Our finding that 64.8% of the HCWs reported never having been screened
for tuberculosis was concerning. This is astounding in a country with such
a high prevalence of tuberculosis and the knowledge that HCWs are a
high-risk population because of occupational exposure. As international
and national guidelines clearly indicate that HCWs should be regularly
screened for tuberculosis, this situation clearly needs attention. A
recent study found that the diagnosis of tuberculosis in medical doctors
in KwaZulu-Natal was often delayed, further stressing the need for
improved tuberculosis screening, as well as infection control training.16
In addition, our workplace audit revealed that N95® respirators were not
used appropriately and were not always available, confirming the survey
results found. Furthermore, the importance of training in safe practices
is clear from the significant observed association between training
and screening for tuberculosis and the use of N95® respirators. This is
supported by the findings of a study at a South African hospital whereby
HCWs with greater knowledge were more likely to use respirators and to
practise cough hygiene.10