Abstract
ObjectiveTo determine the impact factors of latent tuberculosis infection (LTBI) and the knowledge of TB prevention and treatment policy among health care workers (HCWs) in different types of hospitals and explore the strategies for improving TB prevention and control in medical institutions in China.MethodsA cross-sectional study was carried out to evaluate the risk of TB infection and personnel occupational protection among HCWs who directly engage in medical duties in one of two public hospitals. Each potential participant completed a structured questionnaire and performed a tuberculin skin test (TST). Factors associated with LTBI were identified by logistic regression analysis.ResultsSeven hundred twelve HCWs completed questionnaires and 74.3% (n = 529) took the TST or had previous positive results. The TST-positive prevalence was 58.0% (n = 127) in the infectious disease hospital and 33.9% (n = 105) in the non-TB hospital. The duration of employment in the healthcare profession (6–10 years vs. ≤5 years [OR = 1.89; 95% CI = 1.10, 3.25] and>10 vs. ≤5[OR = 1.80; 95% CI = 1.20, 2.68]), type of hospital (OR = 2.40; 95% CI = 1.59, 3.62), and ever-employment in a HIV clinic or ward (OR = 1.87; 95% CI = 1.08, 3.26)were significantly associated with LTBI. The main reasons for an unwillingness to accept TST were previous positive TST results (70.2%) and concerns about skin reaction (31.9%).ConclusionA high prevalence of TB infections was observed among HCWs working in high-risk settings and with long professional experiences in Henan Province in China. Comprehensive guidelines should be developed for different types of medical institutions to reduce TB transmission and ensure the health of HCWs.
Highlights
According to the Global Tuberculosis Report from the World Health Organization (WHO), tuberculosis (TB) remains a major global health problem
Serial surveillance of latent TB infection (LTBI) and occupational infection control measures have been implemented as regular tasks in the TB infection control programs, and as a result, TB infections have clearly declined in number [6]; the situation is very different in low- and middle-income countries because of the high TB burden and limited resources [7,8,9,10]
Infection and the levels of personnel occupational protection among health care workers (HCWs) who directly engage in medical duties
Summary
According to the Global Tuberculosis Report from the World Health Organization (WHO), tuberculosis (TB) remains a major global health problem. With the emergence of extensively drug-resistant TB, efforts have refocused on TB infection control in healthcare facilities and occupational protection among health care workers (HCWs). Many high-income countries have offered detailed recommendations for latent TB infection (LTBI) screening and preventive therapy among HCWs in their TB guidelines [5]. In these countries, serial surveillance of LTBI and occupational infection control measures have been implemented as regular tasks in the TB infection control programs, and as a result, TB infections have clearly declined in number [6]; the situation is very different in low- and middle-income countries because of the high TB burden and limited resources [7,8,9,10]. A systematic review of 51 studies showed that the prevalence of LTBI and the annual incidence of TB disease in HCWs ranged from 33% to 79%and 69 to 5,780 per 100,000 in low- and middle-income countries, respectively [11]
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