Compliance With National Recommendations for Tuberculosis Screening and Immunization of Healthcare Workers in a Children's Hospital

Abstract

Physicians and clinical employees at a children's hospital were surveyed to compare their tuberculosis (TB) screening and immunization statuses. Failure to offer screening and immunization services to non-employee physicians was associated with lower rates of reported immunity to several vaccine-preventable diseases and with markedly lower rates of TB screening.

Screening and Treatment of Latent Tuberculosis Among Healthcare Workers at Low, Moderate, and High Risk for Tuberculosis Exposure: A Cost-Effectiveness Analysis

“…Many healthcare institutions have mandatory annual tuberculin screening for their HCWs. 7 Annual screening provides significant protection for HCWs as most active cases develop within the first few years after the initial infection. 16 The results of this analysis indicate that yearly screening prevented approximately 80% of the TB cases and was associated with a net savings for HCWs at moderate to high risk for TB infection.…”

“…6 Many institutions have mandatory annual tuberculin skin testing policies for their employees, although the optimal screening interval for HCWs is not known. 7 Some institutions choose to treat HCWs who convert during employment but not those who have latent infections found on entry to the workforce. A decision analysis was performed to evaluate cost-effective screening and treatment strategies for HCWs at low, moderate, and high risk for TB exposure.…”

Providing detailed information about latent tuberculosis and compliance with the PPD test among healthcare workers in Israel: A randomized controlled study

“…The results may be explained by the fact HCWs may still not understand TB epidemiology and pathogenesis and may not be conscious of the consequences of latent TB [21]. Research suggests that a low perceived risk of TB among healthcare professionals, a belief that TB testing may be harmful, and the voluntariness of screening tests might decrease PPD test adherence [22]. It is also the case that unlike screening tests such as mammography or cholesterol measurement, the PPD test requires a follow-up visit within 72 h of initial application of PPD for interpretation of the results.…”

Compliance with treatment of latent Tuberculosis infection in healthcare workers

“…1,3 Although little is known about the factors influencing HCWs' abilities or decisions to adhere to screening and treatment, a low perceived risk of TB, the voluntary nature of screening programs, adverse drug effects and past history of BCg vaccination have all been associated with non-adherence to lTBI treatment. 8,11 A study by Joseph et al, 12 which involved several focus group discussions involving healthcare personnel, identified several barriers to treatment adherence, including misperception regarding lTBI treatment, misunderstanding regarding TB pathology, and contradictory messages from eHS and other healthcare providers, leading to distrust and lack of confidence in employee health. In our study, we examined a number of factors that may have impacted the decision of an employee to take treatment for lTBI; however we did not find a statistically significant correlation between gender, direct patient care, history of BCg, country of birth, and type of follow up (e.g.…”