Scaling-Up TB Infection Control Practices in Central America: A Profile of Dr. Diana Forno

Dr. Diana Forno, CDC-Central America Regional (CAR) Office Tuberculosis/HIV Epidemiologist (right) with a TB clinic physician demonstrating the use of personal protective equipment during a TB infection-control training and facility risk assessment in the Dominican Republic. Photo source: CDC-CAR

The spread of drug-resistant TB is largely due to a lack of TB controls in place to identify and effectively treat TB before it has the chance to develop resistance. In order to prevent drug-resistant TB from spreading, communities and health care professionals who work with vulnerable high risk populations have to be trained to identify and treat the disease.

Enter Dr. Diana Forno, a physician and licensed surgeon in Guatemala who has spent decades working with Ministries of Health (MOH) and partners to conduct TB infection control (TBIC) trainings and evaluations of healthcare facilities to reduce the risk of TB transmission to patients and healthcare workers.  She has conducted trainings for healthcare workers in Belize, Guatemala, Honduras, Nicaragua, Panama and the Dominican Republic. 

Dr. Forno has supported TB infection control activities by assisting in the development of national guidelines and working with facilities to develop facility-specific customized plans. Through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) CDC-CAR helps Ministries of Health (MOH) implement HIV and TB prevention, care, and treatment programs and services in Central America.

Regular monitoring to ensure the quality of TBIC practices was conducted by CDC and partner MOHs this summer. In Guatemala an infection control committee was established that has already seen measurable success. A congested indoor waiting area is now a covered area outside, an electronic system is operational and collects data from HIV-positive TB patients to improve the co-management of both diseases.  These changes were made as a result of the trainings conducted by Dr. Forno and she anticipates additional train-the-trainer sessions in other high burden TB and HIV districts to ensure ownership of the activities. “Moving forward, the goal is to have a local champion who will monitor implementation of TBIC plans in all sites and follow-up on recommendations.”

Since 2003, the CDC-Central American Regional Office has worked to help strengthen and coordinate prevention strategies that target key populations in the region. It is clear that an effective fight against TB cannot be waged with outdated tools when 4,000 people die every day from TB.  The trainings by Dr. Forno are essential to improved screening, more sophisticated surveillance systems, improved lab capacity, stronger TB infection control measures, and an effective vaccine to prevent TB are all necessary for better outcomes.

Dr. Forno says that her goal is “to bring the best technical support to the countries that most need it to help control and prevent high burden diseases such as TB and HIV.”