Prevalence of Latent Tuberculosis Infection among Health Care Workers in South Korea: A Multicenter Study

Abstract

BackgroundWe investigated the prevalence of latent tuberculosis infection (LTBI) among the health care workers (HCWs) and analyzed its risk factors in South Korea.MethodsA standard questionnaire regarding the baseline demographics and risk factors for LTBI was given to each participant and tuberculin skin test (TST), QuantiFERON-TB GOLD In-Tube (QFT-GIT) assay, and chest radiography were performed.ResultsA total of 493 participants, 152 (30.8%) doctors and 341 (69.2%) nurses were enrolled in eight tertiary referral hospitals. The mean age of the subjects was 30.6 years old, and 383 (77.7%) were female. Of the 152 doctors, 63 (41.4%) and 36 (23.7%) were positive by TST and by QTF-GIT, respectively, and among the 341 nurses, 119 (34.9%) and 49 (14.4%) had positive TST and QFT-GIT results, respectively. Overall, the agreement between the two tests was 0.22 by the chance corrected proportional agreement rate (kappa coefficient) in 493 subjects. Experience of working in tuberculosis (TB)-related departments was significantly associated with positive LTBI test results by QFT-GIT assay, not by TST. In multivariate analysis, only age was independently associated with increased risk of a positive TST result, while age and experience of working in TB-related departments (odds ratio, 2.29; 95% confidence interval, 1.01-5.12) were independently associated with increased risk of a positive QFT-GIT result.ConclusionA high prevalence of LTBI was found among South Korean HCWs. Considering the association between the experience of working in TB-related departments and high risk of LTBI, QFT-GIT may be a better diagnostic test for LTBI than TST in HCWs.

Tuberculosis in farm workers exposed to dairy and beef livestock in Colombia

“…These findings are consistent with other studies. In 2013, a study by Jo and collaborators [22] found that the agreement between these tests was ‘regular’ (k-0.22); in 2017, Ochoa and collaborators [18] found a ‘moderate’ agreement (k-0.47) between these two tests on health care workers. According to WHO guidelines, regardless of the concordance between TST and QFT, both tests could be used to diagnose latent TB; however, the findings of this study do not allow us to conclude which of the two tests is more advisable to make a diagnosis of latent TB in people exposed to cattle.…”

Tuberculin Skin Test and QuantiFERON^®-TB Gold In-Tube Test for Diagnosing Latent Tuberculosis Infection among Thai Healthcare Workers

“…Comparative data on the performance of TST and IGRA in LTBI detection is largely from low TB prevalence settings (8). Among Asian countries (Table 1), the overall agreement between TST and IGRA results was poor to fair and depended on the cut-offs for TST reactivity used (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). The main factor reported to be associated with poor agreement between the 2 tests was prior BCG vaccination, which resulted in false reactivity of TST (23).…”

Selection of Health Care Workers for Screening for Latent Tuberculosis Infection

“…In several Korean studies carried out before, laboratory workers were found to be vulnerable to TB infection through exposure to contagious specimens from patients[19].Increased age was the only significant risk factor identified in this study. Many other studies also reported increased age to be a factor influencing the increase in LTBI[20] [21][22]. In the LTBI screening conducted by the government in 2017 mentioned above, the LTBI rate similarly increased with age.…”