Prevalence of Tuberculosis Infection Among Health-Care Workers in Hamedan, West of Iran

Abstract

Background: Tuberculosis has been recognized as a risk to health care workers for several decades. Nevertheless, little information is available about the situation of tuberculosis infection in health care workers in Iran. The aim of this study was to ascertain the prevalence of latent tuberculosis infection and pulmonary tuberculosis, and to assess the risk factors for tuberculosis infection among health care workers in Hamedan, Iran.Methods: Tuberculin skin test was conducted among 245 health care workers in two educational hospitals in Hamedan. The reaction was reported as ''positive'' if the diameter of induration was equel to or more than 10mm. Individuals with a positive test more than 15 mm were encouraged to seek further medical evaluation, including a chest-x-ray, and smear and culture of the sputum for acidfast bacilli in those with radiographic changes indicating tuberculosis.Results: Out of 245 health-care workers included in this study, 92 (38%) had positive tuberculin test. There was a significant association between the increase of age and tuberculin positivity. In addition, there was a significant association between the length of employment and tuberculin positivity. Ward attendants had higher rates of positive test than the other occupational groups. Fifty-six subjects showed tuberculin reaction of more than 15 mm, 4(7.1%) of them had calcification on radiograph. No cases of active pulmonary tuberculosis were found in the subjects.Conclusion: Latent tuberculosis infection is common among health-care workers. Age, occupational group, and length of employment are strongly associated with risk of tuberculin positivity. More emphasis on tuberculosis control measures and regular staff screening may be needed.