Preventive measures at patients’ homes — MSF Tuberculosis — Médecins Sans Frontières 2026

MSFClinical guideline (chapter)Current edition

From Tuberculosis › Chapter 14: Infection prevention and control · Médecins Sans Frontières, Current online edition, 2026

MSF guidance on infection prevention and control measures for tuberculosis patients in home settings.

In one sentenceTB patients at home should sleep separately, maximise outdoor time, wear surgical masks when with others; household contacts need respirators in shared spaces and immediate TB screening.

Issuer: Médecins Sans Frontières
Edition: Current online edition, 2026
Audience: TB programme staff, treatment supporters, clinicians, household members
Evidence: Expert consensus based on TB-IPC principles
Reviewed: 23 Oct 2026 · GMJ

Read the original on MSF Whole guideline (PDF)

Summary by GMJ Guidelines Desk•Reviewed by Prof. Giorgi Pkhakadze, MD, MPH, PhD•Record updated 23 Oct 2026•Next check Apr 2027

What this guideline says

GMJ summary

This section of the MSF Tuberculosis guideline adapts TB infection prevention and control principles from health care facilities to patients’ homes during the infectious period. It addresses the risk of TB transmission in household settings through administrative, environmental and respiratory protection measures.

Key interventions include screening household and close contacts for active TB as soon as possible after diagnosis, physical separation of infectious patients (separate sleeping rooms with closed doors), minimising time in enclosed shared spaces and congregate settings, and ensuring adequate ventilation with outdoor time when weather permits. Respiratory protection is specified: treatment supporters, household members and close contacts should wear respirators when sharing enclosed spaces with patients, whilst patients should wear surgical masks when with others, particularly when caring for young children.

The guidance emphasises cough etiquette for all household members, proper training and fit-testing for respirator use, and safe waste management practices including hermetic sealing of contaminated materials (sputum containers, tissues, masks) in plastic bags for normal waste disposal or disposal of tissues in latrines.

Key points

For clinicians — doses and thresholds as stated in the guideline

Screen household and close contacts for active TB as soon as possible after the patient has been diagnosed
Patients should sleep in a separate room with the door closed off to the rest of the house, if possible
Patients should spend as much time as possible outdoors if weather permits, and houses should be adequately ventilated
Treatment supporters, household members and close contacts should wear a respirator when sharing an enclosed space with the patient; fit testing should be carried out
Patients should wear a surgical mask when sharing an enclosed space 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 outdoors
Enclose waste (sputum containers, tissues, respirators/surgical masks) hermetically in plastic bags and discard in normal waste; do not empty sputum containers before discarding

From the guideline

Verbatim

“Screening for active TB should be performed in household and close contacts as soon as possible after the patient has been diagnosed.”

— Médecins Sans Frontières, Preventive measures at patients’ homes — MSF Tuberculosis, Section 14.5.1 (2026)

Editor’s perspective

Why this matters for Georgia and the region

Prof. Giorgi Pkhakadze, MD, MPH, PhD

Editor-in-Chief, Georgian Medical Journal · Chair, Public Health Institute of Georgia · WHO consultant, health and migration

As a WHO consultant on health and migration, I recognise that home-based TB infection control is particularly challenging yet essential in Georgia and the South Caucasus, where most TB patients complete treatment at home and multi-generational households are common. The distinction this guidance makes between respirators for household contacts and surgical masks for patients is critical but often misunderstood in practice—our national programmes must invest in proper respirator supply and fit-testing infrastructure, not simply distribute surgical masks to everyone. The recommendation for immediate household contact screening aligns with Georgia's TB programme protocols, but implementation of physical separation and adequate ventilation measures requires honest acknowledgement of housing realities: many families in Tbilisi and regional centres live in Soviet-era apartments where separate rooms are unavailable, making respiratory protection and maximising outdoor time even more crucial. The guidance on waste management is practical and feasible, but we need Georgian-language materials that address specific local practices around sputum disposal and mask reuse.

ORCID 0000-0001-7609-4515 · Perspective written for the GMJ Guidelines Library, 23 Oct 2026

Applicability

Georgia and the South Caucasus

Home-based TB care is highly relevant for Georgia and the South Caucasus, where national TB programmes increasingly emphasise outpatient management and community-based treatment support. In settings with multi-generational households common in the region, the guidance on physical separation and ventilation requires contextual adaptation: many families live in small apartments where separate rooms may not be feasible, making respiratory protection and outdoor time even more critical. National TB programmes in Georgia, Armenia and Azerbaijan should integrate these home-based IPC measures into treatment supporter training, ensure availability of appropriate respirators (not just surgical masks) for household contacts, and develop culturally appropriate information materials that address local housing conditions and family structures. The recommendation for fit-testing of respirators presents a logistical challenge that may require phased implementation starting in high-burden areas.

Questions this guideline answers

Quick answers

When can a TB patient stop wearing a mask at home?

Patients should wear surgical masks when sharing enclosed spaces with other people and when caring for young children, but masks are not necessary when patients are alone in their room or when outdoors. The guidance applies as long as patients are infectious or potentially infectious.

What type of respiratory protection should household members use?

Household members and close contacts should wear a respirator (not a surgical mask) when sharing an enclosed space with the patient. They should be trained in proper use and undergo fit testing. Surgical masks are for patients to wear, not for household contacts.

How should we dispose of sputum containers and used masks at home?

Enclose all waste (sputum containers, tissues, respirators/surgical masks) hermetically in plastic bags and discard in normal waste. Do not empty sputum containers before discarding. Alternatively, tissues can be thrown in the latrine.

When should household contacts be screened for TB?

Screening for active TB should be performed in household and close contacts as soon as possible after the patient has been diagnosed.

Related on GMJ

Interconnected resources

Dictionary of Public Health

Tuberculosis

Conditions A–Z

Tuberculosis

GMJ News coverage

Quality & accreditation

Same guideline

Respiratory protection measures in health facilities — MSF TuberculosisChapter 14: Infection prevention and control
Environmental Measures in Health Facilities — MSF TuberculosisChapter 14: Infection prevention and control
Administrative measures in health facilities — MSF TuberculosisChapter 14: Infection prevention and control
Tuberculosis infection prevention and control (Chapter 14.1: Introduction) — MSF TuberculosisChapter 14: Infection prevention and control
Therapeutic patient education and patient support services — MSF TuberculosisChapter 13: Adherence to tuberculosis treatment
Factors that influence adherence — MSF TuberculosisChapter 13: Adherence to tuberculosis treatment

Preventive measures at patients’ homes — MSF Tuberculosis

What this guideline says

Key points

From the guideline