Prevalence and Risk Factors for Latent Tuberculosis Infection among Health Care Workers in China: A Cross-Sectional Study

Abstract

BackgroundHealth care workers (HCWs) are at risk of latent tuberculosis infection (LTBI). In China, tuberculosis (TB) is a major public health problem, but the prevalence of LTBI in HCWs especially in the hospital for pulmonary diseases has not been assessed enough. The aim of this study was to determine the prevalence and putative risk factors of LTBI among HCWs in a chest hospital and a TB research institute in China.Methodology/Principal FindingsA cross-sectional study was conducted among HCWs in China in 2012. LTBI was assessed by T-SPOT.TB, and information on HCWs was collected using a standardised questionnaire. Risk factors for LTBI were analyzed by univariate and multivariate regression. The overall prevalence of LTBI among HCWs was 33.6%. Analyzed by job category, the highest prevalence was found among laboratory staff (43.4%). In the different workplaces, the proportion of LTBI was significantly higher among the high risk workplaces (37.4%) compared to the low risk workplaces. The duration of employment had a significant impact on the prevalence of LTBI. Positive T-SPOT.TB test results accounted for 17.6%, 16.8%, 23.5%, 41.8% and 41.6% in groups of ≤2, 3–5, 6–10, 11–20, and >20 working years respectively. In multivariate analysis, job categories (Laboratory staff [2.76 (95% CI: 1.36; 5.60)], technician staff [2.02 (95% CI: 1.12; 3.64)]); working duration as a HCW for 11 to 20 years [3.57 (95% CI: 1.46; 8.71)], and 20 years above [3.41 (95% CI: 1.28; 9.11)]; and the history of household TB contact [2.47 (95% CI: 1.15; 5.33)] were associated with increased risk of LTBI.Conclusions/SignificancePrevalence of LTBI estimated by T-SPOT.TB is high among Chinese HCWs and working duration, job category and the history of household TB contact were associated with increased risk. These data highlight adequate infection control measures should be undertaken.

Prevalence of Latent Tuberculosis Infection in Type 2 Diabetic and NonDiabetic Individuals

“…The risk of Diabetes was lower when compared to other risk group like prisoners, illicit drug users, homeless people and health care workers, HIV /AIDS, patients on TNF alpha inhibitors, hemodialysis, nevertheless these are data from the low prevalent TB countries. Various studies have shown that employment categories at highest risk include healthcare workers and gold miners [9,25,26] ; participants in our study worked in diverse settings but none were in the known high-risk categories. Our findings and those from previous studies suggest a potential need for periodic LTBI screening coupled with preventive treatment programs at workplaces but the cost-effectiveness of such an intervention should be evaluated.…”

“…This finding was in agreement with studies done in Uganda, Thailand, and China which have reported more transmission at home due to household contact exposure [15][16][17][18][19] . However, other studies have shown that more transmission happens outside home especially in work places like healthcare settings due to nosocomial transmission [9,20,21,22] . Others demonstrate higher transmission among students in the healthcare settings, prisoners and gold miners [9,23,24,25] which are higher risk populations.…”

“…However, other studies have shown that more transmission happens outside home especially in work places like healthcare settings due to nosocomial transmission [9,20,21,22] . Others demonstrate higher transmission among students in the healthcare settings, prisoners and gold miners [9,23,24,25] which are higher risk populations. To the best of our knowledge, our study is among the first to show that the risk of LTBI is higher among those who are Diabetic and have a contact history of TB in the population.…”

“…in the latent phase. Few studies have investigated the prevalence of LTBI in healthcare workers, prisons [4][5][6][7][8][9] . Many research questions regarding association between diabetes and LTBI remains unanswered because of inadequate studies, furthermore none in India have considered diabetic population which is a high risk group.…”

Risk Factors for Extra Pulmonary Tuberculosis in the Health District of Thies, Senegal

“…In the USA, unemployment was associated with EPTB [12,16]. This is the case too in China [27] and Japan too [28]. Indeed, having a job provides income, improves standard of living, prevent from promiscuity and thus protects against tuberculosis.…”