Administrative controls

Clinical description

Administrative control measures serve as the first line of defence against the spread of TB. They have the potential to have the greatest impact on preventing the transmission of TB and should be prioritised in all health care facilities and congregate settings. Administrative controls serve to promptly identify persons with presumptive TB and initiate effective treatment, and in doing so protect close contacts, patients, visitors and staff working in high-risk settings or performing high-risk procedures by reducing the generation of and exposure to MTB.

Prompt identification of patients with presumptive or bacteriologically confirmed infectious TB disease (triage) is the first administrative control. A health care worker should be assigned to screen patients with a cough of two weeks or more immediately after they arrive at the facility and before they enter an enclosed space.

64 National Tuberculosis Control Programme After triaging, patients with chronic cough (>2 weeks) should be educated on cough etiquette.

Education on proper cough etiquette should be given routinely to patients with presumptive or confirmed TB. Face masks should be provided to patients with chronic cough.

All patients with presumptive pulmonary TB should be fast-tracked (to avoid queuing), separated (to avoid mixing with other patients in crowded, poorly ventilated enclosed areas), placed near a window for good ventilation or separated/isolated from other patients without respiratory symptoms at a separate outdoor waiting area or part in the ward, or referred to a higher-level health care facility.