TB-IPC principles and measures (administrative, environmental, and respiratory protection) that apply in health care facilities also apply with adaptations to patients' homes as long as patients are infectious or potentially infectious (Box 14.1).
14.5.1 Screening of household and close contacts
Screening for active TB should be performed in household and close contacts as soon as possible after the patient has been diagnosed (Chapter 6).
14.5.2 Separation and isolation
Patients should:
- Sleep in a separate room, if possible, with the door closed off to the rest of the house.
- Avoid or spend as little time as possible in congregate settings or public transport.
Household members and close contacts should spend as little time as possible in the same enclosed spaces as patients.
14.5.3 Respiratory hygiene and cough etiquette
Patients, household members and close contacts should cover their mouth and nose when they cough or sneeze.
14.5.4 Ventilation
Patients should spend as much time as possible outdoors if weather permits.
Houses should be adequately ventilated. When it is not possible to keep the windows open, regularly ventilate the patient's room and common spaces.
14.5.5 Respiratory protection
- Treatment supporters, household members and close contacts should wear a respirator (Appendix 27) when sharing an enclosed space (room, vehicle, etc.) with the patient. Treatment supporters and household members should be educated on the proper use of respirators and a fit test should be performed.
- Patients should wear a surgical mask (Appendix 28) when sharing an enclosed space (room, vehicle, etc.) with other people and when taking care of young children.
- Surgical masks are not necessary when patients are alone in their room or when they are outdoor.
14.5.6 Education for patients and household members
Education on the risk of TB transmission and on precautions to be observed should be provided by the healthcare staff:
- Cough etiquette
- Use of respirators/surgical masks
- Waste management: enclose waste (i.e. sputum containers, tissues, respirators/surgical masks) hermetically in plastic bags and discard in the normal waste. Do not empty sputum containers before discarding. Alternatively, tissues can be thrown in the latrine.