Abstract
The aim of this work was to assess the prevalence of latent tuberculosis infection (LTBI) in multinational healthcare workers (HCWs) in Muhayil, Saudi Arabia. This work was carried out in 2013 and included all hired HCWs in Muhayil National Hospital (MNH), Muhayil, south of Saudi Arabia. Data were collected from HCWs including age, sex, job category, and country of citizenship. They were examined for LTBI using the tuberculin skin test (TST) after obtaining their consent to perform the test. CXR was also carried out in all participants to (and if needed sputum stain for Mycobacterium tuberculosis smear) for the detection of active disease. Statistical analysis was carried out, and P values less than 0.05 were considered significant. Out of the 208 HCWs tested with TST, 47 (22.5%) were positive. The prevalence of LTBI was the highest in the age group of 50 years or more [26.3% (n = 5)] and the lowest in the age group 20–29 years [19% (n = 14)]. The prevalence of LTBI was the highest in nurses [28.7% (n = 21)] and the lowest in physicians [16.5% (n = 7)]. The prevalence of LTBI was the highest in HCWs from the Philippines [27.5% (n = 23)] and the lowest in HCWs from the Middle East, Saudi Arabia, and Yemen [16.5% (n = 3)]. Signs suggestive of inactive TB were found in 10% of the participants (N = 21), and all of them were TST positive (44.5% of all TST-positive participants). LTBI is prevalent in HCWs in MNH, especially in nurses and in HCWs from countries with high rates of tuberculosis (Philippine and South Asia).
Highlights
Introduction and aim of the workAccording to the WHO, one-third of the world’s population is already infected with TB and every second, someone somewhere is newly infected with tuberculosis [1].Tuberculosis can be considered both a nosocomial and an occupational infection [2]
Most published data on latent tuberculosis infection (LTBI) in healthcare workers (HCWs) in Saudi Arabia were from hospitals of big cities such as Riyadh and Jeddah, and not much data are available for HCWs in remote areas such as Muhayil South of Saudi Arabia
The prevalence of positive TST according to countries of citizenship or region of HCWs was 16.5% (n = 4) in HCWs from Saudi Arabia, 27.5% (n = 23) in HCWs from the Philippines (OR: 1.9; 95% confidence interval (CI): 0.6, 6.2), 24.4% (n = 10) in HCWs from South Asia (OR: 1.6; 95% CI: 0.44, 5.85), 16.5% (n = 7) in HCWs from the Middle East (OR: 1; 95% CI: 0.26, 3.84), and 16.5% (n = 3) in HCWs from Yemen (OR: 1; 95% CI: 0.19, 5.15) (Tables 3 and 5)
Summary
According to the WHO, one-third of the world’s population is already infected with TB and every second, someone somewhere is newly infected with tuberculosis [1]. Tuberculosis can be considered both a nosocomial and an occupational infection [2]. TB in healthcare workers (HCWs) is often caused by an infection at their workplace [3]. Adequate infection control measures by the hospital authorities, high suspicion of tuberculosis by clinicians, and early identification of latent tuberculosis infection (LTBI) are necessary to prevent tuberculosis among HCWs [4]. Most published data on LTBI in HCWs in Saudi Arabia were from hospitals of big cities such as Riyadh and Jeddah, and not much data are available for HCWs in remote areas such as Muhayil South of Saudi Arabia Tuberculin skin test (TST) testing is an accepted inexpensive method for the detection of LTBI despite debates on its limitations and effectiveness in individuals recently vaccinated with BCG [5].
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