Conductas frente al viraje de la prueba de Tuberculina en estudiantes de medicina de una universidad de Lima, Perú

Calixto-Aguilar, Lesly; Manrique-Zegarra, Martiel; Gotuzzo-Herencia, Eduardo; Samalvides-Cuba, Frine

doi:10.17843/rpmesp.2016.332.2216

Cited by 5 publications

(6 citation statements)

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“…The annual LTBI incidence (defined as test conversion after 1 year) was reported in 15 studies using the TST [12,25,27,29,30,35,39,43,48,54,58,63,72,75,83] and five studies using the IGRA [12,41,48,72,77] (supplementary table S6a and b). The forest plot (figure 4) shows the variability in the estimates of incidence of LTBI using the TST; estimates ranged from 1% to 38% with evidence of significant heterogeneity ( p<0.009).…”

Section: Incidence Of Ltbi Measured By Tst and Igra Conversionmentioning

confidence: 99%

Latent tuberculosis infection in healthcare workers in low- and middle-income countries: an updated systematic review

et al. 2019

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Healthcare workers (HCWs) are at increased risk of latent tuberculosis (TB) infection (LTBI) and TB disease.We conducted an updated systematic review of the prevalence and incidence of LTBI in HCWs in low- and middle-income countries (LMICs), associated factors, and infection control practices. We searched MEDLINE, Embase and Web of Science (January 1, 2005–June 20, 2017) for studies published in any language. We obtained pooled estimates using random effects methods and investigated heterogeneity using meta-regression.85 studies (32 630 subjects) were included from 26 LMICs. Prevalence of a positive tuberculin skin test (TST) was 14–98% (mean 49%); prevalence of a positive interferon-γ release assay (IGRA) was 9–86% (mean 39%). Countries with TB incidence ≥300 per 100 000 had the highest prevalence (TST: pooled estimate 55%, 95% CI 41–69%; IGRA: pooled estimate 56%, 95% CI 39–73%). Annual incidence estimated from the TST was 1–38% (mean 17%); annual incidence estimated from the IGRA was 10–30% (mean 18%). The prevalence and incidence of a positive test was associated with years of work, work location, TB contact and job category. Only 15 studies reported on infection control measures in healthcare facilities, with limited implementation.HCWs in LMICs in high TB incidence settings remain at increased risk of acquiring LTBI. There is an urgent need for robust implementation of infection control measures.

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Section: Incidence Of Ltbi Measured By Tst and Igra Conversionmentioning

confidence: 99%

Latent tuberculosis infection in healthcare workers in low- and middle-income countries: an updated systematic review

et al. 2019

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“…En una población similar a la nuestra en Lima, la mitad de los estudiantes de medicina no inició la TPI porque refirió no haber recibido orientación para hacerlo. 11 Asimismo, un estudio cualitativo en personal de salud de los Estados Unidos (EE.UU.) encontró que los múltiples procedimientos, las complicaciones logísticas para acceder al tamizaje por salud ocupacional, la toma del PPD y la terapia preventiva disuadían de hacerlo.…”

Section: Discussionunclassified

“…10 En un estudio en Lima, el 20.5% de participantes no inició la TPI por temor a los efectos adversos, mientras que el 9% no la inició por la recomendación de no consumir alcohol. 11 En nuestro estudio, algunos participantes reportaron haber presentado efectos adversos, lo que motivó a que uno de ellos no concluya el tratamiento, mientras que tres participantes lo postergaron o no lo iniciaron por la recomendación de no consumo de alcohol.…”

Section: Discussionunclassified

“…10 Asimismo, la falta de información y la toma de algún otro fármaco al momen-Terapia preventiva con isoniacida en estudiantes de medicina to del viraje a un resultado positivo del PPD han sido asociados a no completar la terapia preventiva para TB. 11 En este estudio buscamos describir la frecuencia de inicio y el cumplimiento de la TPI y los factores que influyen en el continuo de la atención en los estudiantes de medicina de una universidad privada en Lima, Perú.…”

Section: Introductionunclassified

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Estudio de métodos mixtos sobre el uso de terapia preventiva con isoniacida en estudiantes de medicina de una universidad privada en Lima

