Poor ventilation in public transport responsible for transmission of airborne tuberculosis (TB) infection in South Africa, says study.

  • 10/11/2019

South Africa is one of the countries with the highest burden of tuberculosis (TB). According to the World Health Organisation (WHO) statistics, 322,000 TB cases reported in South Africa in 2017. The highest TB incidence rates reported in Western Cape province in South Africa and reported rate was 938 per 100,000. To control airborne infectious diseases, some measures are applied in public assemble places like public transport. According to a study published in South African Journal of Science (https://www.sajs.co.za/article/view/5737), poor ventilation in public transport is responsible for transmission of airborne diseases, particularly tuberculosis. Researchers from the country’s University of Cape Town studied whether minibus taxis could provide sufficient ventilation to mitigate the spread of TB from undiagnosed and untreated passengers. In South Africa, minibus taxis are an important component of the public transport system, accounting for 68% of public transport commutes to work nationally. According to 2013 survey, in the Western Cape, minibus taxis were found to account for 39% of public transport commutes to work. “The high passenger occupancy seen in taxis combined with unguided open window policies means there is a danger of airborne infectious diseases such as TB being spread unknowingly to passengers,” says Munyaradzi Matose, a biomedical engineer at the University of Cape Town, South Africa and lead researcher of the study. The study focused on open-window configurations and found that front and back pairs of windows open at all speeds could provide a minimum ventilation rate of 218 litres per second measured at 40 kilo-metres per hour, exceeding that recommended by the WHO for an airborne disease precaution room. The WHO recommends that ventilation in general wards and outpatient departments be at least 60 litres per second for each patient and that new health-care facilities precaution rooms should have a ventilation rate of 80 litres per second for each patient. Though the ventilation rates achieved in the study, natural ventilation cannot be maintained if passengers in operating taxis not support the fully open window configurations, due to discomfort caused by temperature changes, safety concerns, or inclement weather. Overloading during peak-traffic commuting journeys are also of concern. Recommendation: According to Munyaradzi Matose, vehicles can be designed to have improved air circulation. He recommends minibus taxi operators and passengers to keep windows open particularly in fully occupied vehicle to stop the spread of TB. The potential role of airborne infection control devices to address the suboptimal ventilation scenarios must be considered such as ultraviolet germicidal irradiation devices, filtration devices or mechanical ventilation.