Korean J healthc assoc Infect Control Prev.  2019 Dec;24(2):52-59. 10.14192/kjicp.2019.24.2.52.

Prevalence and Risk Factors of Latent Tuberculosis Infection among Healthcare Workers

• Lee S
• Lee YL
• Kim YC
• Kim EJ
• Heo JY
• Choi YH

• KMID: 2467904
• DOI: http://doi.org/10.14192/kjicp.2019.24.2.52

Abstract

BACKGROUND
Due to occupational exposure, healthcare workers (HCW) face an increased risk of tuberculosis (TB) infection. This study was conducted to assess the prevalence and risk factors of latent tuberculosis infection (LTBI), and to estimate the cumulative risk of active TB among HCWs.
METHODS
We conducted a cross-sectional study among HCWs in Ajou university medical center. A standard questionnaire was used for data collection, and LTBI was detected using the Interferon gamma-release assay (IGRA). The biographical information was collected from the electronic database. A computerized algorithm was used to evaluate the predicted cumulative risk of active TB in HCWs with LTBI.
RESULTS
Of a total of 1,407 HCWs, a positive IGRA result was detected in 138 HCWs. The prevalence of LTBI in HCWs was found to be 9.8% [95% confidence interval (CI) 8.2-11.4]. It was observed that the prevalence of LTBI increased with age (P value < 0.001). However, it was also observed that duration of the working periods in a TB-related department was not associated with LTBI (P value=0.369). According to the multivariate analysis, an increased risk of LTBI was observed among participants aged ≥ 50 years [odds ratio (OR) 7.522, 95% CI 3.56-15.89] and nursing assistants (OR 2.912, 95% CI 1.283-6.608). The median cumulative risk of active TB with LTBI was estimated to be 4.31% [interquartile range (IQR) 3.43-5.29], and 4.41% (IQR 3.14-5.29) in HCWs with and without work experience in TB-related department, respectively. No significant difference was observed between two groups (P value=0.715).
CONCLUSION
The prevalence of LTBI among HCWs may not be higher than that of individuals in other group facilities. It may be necessary to revise the treatment recommendations, which are classified based on the risk for LTBI associated with departments and locations of work.

Keyword

Healthcare workers; IGRA; Latent tuberculosis infection; Risk factor; Tuberculosis

MeSH Terms

Academic Medical Centers
Cross-Sectional Studies
Data Collection
Delivery of Health Care*
Interferons
Latent Tuberculosis*
Multivariate Analysis
Nursing
Occupational Exposure
Prevalence*
Risk Factors*
Tuberculosis
Interferons

Figure

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  Fig. 1 Flow chart of the study. Abbreviations: See Table 1.

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  Fig. 2 Distribution of people by group.

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  Fig. 3 IGRA positive rate by work period in each risk group.

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  Fig. 4 IGRA positive rate according to age group.

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  Fig. 5 IGRA positive rate by occupation.

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  Fig. 6 Age, total work period and work period in TB related department according to occupation.

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  Fig. 7 Cumulative risk of active tuberculosis in healthcare workers with latent tuberculosis infection by age group.

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  Fig. 8 Treatment status by risk group.

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