Guideline

WHO guidelines on tuberculosis infection prevention and control: 2019 update

Year of Publication

2019

Issuing Institution

WHO

Links

WHO IRIS

Recommendations

18 included recommendations

Triage of people with TB signs and symptoms, or with TB disease, is recommended to reduce M. tuberculosis transmission to health workers (including community health workers), persons attending health care facilities or other persons in settings with a high risk of transmission.

Status

Updated

Recommended in favor

Conditional

Certainty of evidence

Very low

Respiratory separation / isolation of people with presumed or demonstrated infectious TB is recommended to reduce M. tuberculosis transmission to health workers or other persons attending health care facilities

Status

Updated

Recommended against

Conditional

Certainty of evidence

Very low

Prompt initiation of effective TB treatment of people with TB disease is recommended to reduce M. tuberculosis transmission to health workers, persons attending health care facilities or other persons in settings with a high risk of transmission

Status

Maintained

Recommended in favor

Conditional

Certainty of evidence

Very low

Respiratory hygiene (including cough etiquette) in people with presumed or confirmed TB is recommended to reduce M. tuberculosis transmission to health workers, persons attending health care facilities or other persons in settings with a high risk of transmission.

Status

Maintained

Recommended against

Conditional

Certainty of evidence

Very low

Upper-room germicidal ultraviolet (GUV) systems are recommended to reduce M. tuberculosis transmission to health workers, persons attending health care facilities or other persons in settings with a high risk of transmission.

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

Moderate

Ventilation systems (including natural, mixed-mode, mechanical ventilation and recirculated air through high-efficiency particulate air [HEPA] filters) are recommended to reduce M. tuberculosis transmission to health workers, persons attending health care facilities or other persons in settings with a high risk of transmission.

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

Moderate

Particulate respirators, within the framework of a respiratory protection programme, are recommended to reduce M. tuberculosis transmission to health workers, persons attending health care facilities or other persons in settings with a high risk of transmission.

Status

Maintained

Recommended in favor

Strong

Certainty of evidence

Moderate

1a. Health care facility level The panel recommends that an IPC (infection prevention and control) programme with a dedicated, trained team should be in place in each acute health care facility for the purpose of preventing HAI (health care-associated infection) and combating AMR (antimicrobial resistance) through IPC good practices.

Status

Maintained

Recommended in favor

Conditional

Certainty of evidence

Very low

The panel recommends that evidence-based guidelines should be developed and implemented for the purpose of reducing HAI (health care-associated infection) (health care-associated infection) and AMR (antimicrobial resistance). The education and training of relevant health care workers on the guideline recommendations and the monitoring of adherence with guideline recommendations should be undertaken to achieve successful implementation

Status

Maintained

Recommended in favor

Conditional

Certainty of evidence

Very low

3a. Health care facility level The panel recommends that IPC (infection prevention and control) education should be in place for all health care workers by utilizing team- and task-based strategies that are participatory and include bedside and simulation training to reduce the risk of HAI (health care-associated infection) and AMR (antimicrobial resistance).

Status

Maintained

Recommended in favor

Conditional

Certainty of evidence

Moderate

4a. Health care facility level The panel recommends that facility-based HAI (health care-associated infection) surveillance should be performed to guide IPC (infection prevention and control) interventions and detect outbreaks, including AMR (antimicrobial resistance) surveillance with timely feedback of results to health care workers and stakeholders and through national networks.

Status

Maintained

Recommended in favor

Conditional

Certainty of evidence

Very low

4b. National level The panel recommends that national HAI (health care-associated infection) surveillance programmes and networks that include mechanisms for timely data feedback and with the potential to be used for benchmarking purposes should be established to reduce HAI (health care-associated infection) and AMR (antimicrobial resistance).

Status

Maintained

Recommended in favor

Conditional

Certainty of evidence

Very low

5a. Health care facility level The panel recommends that IPC (infection prevention and control) activities using multimodal strategies should be implemented to improve practices and reduce HAI (health care-associated infection) and AMR (antimicrobial resistance).

Status

Maintained

Recommended in favor

Conditional

Certainty of evidence

Very low

5b. National level The panel recommends that national IPC (infection prevention and control) programmes should coordinate and facilitate the implementation of IPC (infection prevention and control) activities through multimodal strategies on a nationwide or subnational level.

Status

Maintained

Recommended in favor

Conditional

Certainty of evidence

Very low

6a. Health care facility level The panel recommends that regular monitoring/ audit and timely feedback of health care practices according to IPC (infection prevention and control) standards should be performed to prevent and control HAI (health care-associated infection) and AMR (antimicrobial resistance) at the health care facility level. Feedback should be provided to all audited persons and relevant staff.

Status

Maintained

Recommended in favor

Conditional

Certainty of evidence

Very low

6b. National level The panel recommends that a national IPC (infection prevention and control) monitoring and evaluation programme should be established to assess the extent to which standards are being met and activities are being performed according to the programme’s goals and objectives. Hand hygiene monitoring with feedback should be considered as a key performance indicator at the national level.

Status

Maintained

Recommended in favor

Conditional

Certainty of evidence

Very low

The panel recommends that the following elements should be adhered to in order to reduce the risk of HAI (health care-associated infection) and the spread of AMR (antimicrobial resistance): (1) bed occupancy should not exceed the standard capacity of the facility; (2) health care worker staffing levels should be adequately assigned according to patient workload.

Status

Maintained

Recommended in favor

Conditional

Certainty of evidence

Very low

8b. The panel recommends that materials and equipment to perform appropriate hand hygiene should be readily available at the point of care.

Status

Maintained

Recommended in favor

Conditional

Certainty of evidence

Very low