Tuberculin Skin Testing Among Healthcare Workers in the University of Malaya Medical Centre, Kuala Lumpur, Malaysia

Tan, Lian-Huat; Kamarulzaman, Adeeba; Ck, Liam; Lee, Toong-Chow

doi:10.1086/501975

Cited by 15 publications

(11 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Healthcare workers working in the medical domain reported a higher prevalence of LTBI compared to the surgical domain similarly to what Tan et al found [35]. Other studies found a similar pattern among the occupational categories [36].…”

Section: Discussionsupporting

confidence: 78%

Prevalence and risk factors for latent tuberculosis infection among healthcare workers in Nampula Central Hospital, Mozambique

Belo

Naidoo

2017

BMC Infect Dis

View full text Add to dashboard Cite

BackgroundHealthcare workers in high tuberculosis burdened countries are occupationally exposed to the tuberculosis disease with uncomplicated and complicated tuberculosis on the increase among them. Most of them acquire Mycobacterium tuberculosis but do not progress to the active disease – latent tuberculosis infection. The objective of this study was to assess the prevalence and risk factors associated with latent tuberculosis infection among healthcare workers in Nampula Central Hospital, Mozambique.MethodsThis cross-sectional study of healthcare workers was conducted between 2014 and 2015. Participants (n = 209) were administered a questionnaire on demographics and occupational tuberculosis exposure and had a tuberculin skin test administered. Multivariate linear and logistic regression tested for associations between independent variables and dependent outcomes (tuberculin skin test induration and latent tuberculosis infection status).ResultsThe prevalence of latent tuberculosis infection was 34.4%. Latent tuberculosis infection was highest in those working for more than eight years (39.3%), those who had no BCG vaccination (39.6%) and were immunocompromised (78.1%). Being immunocompromised was significantly associated with latent tuberculosis infection (OR 5.97 [95% CI 1.89; 18.87]). Positive but non-significant associations occurred with working in the medical domain (OR 1.02 [95% CI 0.17; 6.37]), length of employment > eight years (OR 1.97 [95% CI 0.70; 5.53]) and occupational contact with tuberculosis patients (OR 1.24 [95% CI 0.47; 3.27]).ConclusionsPersonal and occupational factors were positively associated with latent tuberculosis infection among healthcare workers in Mozambique.

show abstract

Section: Discussionsupporting

confidence: 78%

Prevalence and risk factors for latent tuberculosis infection among healthcare workers in Nampula Central Hospital, Mozambique

Belo

Naidoo

2017

BMC Infect Dis

View full text Add to dashboard Cite

show abstract

“…The lack of association between BCG and TST positivity was confirmed among 263 health care workers (HCW) in a tertiary referral hospital in Malaysia [35]. Currently, the US Centers for Disease Control and Prevention (CDC) recommends interpretation of TST reaction regardless of the BCG vaccination history since BCG immunogenicity wanes after a few years [17].…”

Section: Discussionmentioning

confidence: 99%

“…A TST survey among another high-risk group in Malaysia reported a reactive TST prevalence of 52% among predominantly young female health care workers [35]. Arguably, however, an older and predominantly male group may have higher prevalence of LTBI in an intermediate TB burden country, but the prevalence of a reactive TST was uniformly high among all screened age groups (Figure 2).…”

Section: Discussionmentioning

confidence: 99%

Latent tuberculosis infection in a Malaysian prison: implications for a comprehensive integrated control program in prisons

