Risco de infecção pelo Mycobacterium tuberculosis entre alunos da Faculdade de Medicina da Universidade Federal do Rio de Janeiro

Abstract

Introduction:There have been few Latin American studies investigating the fact that the rate of tuberculosis (TB) infection among medical students is higher than the 1.3% rate seen in the population at large.Objective: To describe the cumulative incidence and the relative risk for TB infection among medical students.Method: In 1998, a prospective cohort study was conducted involving medical students at the Universidade Federal do Rio de Janeiro Faculdade de Medicina who tested negative (induration <10 mm) on the tuberculin skin test (TST). Students were tested using the two-step TST method and were retested one year later. The students tested were at two different stages in their training: pre-clinical (no contact with patients) and final year (contact with patients). Information about demographic characteristics, BCG vaccination history, and instances of potential exposure to Mycobacterium tuberculosis were obtained using a standardized questionnaire. Of the 575 students initially enrolled, 72% (414) completed the study. Results:The TSTs of 16 (3.9%) of the 414 students converted, representing a cumulative incidence of 3.9% (95% confidence interval = 1.06 to 12.1). Senior medical students were at an almost fourfold higher risk for M. tuberculosis infection than were those in pre-clinical training. Conclusion:The risk for TST conversion is very high in this population.

Prevalência e fatores associados à infecção pelo Mycobacterium tuberculosis entre agentes comunitários de saúde no Brasil, usando-se a prova tuberculínica

“…Primeiro, o estudo transversal é limitado em sua capacidade de identificar associações causais, de modo que um estudo longitudinal seria mais adequado para identificar as taxas de conversão à PT e os fatores associados. Portanto, um nexo de causalidade entre a prevalência positiva da PT e a transmissão de M. tuberculosis não pode ser feita; além disso, as mudanças ao longo do tempo não podem ser monitoradas 13,33 . Em segundo lugar, estudos têm avaliado o efeito booster, que variou de 5,8% a 7,8% 34,35 .…”

“…Considerando-se os grupos de risco para IL-TB, os profissionais da área da saúde estão entre os mais vulneráveis, como demonstram várias publicações 12,13,14,15,16,17,18,19,20 . Uma revisão sistemática encontrou que a incidência de ILTB, demonstrada por meio da conversão da prova tuberculínica (PT), pode chegar a 14% nesses profissionais, e o risco de evoluir para TB doença é de 5.361 casos/100 mil profissionais de saúde a cada ano, em virtude da exposição nosocomial 21 .…”

Knowledge as a factor in vulnerability to tuberculosis among nursing students and professionals

“…Those efforts may benefit both students and professionals, contributing to broaden nurses' awareness about their vulnerability to the disease (17)(18)(19) . Moreover, adequate knowledge of TB may also directly impact nursing practice, as the individual and collective aspects of appropriate biosafety measures could be addressed.…”

Risco de infecção tuberculosa em agentes comunitários de saúde

“…Some studies 3,6,7,9,10,13,17,18,a have dealt with healthcare professionals' risk of infection and becoming ill with Mycobacterium tuberculosis. However, in Brazil, only one study has looked into this risk among community health agents (CHAs).…”