Protecting Health Care Workers in South Africa

By Jonathan Eichberger

With an incidence rate of 940 cases per 100,000 people in 2006, South Africa ranks fifth among countries for its high rate of tuberculosis (TB). For Johns Hopkins University School of Nursing assistant professor Jason Farley, PhD, MPH, CRNP, these statistics are unacceptable.

An expert in the epidemiology, prevention, and management of drug-resistant infections and international infection control, Farley has received a faculty grant from the Johns Hopkins Center for Global Health to explore the barriers of TB infection control in South Africa.

“Nurses and other health care workers in under-resourced settings often have twice the prevalence of TB compared with the general population,” says Farley. “Infection control can help prevent infection and repeated exposure to increasing drug-resistant strains.”

Spending several weeks in the country throughout 2009, Farley will partner with the Medical Research Council of South Africa’s Tuberculosis Epidemiology and Intervention Research Unit. He aims to assess infection control knowledge, attitudes, practices, and environmental infrastructure among multi-drug resistant and extremely drug-resistant TB centers in 18 sites throughout South Africa.

Farley and his team of researchers-which includes two Hopkins nursing graduate students-will investigate, among many other variables, whether employers offer HIV testing to health care workers prior to employment in such high risk settings. They will also observe and inspect the infection control infrastructure, including ventilation systems and the collection of respiratory samples.

“Given the crisis of trained health care workers in sub-Saharan Africa and the moral imperative to protect our health care colleagues, this work will provide the initial framework to improve infection control practices in such high risk settings,” says Farley. “It can lead to a healthier, safer workforce.”