Researched solutions for long-term accommodation units for drug-resistant tuberculosis patients in South Africa

Abstract

South Africa has been ranked as one of the 22 high-burden TB countries in the world by the WHO, and is also burdened with a high prevalence of HIV/AIDS. TB, both in its drug-susceptible and drug-resistant form, is the most common opportunistic infection for HIV patients and actively accelerates the progression of HIV into AIDS. Active treatment and reduction of opportunities for cross-infection are therefore high priorities in South Africa. TB is transmitted through the airborne route: poorly designed or overcrowded buildings and other closed congregate areas such as public transport form important transmission nodes. The CSIR was approached by the National Department of Health (NDoH) to research and facilitate the design and construction of new long-term accommodation units for some 400 patients in 9 centres across the country in a project funded by The Global Fund. The project required the Architectural Sciences group of CSIR Built Environment to act both as technical advisor to NDoH and provincial recipients for the planning, design and construction of the units as well as to manage project implementation. The project has provided a unique opportunity to review current policy, to develop guidelines for long-term accommodation of patients with drug-resistant TB and to research, test and validate the performance of accommodation units provided through the project. The project has also provided valuable insight into facility risk assessment and design guidelines for other types of public buildings. The planning and design of such facilities must recognise not only health care needs, but also the social and personal needs and safety of patients and staff. Full use was made, wherever possible, of natural ventilation and environmentally sustainable design solutions. The design solutions are being tested for efficacy using CSIR’s newly developed Building Performance Laboratory primarily through the use of computational fluid dynamics (CFD) modelling. Once completed and occupied, projects will be tested and validated against predicted and desired performance standards. The first unit was occupied in October 2009; it is expected that the last will be occupied early in 2011