONCLUSION TBIC measures at study centres were inadequate. Institutional commitment, renovation of existing and appropriate design of new DOTS centres in the future to improve TBIC implementation is recommended. .