A Study on Tuberculosis Epidemic and Related Infection Control Measures of Populous Institutions in Taipei City and New Taipei City, Taiwan, 2013–2016

DOI: 10.6525/TEB.20171205.33(23).001

Ling-Ling Lin^＊, Chun-Ru Du, Hsiao-Ping Tung, Hui-Rong Liu, Jer-Jea Yen

2017 Vol.33 NO.23

Correspondence Author： Ling-Ling Lin^＊

Abstract：

In response to entering into the aging society, the demand for long-term care institutions is increasing in Taiwan. The government has also devoted considerable efforts to integrating relevant resources and improve our long-term care system in recent years. According to the surveillance data, 601 tuberculosis (TB) cases were reported from the populous institutions in Taipei City and New Taipei City during 2013 to 2016, of which 80% were over 65 years of age; about half of the cases (51.4%) died from TB. Because the populous institution residents were mostly elder, with lower immunity function, and the environment was crowded, TB outbreaks occurred easily. A total of 37 institutions reported TB cases. Among them, 35 were long-term care service institutions; accounting for 94.6%, of which 62.9% were nursing care institutions. Moreover, the number of confirmed outbreaks was increasing by year. We examined the implementation of TB-related infection control measures in those institutions without TB outbreaks and found that they were more likely to have implemented relevant control measures (36%–100%). For effectively preventing TB outbreaks in institutions, and strengthening the self-monitoring ability, by referring to the TB guidelines of infection control by U.S. CDC and the recommendations from expert meetings, we recommended that institutions must have a clear infection control program or standard operating procedures, ensure the quality of chest X-ray interpretation, implement TB-related symptoms monitoring, strengthen training of nursing care workers about TB infection control, and measure the concentration of carbon dioxide regularly.