References in the content below refer to the PBMEF Guide.
Definitions
Percent of congregate settings with infection prevention and control (IPC) measures in place.
Congregate settings: A mix of institutional (non-healthcare) settings where people reside in close proximity to each other. Congregate settings include correctional facilities (prisons and jails), homeless shelters, refugee camps, army barracks, dormitories, and nursing homes; data may be reported on these individual settings based on country prioritization and availability of data (WHO guidelines on tuberculosis infection prevention and control, 2019 update).
IPC measures include designated IPC focal person, IPC facility committee and plan, regularly scheduled meetings, monitoring of healthcare workers (HCWs) for TB and TB infection (TBI) through annual screening with tuberculin skin test (TST), interferon-gamma release assay (IGRA), or chest X-ray (CXR).
Calculation: (Numerator/Denominator) x 100
Numerator
Denominator
Ref # |
SN_IPC
|
Tier Level |
Project Level Indicators
|
Category |
Prevent
|
Type |
Output
|
Unit of Measure |
Percent of congregate settings
|
Data Type |
Percentage
|
Disaggregations |
Congregate Setting Type
|
Reporting Level |
Project Level indicators are expected to be reported at the subnational level for subnational units where the partner is operating. National data may also be reported if available.
|
Reporting Frequency |
This indicator should be reported on an annual basis at a minimum. More frequent monitoring on a quarterly or monthly basis is recommended.
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Data source may vary from country to country and include administrative reports from relevant ministry on congregate settings, National TB Program (NTP) reports, survey of congregate setting facilities, or supervision visits.
TB is airborne disease and congregate settings are one of the high-risk environments for its transmission. Hence, TB prevention and control measures are among the major interventions to reduce transmission in areas with minimal circulation of air such as congregate settings. TB prevention and control measures consist of a combination of measures designed to minimize the risk of M. tuberculosis transmission within populations. A three-level hierarchy of controls comprising administrative controls, environmental controls, and respiratory protection has been shown to reduce and prevent the risk of transmission and exposure to M. tuberculosis (WHO guidelines on tuberculosis infection prevention and control, WHO, 2019).
The use of respiratory isolation or separation measures applies to all settings with a high risk of M. tuberculosis transmission including congregate settings where healthcare services, including hospitalization, is provided, regardless of the burden of TB disease in the community. Similarly, respiratory hygiene measures apply to people with confirmed or presumptive TB in settings with a high risk of M. tuberculosis transmission including congregate settings such as correctional facilities and refugee and asylum centers. Such respiratory hygiene must be implemented at all times. The use of surgical masks, in particular, is of utmost importance in waiting areas, during transport, and in any situation which can lead to temporary exposure to M. tuberculosis (e.g., in physician offices). The use of poorly designed or poorly maintained ventilation systems leading to inadequate airflow can result in healthcare associated transmission of M. tuberculosis. Inadequate ventilation also increases the risk of transmission in other non-healthcare congregate settings such as correctional facilities and refugee and asylum centers.
Hence, this indicator measures the existence of infection control measures in the congregate settings, and it is one of the required reports for the End TB Now Act that specifically mentions hospitals, clinics, and prisons.
Tracking the percentage of congregate settings with IPC measures in place can be indicative of the coverage and success of TBI control activities. It is usually measured and reported with focus on healthcare settings, and the purpose of including this indicator in the monitoring, evaluation, and learning (MEL) project category is to emphasize the significance of implementing infection control in community settings, especially in those areas where the risk of transmission is very high.
In terms of visualization, it can be visualized with basic graphs to show trends in IPC coverage in the defined congregate setting over a period of time. This data can also be plotted alongside geographical mapping of congregate settings and highlighting those where IPC measures are implemented. Since infection control includes a long list of interventions, data can also be presented with additional details depending on the scope of IPC measures in place in the particular setting and its degree of implementation.
Example charts/graphs:
- Trends over time by geographic coverage, types of facilities, types of infection control
Indicator Visualizations
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