Respiratory protection measures in health facilities — MSF Tuberculosis

What this guideline says

GMJ summary

This section of the MSF Tuberculosis guideline provides practical recommendations on respiratory protection measures to prevent TB transmission in health facilities. It distinguishes between two types of personal protective equipment: respirators for healthcare workers, non-medical staff, attendants and visitors in high-risk situations; and surgical masks for infectious TB patients when they must leave isolation.

Respirators must be worn by all staff when entering high-risk areas (defined in Box 14.2), performing high-risk procedures such as sputum collection or pulmonary surgery, entering rooms recently vacated by infectious patients before adequate ventilation time has elapsed, and when handling sputum containers. Attendants and visitors sharing enclosed spaces with infectious patients must also wear respirators. The guideline emphasises that respirator use requires proper training, fit testing (detailed in Appendix 27) and continuous supervision, with visible signage reminding staff and visitors when protection is required.

Infectious TB patients should wear surgical masks when leaving their rooms, during transport in any enclosed vehicle, or when caring for young children. Masks are not required when patients are alone in their rooms or outdoors. This two-tiered approach—respirators for those entering high-risk environments, surgical masks for source control from infectious patients—forms a core component of administrative and personal protective measures in TB infection control.

Key points

For clinicians — doses and thresholds as stated in the guideline

1. Medical and non-medical staff must wear respirators when entering any high-risk area, entering rooms previously occupied by infectious TB patients before adequate ventilation, performing high-risk procedures (sputum collection, pleural puncture, pulmonary surgery), and collecting/disposing of sputum containers
2. Respirator use requires proper training, fit testing (Appendix 27) and continuous supervision; posters should be displayed to remind staff when and where to wear respirators
3. Attendants must wear respirators when sharing any enclosed space with infectious patients (wards, diagnosis rooms, sputum collection rooms, ambulances, taxis, or any vehicle)
4. Visitors must wear respirators when entering wards or rooms of infectious patients; visible signs on entrance doors should remind them, and health staff should provide information on TB transmission risk before visits
5. Infectious TB patients should wear surgical masks when leaving their room to go to any enclosed space, during transport, and when taking care of young children
6. Surgical masks should not be worn by patients when alone in their room or when outdoors

From the guideline

Verbatim

“Using respirators needs proper training, fit testing (Appendix 27) and continuous supervision.”

Editor’s perspective

Why this matters for Georgia and the region

Applicability

Georgia and the South Caucasus

Questions this guideline answers

Quick answers

Related on GMJ

Interconnected resources

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