Tuberculosis in health care workers from a public health service in Santiago, Chile

Abstract

To evalúate the risk of tuberculosis (TBC) among health care workers (HCW) of the Southern Metropolitan Health Service (SMHS) of Santiago, Chile. A retrospective study using records of patients receiving TBC treatment in the SMHS from 2001 to 2006 was performed, in which HCW were identified. Total population of HCWs at risk was calculated using annual records of personnel hired at the SMHS. Data on TBC cases and rates were compared against data of the SMSH and hazard ratio (HR) and confidence intervals obtained. Fourteen cases were identified, predominantly among auxiliary personnel (n: 4, 35.7%), nursing staff and ambulance drivers (n: 2, 14.3%) each). Cases occurred in personnel from 41.7% of hospitals and 10.3% of ambulatory care centers within the SMHS and 92.2% involved personnel with direct patient care or contact. Pulmonary localization was seen in 11 (78.6%), and more than half (57.2%) had a positive sputum stain or culture. All cases initiated treatment, but 1 abandoned it and other died of liver failure associated to cirrhosis (7.1% each). Between 2003 and 2006, the annual rate of TBC among HCW ranged between 0 and 79 per 100.000, and during 2004 it was higher than the rate observed in SMHS (Hazard ratio 4.56; IC(95): 1.83-10.62). [corrected] Despite TBC rate decline in Chile, this disease still represents a significant occupational risk for HCW. Notably, more than half of cases among HCWs are contagious, and despite treatment, some have a lethal evolution.