Estimating waiting times, patient flow, and waiting room occupancy density as part of tuberculosis infection prevention and control research in South African primary health care clinics

• Published in: PLOS global public health 2022, Vol.2 (7), p.e0000684-e0000684
• Main Authors: Karat, Aaron S, McCreesh, Nicky, Baisley, Kathy, Govender, Indira, Kallon, Idriss I, Kielmann, Karina, MacGregor, Hayley, Vassall, Anna, Yates, Tom A, Grant, Alison D
• Format: Article
• Language: English
• ISSN: 2767-3375; 2767-3375
• DOI: 10.1371/journal.pgph.0000684

Transmission of respiratory pathogens, such as Mycobacterium tuberculosis and severe acute respiratory syndrome coronavirus 2, is more likely during close, prolonged contact and when sharing a poorly ventilated space. Reducing overcrowding of health facilities is a recognised infection prevention and control (IPC) strategy; reliable estimates of waiting times and 'patient flow' would help guide implementation. As part of the Umoya omuhle study, we aimed to estimate clinic visit duration, time spent indoors versus outdoors, and occupancy density of waiting rooms in clinics in KwaZulu-Natal (KZN) and Western Cape (WC), South Africa. We used unique barcodes to track attendees' movements in 11 clinics, multiple imputation to estimate missing arrival and departure times, and mixed-effects linear regression to examine associations with visit duration. 2,903 attendees were included. Median visit duration was 2 hours 36 minutes (interquartile range [IQR] 01:36-3:43). Longer mean visit times were associated with being female (13.5 minutes longer than males; p