Risk factors for nosocomial tuberculosis transmission among health care workers

Ito, Yutaka; Nagao, Miki; Iinuma, Yoshitsugu; Matsumura, Yasufumi; Yamamoto, Masaki; Takakura, Shunji; Igawa, Junko; Yamanaka, Hiroe; Hashimoto, Akiko; Hirai, Toyohiro; Ichiyama, Satoshi; Mishima, Michiaki

doi:10.1016/j.ajic.2015.11.022

Cited by 10 publications

(9 citation statements)

References 9 publications

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“…There was an increased risk for TB with longer working durations (> 7 days, 12/12 [100%] vs. ≤ 7 days, 18/43 [41.9%]; p = 0.0002) [ 41 ] and direct contact with patients (OR: 2.83, 95% CI: 1.47–5.45) [ 42 ]. The infection was also observed more frequently in underweight HWs (BMI < 18.5, OR: 2.96, 95% CI: 1.49–5.87) [ 42 ], or in HWs with human immunodeficiency virus (OR: 6.35, 95% CI: 3.54–11.37) [ 43 ].…”

Section: Resultsmentioning

confidence: 99%

Tuberculosis infection status and risk factors among health workers: an updated systematic review

Lee

Kang

2021

Ann Occup Environ Med

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Tuberculosis (TB) infection is a common occupational risk for health workers (HWs) and poses a threat to the patients under their care and to other HWs. Hence, the development of a prevention strategy is crucial. We conducted a study to understand the status and risk factors of TB infection among HWs. The existing literature was searched for all published reports from 1 August 2010 to 31 December 2018, related to TB among HWs according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The inclusion criteria were: (1) study participants working in a health care facility; (2) TB cases diagnosed by medical professionals; (3) original research articles; and (4) English reports in a peer-reviewed journal. We finally included 61 studies from 642 articles searched initially. The TB infection rate in HWs was higher than that of the general population. Based on 39 studies, the prevalence of TB in HWs (tuberculin skin test positive) was 29.94%. In contrast, the global burden of latent TB infection was 23.0% (95% uncertainty interval: 20.4%–26.4%) in 2014. The risk factors of TB among HWs were aging, long duration of employment, nursing professionals, lack of Bacillus Calmette-Guerin vaccination, and low body mass index. HWs have an increased risk for TB infection, which can cause secondary infections in patients or other HWs. An effective prevention strategy must be developed to enable early diagnosis and prompt treatment.

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Section: Resultsmentioning

confidence: 99%

Tuberculosis infection status and risk factors among health workers: an updated systematic review

Lee

Kang

2021

Ann Occup Environ Med

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“…Another possible interpretation is that the recurrence of previous TB cases after treatment due to the increasing drug resistance of M. tuberculosis was very likely to increase the prevalence [39,40], especially in the regions with high incidence rates in the previous year. As far as the count of o cially appointed medical institutions is concerned, its heavy in uences on the TB epidemic were probably correlated with being representative places for gathering various patients, including potential TB patients and susceptible people with low immunity [22]. Besides, the number of bus stops termed for public transportation condition was another non-neglected in uencing factor for the TB epidemic because higher probability of the contacts among individuals and population mobility tended to be increased by the convenient public tra c system [16].…”

Section: Discussionmentioning

confidence: 99%

Specific Urban Elements Identified for Tuberculosis Epidemic in Guangzhou by Using Geographical Detector

