Abstract
OBJECTIVE: Airborne and Tuberculosis (TB) control measures have been implemented in Songklanagarind hospital. The infection control unit of the hospital has provided a voluntary two-step tuberculin skin test (TST) for pre-clinical medical students and serial TST for clinical medical students. This study aimed to determine the incidence of negative outcome and booster phenomenon from two-step TST as well as the TST conversion rate from serial TST among medical students in the hospital. MATERIALS AND METHODS: Percentages of negative cases and boosting phenomenon were calculated from the two-step TST records. Conversion rates of each year were calculated from serial TST data. Then the TST conversion rates were predicted based on the Jointpoint model. RESULTS: Two-step TSTs performed from 2001 to 2016 showed 40 to 100% of negative cases and zero to 14% of boosting phenomenon among 2,271 medical students. Serial TSTs from 2002 to 2016 among 665 medical students showed 60 conversion cases. Conversion rates varied from zero to 13.6%. The decline of conversion rates after the year 2006 is demonstrated in 1-Joinpoint model with statistical significance (p = 0.0129). The model corresponded with the timeline data of airborne infection control measures which were mostly implemented after 2006. CONCLUSIONS: A decline in TST conversion rate was shown after 2006. This coincided with airborne infection control measures at the institute. Keywords: tuberculin skin test, conversion rate, medical student, Songklanagarind hospital Address Correspondence to author: Sarinpant Pongpant, MD. Occupational health unit, Department of family medicine and preventive medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, 90110, Thailand. email: jibpongpant@gmail.com Received: May 25, 2018 Revision received: May 31, 2018 Accepted after revision: July 3, 2018 BKK Med J 2018;14(2): 17-21. DOI: 10.31524/bkkmedj.2018.09.004
Highlights
Systemic testing and treatment for latent tuberculous infection (LTBI) should be considered in health care workers at risk.[5] Medical students are at risk for TB infection during their clinical years.[6,7,8,9,10] TB control in healthcare settings plays an important role in limiting transmission from patient-to-patient, patient-to-healthcare worker and healthcare worker–to-patient.[1,11] Tuberculin skin test (TST) is a classic, widely-used and affordable screening tool for LTBI.[12,13] Casas et al found that annual TST conversion in healthcare workers (HCW) has declined during the 20-year period of their study
This study aimed to evaluate trends in serial TST survival from 2001-2016 with TB control implementation
Exclusion criteria: Records without data from the serial tuberculin skin test were not included in the calculation of TST conversion rate
Summary
Systemic testing and treatment for LTBI should be considered in health care workers at risk.[5] Medical students are at risk for TB infection during their clinical years.[6,7,8,9,10] TB control in healthcare settings plays an important role in limiting transmission from patient-to-patient, patient-to-healthcare worker and healthcare worker–to-patient.[1,11] Tuberculin skin test (TST) is a classic, widely-used and affordable screening tool for LTBI.[12,13] Casas et al found that annual TST conversion in HCW has declined during the 20-year period of their study. The tool should include local epidemiological, climatic and socioeconomic status alongside TB and HIV burden.[1] Songklanagarind hospital has provided an annual voluntary TST for medical students before and during their clinical year. Records of TST results from the infection control unit were used.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