Félix¹,

Uribe²,

Liu-Sanchez³

et al. 2022

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Antecedentes: los estudiantes de medicina con infección latente por tuberculosis (TB) tienen riesgo de enfermar si no completan la terapia preventiva con isoniacida (TPI). Objetivo: determinar la proporción de estudiantes de medicina con TB latente que completa los seis meses de TPI y los factores que influyen en hacerlo. Material y métodos: estudio de métodos mixtos de tipo secuencial. Se envió un cuestionario en línea a estudiantes de medicina de segundo a séptimo año de una universidad privada en Lima y se realizaron entrevistas en profundidad a aquellos con una prueba cutánea de derivado proteico purificado (PPD) positiva. Resultados: de los 147 participantes que respondieron la encuesta, 86/147 (58.5%) fueron mujeres, la mediana de edad fue de 22 años (rango intercuartil: 21-23), 37/147 (25.2%) reportaron un PPD positivo, 21/33 (64%) refirieron que se les indicó la TPI, 13/33 (39%) refirieron haberla iniciado y 8/33 (24%) la completaron. Los factores que facilitaron el inicio de la TPI fueron haber RECIBIDO:

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“…Addressing LTBI through screening and TB preventive treatment (TPT) is critical to ending the TB epidemic by 2035 ( 24 ). Since the risk of progression of LTBI into active tuberculosis is notably higher in recent converters ( 7 ), this is why TPT is indicated in this group ( 25 ). However, the costs to scale up LTBI screening and TPT programs are prohibitive for many national TB programs in resource-limited countries such as Peru, which are already struggling to provide active TB screening and treatment ( 24 ).…”

Section: Introductionmentioning

confidence: 99%

Latent tuberculosis infection (LTBI) in health-care workers: a cross-sectional study at a northern Peruvian hospital

Meregildo-Rodriguez,

Yuptón-Chávez,

Asmat-Rubio

et al. 2023

Front. Med.

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BackgroundHealthcare workers (HCWs) have a higher risk of latent tuberculosis infection (LTBI) and active tuberculosis than the general population. In HCWs, the risk of tuberculosis infection depends on the local tuberculosis prevalence, HCWs’ characteristics, the healthcare facility, and prevention and control measures. We aimed to estimate the prevalence and risk factors for LTBI in HCWs at a northern Peruvian hospital.MethodsThis study had two phases: (1) a cross-sectional phase involving recruitment, history taking, and sampling for the Interferon-Gamma Release Assays (IGRA test), and (2) a prospective follow-up of IGRA-positive participants. We enrolled direct and non-direct patient caregivers among HCWs. We defined an LTBI case if the IGRA test was positive and clinical, laboratory, and radiological evaluations for active tuberculosis were negative.ResultsWe recruited 308 participants between November 2022 and May 2023. The mean age was 38.6 ± 8.3 years. Over 75% of the participants were female. The most common job category was technicians (30.5%), physicians (22.7%), nurses (20.5%), and other HCWs groups (17.5%). Most participants worked in hospital wards (28.2%), diagnostics departments (16.9%), and critical care departments (15.6%). The LTBI prevalence among HCWs was 17.86% (95% CI 13.84–22.70). In multivariate analysis, after adjusting for age, time working in our hospital, and family history of tuberculosis, males had a higher risk of LTBI (aPR 1.69, 95% CI 1.01–2.77) than females. Working for more than 10 years increased the risk of LBTI (aPR 2.4, 95% CI 1.44–3.97) compared to working for ≤10 years. Even further, participants who had worked for more than 20 years had an aPR of 4.31 (95% CI 1.09–13.65) compared to those with ≤10 years. Similarly, occupational exposure increased the risk of LTBI (aPR 2.21, 95% CI 1.27–4.08) compared to those HCWs not occupationally exposed.ConclusionThe LTBI prevalence in HCWs at a northern Peruvian hospital was lower compared to other Peruvian cities. Males, more experienced, and occupational exposed HCWs are at higher risk of LTBI. LTBI prevalence in Peruvian HCWs is still high. More studies are needed to address some aspects this study has not examined.

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Conductas frente al viraje de la prueba de Tuberculina en estudiantes de medicina de una universidad de Lima, Perú

Cited by 5 publications

References 12 publications

Latent tuberculosis infection in healthcare workers in low- and middle-income countries: an updated systematic review

Latent tuberculosis infection in healthcare workers in low- and middle-income countries: an updated systematic review

Estudio de métodos mixtos sobre el uso de terapia preventiva con isoniacida en estudiantes de medicina de una universidad privada en Lima

Latent tuberculosis infection (LTBI) in health-care workers: a cross-sectional study at a northern Peruvian hospital

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