Ren

et al. 2021

Preprint

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Background: The prevalence of tuberculosis (TB) in China has heavily affected people’s health for decades, which has been widely investigated for the rural regions and west parts. However, its spatial features in urban areas remain little understood. Thus, this study aims to identify its spatial differentiations and their influencing factors in highly urbanized region on a fine scale.Methods: Together with the TB cases in 2017 obtained from Guangzhou Institute of Tuberculosis Control and Prevention, in total 18 socioeconomic and environmental variables were included in this study. Two spatial analysis tools were respectively applied to select the relative appropriate spatial scale (global Moran’s I), and to identify specific urban factors (the Geographical detector) for this epidemic in the central four districts of Guangzhou.Results: The 2 km × 2 km grid was determined as the most appropriate spatial scale due to its relatively higher spatial autocorrelation (Moran’s I=0.33, Z=4.71). At this spatial level, the TB epidemic in the four central districts was obviously closely associated with most of socioeconomic factors (0.31<r<0.76) at the significance level of 0.01. By contrast, among environmental factors, only the concentration of fine particulate matter (PM2.5) correlated with this epidemic (r=0.21) at the significance level of 0.05. Similarly, according to the q-values derived from geographical detector analysis, socioeconomic factors posed stronger impacts (0.08<q<0.57) on the spatial differentiations of TB prevalence than those of environmental variables (0.06<q<0.27), Furthermore, 153 pairs of variables presented more powerful explanatory abilities for this epidemic’s spatial disparities due to their notable enhancements of q-values (7.3%<sq<311.6%) caused by the pairwise interactions.Conclusion: The spatial heterogeneity of TB prevalence was remarkably influenced by a series of specific urban elements and their pairwise interactions across the central region of Guangzhou. We accordingly suggest that more attentions should be paid to the areas with pairwise interactions of these specific urban elements in this city. This study would provide meaningful clues for local authorities making more targeted interventions on this disease in China’s municipal areas featured by both high urbanization and severe tuberculosis.

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“…Thailand does not, however, have access to either test, so the diagnosis of occupational TB is problematic in light of insufficient medical evidence. The use of an individual case investigation—according to the TB epidemiology—can be used to diagnose work-related TB [ 29 , 37 ]. Based on such an investigation, nine out of fifteen health workers were diagnosed with work-related TB.…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, the particular hospital in northeastern Thailand does not have access to such testing due to cost limitations, so a definitive diagnosis of occupational TB according to international guidelines cannot be extended to include the TB prevention policy at the hospital. Nevertheless, individual case investigations according to TB epidemiology could be carried out instead [ 29 , 30 ], which include information about the host, exposure agent, and the occupational environment extending to all related work procedures [ 31 , 32 , 33 , 34 ]. This information and investigative data could be combined to support a diagnosis of work-related TB, which is valuable as medical evidence for the preparation of health surveillance programs to control the spread of TB among health workers [ 35 ].…”

Section: Introductionmentioning

confidence: 99%

Work-Related Tuberculosis among Health Workers Employed in a Tertiary Hospital in Northeastern Thailand: A Report of Nine Cases

Sangphoo

Chaiear

Chanpho

2020

IJERPH

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Between October 2016 and September 2018, fifteen health workers were diagnosed with tuberculosis (TB) at a tertiary hospital in northeastern Thailand. However, the cases could not be diagnosed as occupational TB according to international standards because of hospital limitations. The use of occupational epidemiological information provides a more effective work-related TB diagnosis. This study aims to provide a report of work-related TB using individual case investigation methods. We collected secondary data from the Occupational Health and Safety Office of the hospital in question, including baseline characteristics for the health workers, occupational history, source of TB infection and occupational exposure, and working environmental measurements. We found that nine of the fifteen cases were diagnosable as work-related TB due to two important factors: daily prolonged exposure time to an infected TB patient, and aerosol-generating procedures without adequate respiratory protection. The other six cases were not diagnosable as work-related TB because of inadequate evidence of activities related to the TB infection. The diagnosis of work-related TB thus requires occupational epidemiological information in order to complete the differentiation process.

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Risk factors for nosocomial tuberculosis transmission among health care workers

Cited by 10 publications

References 9 publications

Tuberculosis infection status and risk factors among health workers: an updated systematic review

Tuberculosis infection status and risk factors among health workers: an updated systematic review

Specific Urban Elements Identified for Tuberculosis Epidemic in Guangzhou by Using Geographical Detector

Work-Related Tuberculosis among Health Workers Employed in a Tertiary Hospital in Northeastern Thailand: A Report of Nine Cases

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