2014

Self Cite

View full text Add to dashboard Cite

BackgroundPrisons continue to fuel tuberculosis (TB) epidemics particularly in settings where access to TB screening and prevention services is limited. Malaysia is a middle-income country with a relatively high incarceration rate of 138 per 100,000 population. Despite national TB incidence rate remaining unchanged over the past ten years, data about TB in prisons and its contribution to the overall national rates does not exist. This survey was conducted to address the prevalence of latent TB infection (LTBI) in Malaysia’s largest prison.MethodsFrom July to December 2010, all HIV-infected and a comparative group of HIV-uninfected prisoners housed separately in Kajang prison were asked to participate in the survey after explaining the study protocol. Subjects providing informed consent were interviewed using a structured questionnaire followed by the placement of tuberculin skin test (TST) with 2 TU of PPD RT-23 to subjects not being treated for active TB. TST was read after 48-72 hours and indurations of ≥ 5 mm and ≥ 10 mm were considered positive among HIV-infected and HIV-uninfected subjects, respectively. Additionally, HIV-infected inmates underwent phlebotomy for CD4 lymphocyte count assessment. A logistic regression model was explored to determine factors associated with TST positivity.ResultsOverall, 286 subjects (138 HIV-infected and 148 HIV-uninfected) had complete data and TST results. The majority were men (95.1%), less than 40 years old (median age 36.0, SD 7.87), and Malaysians (93.3%). Most (82.5%) had been previously incarcerated and more than half (53.1%) reported sharing needles just prior to their incarceration. TST was positive in 88.8% (84.7% among HIV-infected and 92.5% among HIV-uninfected subjects) and was independently associated with being HIV-uninfected (AOR = 2.97, p = 0.01) and with frequent previous incarcerations (AOR = 1.22 for every one previous incarceration, p = 0.01) after adjusting for other potential confounding factors.ConclusionsThe prevalence of LTBI was extraordinary high in this sample of Malaysian prisoners, regardless of their age or HIV status. This warrants further examination of the size of the problem of TB in other congregate settings and the establishment of an evidence-based TB control program in Malaysian prisons with integrated TB, HIV and substance abuse components.

show abstract

“…Although BCG vaccination may reduce TST specificity if performed after the first year of life (Farhat, Greenaway, Pai, & Menzies, 2006), repeated BCG vaccination did not significantly influence TST reactivity (Al-Darraji et al, 2011; Tan, Kamarulzaman, Liam, & Lee, 2002). This study confirms earlier reports that HIV infection, presumably through its negative influence on the immune system (Robles et al, 1999), is associated with lower rates of TST positivity among PWUD, even if the TST positivity cut-off was lowered to 5 mm (Graham et al, 1992).…”

Section: Discussionmentioning

confidence: 99%

“…The new IGRA assays perform better than TST but its high cost and technical complexity hamper its potential to be immediately expanded in low- to middle-income countries (World Health Organization (WHO), 2011d). There also does not exist a comparative estimate of the TST reactivity in the Malaysian general population, though the prevalence among Malaysian healthcare workers (52.1%) (Tan et al, 2002) and in the general population in the Western Pacific region (36%) (Dye, Scheele, Dolin, Pathania, & Raviglione, 1999) are markedly lower.…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis screening in a novel substance abuse treatment center in Malaysia: Implications for a comprehensive approach for integrated care

Al-Darraji

Wong

Yeow

et al. 2014

Journal of Substance Abuse Treatment

Self Cite

View full text Add to dashboard Cite

People who use drugs (PWUD) represent a key high risk group for tuberculosis (TB). The prevalence of both latent TB infection (LTBI) and active disease in drug treatment centers in Malaysia is unknown. A cross-sectional convenience survey was conducted to assess the prevalence and correlates of LTBI among attendees at a recently created voluntary drug treatment center using a standardized questionnaire and tuberculin skin testing (TST). Participants (N = 196) were mostly men (95%), under 40 (median age = 36 years) and reported heroin use immediately before treatment entry (75%). Positive TST prevalence was 86.7%. Nine (4.6%) participants were HIV-infected. Previous arrest/incarcerations (AOR = 1.1 for every entry, p < 0.05) and not being HIV-infected (AOR = 6.04, p = 0.03) were significantly associated with TST positivity. There is an urgent need to establish TB screening and treatment programs in substance abuse treatment centers and to tailor service delivery to the complex treatment needs of patients with multiple medical and psychiatric co-morbidities.

show abstract

Tuberculin Skin Testing Among Healthcare Workers in the University of Malaya Medical Centre, Kuala Lumpur, Malaysia

Cited by 15 publications

References 24 publications

Prevalence and risk factors for latent tuberculosis infection among healthcare workers in Nampula Central Hospital, Mozambique

Prevalence and risk factors for latent tuberculosis infection among healthcare workers in Nampula Central Hospital, Mozambique

Latent tuberculosis infection in a Malaysian prison: implications for a comprehensive integrated control program in prisons

Tuberculosis screening in a novel substance abuse treatment center in Malaysia: Implications for a comprehensive approach for integrated care

Contact Info

Product

Resources

About