Operational Handbooks

Individuals receiving TPT should be monitored at every contact with health-care providers. It is important to determine non-adherence as early as possible in order to take corrective action. Monitoring is particularly important at the beginning of treatment, when people are getting used to the routine and their medication. Afterwards, monitoring may be done monthly or more frequently as required for care of people on TPT or as per national policy.

Laboratory staff should be trained to remove their gloves by following these steps:

1. peel one glove off by grasping it under the cuff and rolling the glove off the hand so that it comes off inside out. This keeps most of the contamination inside;

2. hold the used glove in the opposite still-gloved hand. Carefully slip exposed fingers under the cuff of the gloved hand, being careful not to touch the surface of the contaminated glove. Peel the glove off, inside out, rolling it over the other used glove to form a bag of used gloves with contamination inside.

Location

A thimble connection (see Figure 3) is used with Class II type A2 BSC that is ducted to the outside. The thimble fits over the cabinet’s exhaust housing, sucking the air expelled from the cabinet into ducts that lead outside. A small opening (usually 5 cm wide) is maintained between the thimble and the cabinet’s exhaust housing. This opening enables room air to be drawn into the exhaust ducting system. The capacity of the exhaust system must be sufficient to capture both room air and the cabinet’s exhaust.

Class II BSCs differ from Class I cabinets in that they allow only air from a HEPA-filtered (sterile) supply to flow over the work surface.

A Class II type A2 BSC is shown in Figure 2. An internal fan draws room air (supply air) into the cabinet through the front opening and then into the front intake grill. After passing through the grill, the supply air is drawn upwards and through a HEPA filter before flowing downwards over the work surface.

• All procedures must be performed in such a way as to minimize or prevent the formation of aerosols and droplets (see Box 2).
• Mouth pipetting must be strictly prohibited.
• No materials should be placed in the mouth.

Gloves must be worn for all procedures that involve direct contact, or may involve accidental contact, with sputum, blood, body fluids and other potentially infectious materials. After use, gloves should be removed aseptically and hands washed.

Contaminated gloves (and unwashed hands) may be a source of infection for other staff members if they are used to handle or operate equipment in the laboratory (such as a centrifuge or telephone).