UNDERSTANDING THE EFFECTIVENESS OF AIR DISINFECTION TECHNOLOGIES AND FACTORS THAT FACILITATE AND INHIBIT THE IMPLEMENTATION OF THESE TECHNOLOGIES IN HEALTH CARE SETTINGS IN SUB-SAHARAN AFRICA (SSA)

Abstract

Airborne infections significantly contribute to global mortality and morbidity. Tuberculosis (TB), for instance, is an airborne infectious disease with the highest global mortality. The emergence of new strains of airborne infectious diseases is a cause for greater attention. The COVID-19 pandemic, caused by the airborne Coronavirus, has transformed the world in its entirety, infecting over 100 million people and killing more than two million (by the end of January 2021). These underscore the need for airborne infection controls, especially in a congregate environment- health care facilities, where the risk of nosocomial disease transmission is higher than in other areas. In congregate settings, increased chances of rebreathing contaminated air increase the risk of nosocomial disease transmission. But air disinfection technology is proven effective in decontaminating room air and reducing disease transmission. Pathogens that cause TB, measles, influenza, Severe Acquire Respiratory Syndrome (SARS), and other diseases are susceptible to air disinfection technology. However, there is doubt around scaled implementation in Low and Lower Middle-Income Countries (LLMICs). Like other LLMICs and Sub-Saharan African (SSA) countries, Liberia is impoverished and has a high TB burden. In 2008, Liberia's National Leprosy and Tuberculosis Control Program (NLTCP) reported a TB occurrence of 108/100,000 population. The World Health Organization (WHO) annual TB report classifies Liberia among the 30 high TB burden countries. Now that the government is struggling to implement health programs to reduce infections and improve the population's health, understanding the barriers and facilitators to indoor air safety is essential to creating safer health care facilities and other congregate settings. We conducted a systematic review of the literature to understand air disinfection technology in LLMICs—including SSA countries and Liberia. Dilution, filtration, and ultraviolet germicidal irradiation are the three air disinfection technologies covered in the study. The result of the systematic review found studies conducted in high and upper-middle-income countries but not LLMICs— showing the need for more air disinfection research in LLMICs.