Tuberculosis among Health Care Workers

Abstract

To assess the annual risk for latent tuberculosis infection (LTBI) among health care workers (HCWs), the incidence rate ratio for tuberculosis (TB) among HCWs worldwide, and the population-attributable fraction of TB to exposure of HCWs in their work settings, we reviewed the literature. Stratified pooled estimates for the LTBI rate for countries with low (<50 cases/100,000 population), intermediate (50–100/100,000 population), and high (>100/100,000 population) TB incidence were 3.8% (95% confidence interval [CI] 3.0%–4.6%), 6.9% (95% CI 3.4%–10.3%), and 8.4% (95% CI 2.7%–14.0%), respectively. For TB, estimated incident rate ratios were 2.4 (95% CI 1.2–3.6), 2.4 (95% CI 1.0–3.8), and 3.7 (95% CI 2.9–4.5), respectively. Median estimated population-attributable fraction for TB was as high as 0.4%. HCWs are at higher than average risk for TB. Sound TB infection control measures should be implemented in all health care facilities with patients suspected of having infectious TB.

Updates on Knowledge, Attitude and Preventive Practices on Tuberculosis among Healthcare Workers

“…The occurrence of TB cases among healthcare workers for those who came from countries with low, intermediate and high TB incidence accounted for about 67 cases/100,000 persons, 91/100,000 persons and 1,180/100,000 persons, respectively, with an average of 34 (IQR 18-108) with 12,689 (IQR 2,979-57,279) persons-year being infected (16). From another perspective, nosocomial exposure was attributed to the risk of TB disease among healthcare workers with a range of 25 to 5,361 per 100,000 yearly, as reported in a systematic review of healthcare workers in low-and middle-income countries (11).…”

Yield of tuberculosis contact investigation in a low-incidence country

“…The transmission of M. tuberculosis depends on several factors such as the bacteriological status and contagiousness of the index TB case, the susceptibility and immune status of the exposed TB contact and the characteristics of the environment within which such contact occurs (8,9). Under conditions particularly favorable for transmission, an individual with undiagnosed active TB may potentially cause a TB outbreak in confined settings such as schools, prisons and other congregate settings (7,10).…”

Occupational health policies and practices related to tuberculosis in health care workers in KwaZulu-Natal, South Africa

“…[1][2][3][4] More than 50% of HCWs worldwide are estimated to be infected with latent TB, and HCWs are estimated to have a two-to three-fold increased risk of developing TB disease and a fi ve-to six-fold risk of developing drugresistant TB compared with the general population. [3][4][5][6] This risk may be even greater for HCWs in South Africa, where TB incidence is third highest in the world, 7 and the long-standing human immunodefi ciency virus (HIV) epidemic in South Africa places HIV-positive HCWs at an increased risk for developing TB. It is estimated that up to 16% of HCWs in South Africa may be infected with HIV.…”