Prevalence and risk factors for latent tuberculosis infection among primary health care workers in Brazil

Abstract

Health care workers (HCW) are at increased risk of latent tuberculosis infection (LTBI) from occupational exposure to Mycobacterium tuberculosis. The objective was to determine the prevalence of and risk factors for LTBI among primary HCW in five Brazilian cities. We conducted a cross-sectional study, from 2011 to 2013, among primary HCW, using a structured questionnaire and an evaluated for LTBI using the Quantiferon-TB Gold in-tube test. The magnitude of the associations was assessed using hierarchical logistic regression models. Among 708 HCW, the LTBI prevalence was 27% (n = 196; 95%CI: 24%-31%). We found that the following factors were positively associated with LTBI in primary HCW: age > 50 years (OR = 2.94; 95%CI: 1.44-5.99), absence of a BCG scar (OR = 2.10; 95%CI: 1.28-3.43), self-reported ex-smoker status (OR = 1.80; 95%CI: 1.04-3.11), being a nurse (OR = 2.97; 95%CI: 1.13-7.83), being a nurse technician (OR = 3.10; 95%CI: 1.26-7.60), being a community health agent (OR = 2.60; 95%CI: 1.06-6.40), and irregular use of N95 masks (OR = 2.51; 95%CI: 1.11-5.98). In contrast, HCWs who do not work in health care facilities with a TB control program were less likely to have LTBI (OR = 0.66; 95%CI: 0.45-0.97). This study demonstrated a substantial occupational risk of LTBI among primary HCW in Brazil. The Brazilian TB control program, as well as local programs, need to target these high-risk HCW with education, as well as with better personal protective equipment to prevent acquisition of new TB infection.

Factors Associated with Latent Tuberculosis Infection among the Hospital Employees in a Tertiary Hospital of Northeastern Thailand

“…By contrast, previous reports from China suggested that there was a link between HCWs simply working closely with TB patients and infection (OR= 1.99, 95%:1.40-2.82, p < 0.001) [27]. The current study also showed that the risk of LTBI was related to the absence of a BCG scar (adjusted OR = 2.49, 95% CI: 1.65-5.36, p = 0.001) consistent with previous studies [20,[45][46][47]. Using self-reporting of the presence or absence of a BCG scar in the current study could have resulted in an underestimation of BCG vaccination.…”

“…The presence of BCG scarring is an important indicator and confirmation of TB vaccination. Most recipients (80-85%) will have scars after vaccination [45]. A meta-analysis revealed that BCG vaccines could protect against LTBI in children under 16 years and prevent tuberculosis from LTBI [46].…”

A retrospective review of tuberculosis exposure among health care workers in a tertiary hospital

“…Our findings on risk factors for baseline LTBI were similar to previous studies, which demonstrated that increased age 9,10 and foreign origin 11 were risk factors for baseline LTBI among HCWs. Other factors associated with baseline LTBI reported in previous studies include working as a nurse 12,13 or physician, 5 being a man, and having diabetes mellitus. 14 Our study, however, did not find any statistically significant association between occupational groups/sex and baseline LTBI.…”

Infección tuberculosa latente en personal de salud de las Américas

“…Los factores de riesgo para la ITBL más frecuentemente observados en trabajadores de salud fueron: el sexo femenino [15][16][17][18][19] , la edad del trabajador entre 35 y 43 años [15][16][17][18][19] y la presencia de cicatriz de BCG 11,18 .…”

“…Entre los factores de riesgo para el desarrollo de la TB se consideran: edad mayor de 50 años, estado de exfumador auto afirmado, personal de salud, uso irregular de la mascarilla N95 11 , un mayor tiempo de laborar en el establecimiento, entre otros 12 . Conocer la situación de la ITBL es prioritario, ya que estas personas en riesgo de contraer la TB deben ser priorizadas para implementar estrategias de tratamiento.…”