Contact investigation in healthcare personnel exposed to pediatric patients with pulmonary tuberculosis at the pediatric ward, Vajira hospital, Thailand

Abstract

BackgroundTuberculosis (TB) is an important public health problem, and airborne transmission is easily transmitted. Latent TB infection (LTBI) detection and treatment is the key strategy to prevent TB. ObjectiveThis study aimed to perform contact investigation of LTBI in healthcare personnel (HCPS) working with pediatric patients with active pulmonary TB and report the side effects of 12-week-isoniazid and rifapentine (3HP). MethodsThis contact investigation reviewed HCPS who were in close contact with pediatric pulmonary TB. Close contact with pulmonary TB is defined as contact for 8 h per day and 120 h per month, or contact in poor air ventilation spaces. HCPS who participated in this study were tested for the active TB and LTBI by history using physical examination, chest X-ray, and tested with interferon-gamma releasing assays (IGRAs). LTBI is defined as a positive IGRA without any evidence of active TB. ResultsA total of 82 HCPS, including 39 nurses (47%), 13 nursing assistance (16%), 12 pediatrician doctors (15%), 12 pediatric residents (15%), and 6 medical students (7%) had close contact with pediatric pulmonary TB. Of the total, 75 HCPS were women, and the mean age and standard deviation was 33 ± 10.4 years. IGRAs revealed positive results in 14 (17%) HCPS who were diagnosed with LTBI and treated with 3HP, of whom, 12 (86%) completed the LTBI treatment, but 2 discontinued the treatment due to the side effects of 3HP. No serious adverse events from 3HP were reported. The most reported side effect of 3HP was nausea and vomiting, occurring in 50% of the HCPS. No diagnosis of TB was seen after 1-year follow-up. ConclusionThis contact investigation in HCPS of the pediatric ward revealed a large number of LTBI. The LTBI treatment with 3HP showed favorable outcomes and showed minor side effects. Therefore, 3HP was preferred to treat LTBI.