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Control of Tuberculosis in Disaster Situations

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Mycobacterium TuberculosisOn many occasions, when a disaster strikes a primary health care service, it loses control over tuberculosis and the cases can migrate. Under those circumstances, the most important thing is to continue the treatment of those in temporary shelters and establish a monitoring system over those that have shown respiratory problems of the disease for over three weeks. Those who persist with respiratory symptoms should have a smear analysis done and the treatment should immediately start for the positive cases.

Keeping a stock of first line medicine is necessary. A nurse, nurse auxiliary or other health professional should manage this stock in the shelter.

Taking into consideration that tuberculosis is a chronic infectious disease, no special activities are recommended to control it in disaster situation. However, in temporary shelters or camps which remain for a long periods following the emergency, it is necessary to take into account the following risk factors:

    • Population displacements are common in disaster situations, and this can create problems in treating and monitoring patients with TB.
    • Population migration in the aftermath of disasters makes it common for persons from areas where the prevalence of TB differs, to come into contact with each other.
    • Overcrowding is common in shelters and temporary settlements. A patient that is sputum smear positive and that is not controlled can become an active source of transmission.

    Recommendations:

    • Include, in the census data of the displaced population, information on acute and chronic pathologies, including TB.
    • Identify persons who are symptomatic who are coughing or expectorating for more than two weeks 
    • Order, for all persons who are symptomatic, a series of sputum smear exams and send samples to the laboratory of the health center with responsibility for the shelter. 
    • Ensure strictly controlled, quick treatment for all cases of TB, and coordinate the provision of medications with the closest health center. 
    • If the case of TB was discovered in the shelter, control all contact with uninfected persons. 
    • If the patient is in poor general health or suffers severe complications, refer them to a hospital. 
    • Neither special exams nor isolation is recommended for infected persons. However, it is recommended that controls are established in the shelter.

    Contact

    Marlo Libel
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