Latent tuberculosis infection (LTBI) in health-care workers: a cross-sectional study at a northern Peruvian hospital

Abstract

BackgroundHealthcare workers (HCWs) have a higher risk of latent tuberculosis infection (LTBI) and active tuberculosis than the general population. In HCWs, the risk of tuberculosis infection depends on the local tuberculosis prevalence, HCWs’ characteristics, the healthcare facility, and prevention and control measures. We aimed to estimate the prevalence and risk factors for LTBI in HCWs at a northern Peruvian hospital.MethodsThis study had two phases: (1) a cross-sectional phase involving recruitment, history taking, and sampling for the Interferon-Gamma Release Assays (IGRA test), and (2) a prospective follow-up of IGRA-positive participants. We enrolled direct and non-direct patient caregivers among HCWs. We defined an LTBI case if the IGRA test was positive and clinical, laboratory, and radiological evaluations for active tuberculosis were negative.ResultsWe recruited 308 participants between November 2022 and May 2023. The mean age was 38.6 ± 8.3 years. Over 75% of the participants were female. The most common job category was technicians (30.5%), physicians (22.7%), nurses (20.5%), and other HCWs groups (17.5%). Most participants worked in hospital wards (28.2%), diagnostics departments (16.9%), and critical care departments (15.6%). The LTBI prevalence among HCWs was 17.86% (95% CI 13.84–22.70). In multivariate analysis, after adjusting for age, time working in our hospital, and family history of tuberculosis, males had a higher risk of LTBI (aPR 1.69, 95% CI 1.01–2.77) than females. Working for more than 10 years increased the risk of LBTI (aPR 2.4, 95% CI 1.44–3.97) compared to working for ≤10 years. Even further, participants who had worked for more than 20 years had an aPR of 4.31 (95% CI 1.09–13.65) compared to those with ≤10 years. Similarly, occupational exposure increased the risk of LTBI (aPR 2.21, 95% CI 1.27–4.08) compared to those HCWs not occupationally exposed.ConclusionThe LTBI prevalence in HCWs at a northern Peruvian hospital was lower compared to other Peruvian cities. Males, more experienced, and occupational exposed HCWs are at higher risk of LTBI. LTBI prevalence in Peruvian HCWs is still high. More studies are needed to address some aspects this study has not examined.

Prevalence, Risk Factors, and Result Features in the Detection of Latent Tuberculosis Infection in Thai Healthcare Workers Using QuantiFERON-TB Gold Plus

“…Overall, the variation in infection may involve the result of compliance with protective measures for infection control. Regarding employment duration, our finding on the impact of working time was similar to the previous study and systematic review reports on LTBI among HCWs which found the association of TB infection with the length of time working in healthcare facilities [ 13 , 26 , 30 ]. This effect can be explained by the longer working time increasing exposure to TB and, consequently, increasing the risk of acquiring TB infection.…”

“…Univariate and multivariate analyses were performed using logistic regression to assess the association between possible risk factors and QFT-Plus positive results. Several factors may increase the risks of acquiring TB infection, and the risks of LTBI differ among HCWs depending on local TB prevalence, healthcare facilities, and infection prevention and control measures [ 26 ]. Different risk factors for LTBI in HCWs were reported.…”

“…Different risk factors for LTBI in HCWs were reported. A recent study in Peru using QFT-Plus reported that demographic factors associated with LTBI in HCWs included gender, time working in the hospital, and occupational exposure to TB [ 26 ]. In this study, essential factors such as sex, age of the HCWs, and their working duration were considered.…”

“…In addition, acquiring TB infection depends on various determinants. The contact's closeness and the TB case's infectiousness were considered critical determinants for TB infection [ 26 ]. In HCWs working in critical-risk areas for TB infection or at high-risk jobs involving aerosol-contacting procedures, some might be in low-risk TB exposure due to good infection prevention practices.…”