Prevalence and Risk Factors for Latent Tuberculosis Infection among Healthcare Workers in a Low Incidence Country

Coppeta, Luca; Pietroiusti, Antonio; Neri, Anna; Janni, Aurelio; Baldi, Savino; Papa, Francesca; Magrini, Andrea

doi:10.2174/1874306401913010001

Cited by 6 publications

(15 citation statements)

References 12 publications

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“…In a recent meta-analysis, HCWs have been estimated to be both at high risk for active (A) and latent tuberculosis infection (LTBI) based on the results of epidemiological studies conducted in high and intermediate incidence countries [2]. A follow-up study carried out among a large number of North American hospital workers during the period 1995-2007 reported that TB incidence rates among HCWs were similar to those of the general population [6], foreign birth being the major risk factor of LTBI [7][8][9][10][11][12][13]. Moreover, a recent retrospective cohort study found an extremely low rate of Tuberculin Skin Test (TST) conversion among a large population of HCWs working in the low TB-incidence United States.…”

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness of Annual Screening for Tuberculosis among Italian Healthcare Workers: A Retrospective Study

Coppeta

Somma

Baldi

et al. 2020

IJERPH

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Background. In the past few years, healthcare workers (HCWs) have been considered at higher risk for tuberculosis (TB) infection than the general population. On the other hand, recent studies have reported a low conversion rate among these workers. Recently, the Center for Disease Control (CDC) updated its recommendations, suggesting that an annual screening should not be performed in the absence of a documented exposure but only in workers with high-risk duties or with job tasks in settings at high risk of tuberculosis contagion (e.g., departments of infectious or pulmonary diseases). In fact, some studies showed that annual tuberculosis screening for all the HCWs was not cost-effective in countries with a low incidence of TB. In this study, we evaluated the conversion rate and the cost-effectiveness of two different tuberculosis screening strategies in a large population of Italian HCWs. Methods. In our retrospective study, we reviewed data coming from a tuberculosis screening conducted on 1451 HCWs in a teaching hospital of Rome. All workers were evaluated annually by means of the Quantiferon test (QFT) for a five-year period. Then, the conversion rate was calculated. Results. We found a cumulative conversion rate of 0.6%. Considering the cost of the QFT test (48.26 euros per person), the screening of the HCWs resulted in a high financial burden (38,902.90 euros per seroconversion). Only one seroconversion would have been missed by applying the CDC updated recommendations, with a relevant drop of the costs: 6756.40 euros per seroconversion, with a global save of 296,075.10 euros. Conclusion: The risk of TB conversion among our study population was extremely low and it was related to the risk classification of the setting. Giving these results, the annual tuberculosis screening appeared to not be cost effective. We conclude that a targeted screening would be a better alternative in HCWs with a higher risk of TB exposure.

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Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness of Annual Screening for Tuberculosis among Italian Healthcare Workers: A Retrospective Study

Coppeta

Somma

Baldi

et al. 2020

IJERPH

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“…Table II shows fourteen studies with a total of 8,604 individuals from eight countries that were published between 2010 and 2020. Six from Italy (10,(19)(20)(21)(22)(23), two from India (24-25), and one, respectively, from Iran (26), Malaysia (27), South Korea (28), Uganda (29), Saudi Arabia (30) and South Africa (31). These studies were conducted from 2007 through 2019 and published from 2010 through 2020.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The sample size ranged from 79 to 2,466 subjects. Seven studies (19,20,22,(26)(27)(28)31) were conducted amongst the medical students (31.8%), three studies (23,24,30) amongst the nursing students (13.6%) and four studies (10,21, 24,28) reported on both the medical and nursing students (18.2%).…”

Section: Study Characteristicsmentioning

confidence: 99%

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A Systematic Review of Prevalence and Risk Factors of Latent Tuberculosis Infection Among Medical and Nursing Students

Ismail¹,

Musa²,

Ithnin³

et al. 2022

MJMHS

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Introduction: Clinical training may expose medical and nursing students to workplace hazards comparable to those encountered by healthcare workers (HCWs). This study was designed to investigate the prevalence of latent tuberculosis infection (LTBI) and associated risk factors among medical and nursing students. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, a systematic review was conducted utilising four electronic databases to appraise and synthesise the literature on LTBI which used the tuberculin skin test (TST) and the blood interferon-gamma release assay (IGRA). Results: Original articles published in the English language between 2010 and 2020 were included, yielding 14 relevant articles. The average prevalence of LTBI in high-burden countries was 38.2% for TST and 20.6% for the IGRA test. According to TST and IGRA findings, the average prevalence of LTBI in nations with an intermediate burden was 16.7% and 4.7 %, respectively. The average prevalence was 2.8% and 1.1% from the TST and IGRA tests for low-burden countries, respectively. A greater risk of LTBI was shown to be related with an increase in age among postgraduate medical school students, a history of Bacillus Calmette-Guerin (BCG) vaccination, origin from high-risk tuberculosis (TB) countries, increased hours of hospital exposure, a history of contact with TB cases, a high body mass index, older age group students, and a lower TB knowledge score. Conclusion: The available evidence from this review emphasised the importance of developing and implementing efficient and cost-effective TB infection-control programmes, particularly in high-burden countries and amongst students at risk.

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“…Moreover, the symptoms of these diseases take time to manifest in the airways, which can prevent workers from realizing they have been exposed after symptoms begin [ 19 , 20 , 21 ]. For tuberculosis, which is caused by Mycobacterium tuberculosis (a Level 3 organism based on the biological risk it represents), public concern is based on the prevalence of the general population and healthcare workers that suffer from the disease [ 22 ]. In a report of WHO, it was estimated in 2015 that up to 2 billion people around the world suffer from a latent state of tuberculosis [ 23 ], which remains concerningly prevalent in low-risk countries, such as Italy [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

Tuberculosis and Other Airborne Microbes in Occupational Health and Safety

Vaquero-Álvarez

Cubero-Atienza

Ruiz-Martínez

et al. 2020

IJERPH

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Airborne pathogens and non-malignant infectious diseases such as tuberculosis are highly contagious and can have severe effects on healthcare workers. The symptoms of these diseases take time to manifest, which can prevent workers from noticing that they have been exposed until symptoms appear. The current paper sought to assess the occupational safety and preventative measures taken in laboratories in Spain, and to compare these measures with those reported by other studies worldwide. A cross-sectional study of workers (35–50 years old) was conducted using a web survey (N = 30), and a bibliometric analysis was carried out in the Scopus database (92 documents were selected). The occupational safety and health measures were inadequate, according to the opinions of the workers. The training (p < 0.01), the amount of work (p < 0.05), and how the workers followed their protocols (p < 0.001) were linked to incidents and exposure to airborne pathogens. The most significant previous publication was a report (848 citations) stating that the previous variables linked to exposure are vital for prevention. Most works focused on countries like the U.S.A. (p = 0.009) were reviews, with a limited number of studies focused on occupational safety.

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Prevalence and Risk Factors for Latent Tuberculosis Infection among Healthcare Workers in a Low Incidence Country

Cited by 6 publications

References 12 publications

Cost-Effectiveness of Annual Screening for Tuberculosis among Italian Healthcare Workers: A Retrospective Study

Cost-Effectiveness of Annual Screening for Tuberculosis among Italian Healthcare Workers: A Retrospective Study

A Systematic Review of Prevalence and Risk Factors of Latent Tuberculosis Infection Among Medical and Nursing Students

Tuberculosis and Other Airborne Microbes in Occupational Health and Safety

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