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Health Estate. 2013 Nov;67(10):45-50.

Infection control in a developing world.

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Nuffield Centre for International Health, University of Leeds.


The global HIV and tuberculosis (TB) epidemics have placed enormous burdens upon already overstretched healthcare workers and poorly resourced healthcare facilities in sub-Saharan Africa. The rapid emergence of multi-drug resistant TB, and its association with hospital-based outbreaks, have highlighted the role that healthcare facilities inadvertently may play in maintaining TB transmission, and the vital importance of attaining good TB infection control. James Elston, a specialist physician in infectious diseases and general internal medicine, who recently returned from a second stint in Swaziland, says many of the region's healthcare facilities are outdated, poorly ventilated, and were not designed for their current purpose. Here he describes how U.K.-based architects and healthcare engineers responded to an urgent call for assistance and, via close collaboration, and using novel design software, empowered healthcare workers to dramatically and rapidly improve their TB inpatient facilities, and protect the health of patients and staff.

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