Abstract
Cancer patients are at higher risk of tuberculosis (TB) infection, especially in hospital settings with high TB/HIV burden. The study was implemented among adult patients admitted to the largest tertiary-level referral hospital in Botswana. We estimated the TB prevalence at admission and the rate of newly diagnosed TB after hospitalization in the medical and oncology wards, separately. Presumptive TB cases were identified at admission through symptom screening and underwent the diagnostic evaluation through GeneXpert. Patients with no evidence of TB were followed-up until TB diagnosis or the end of the study. In the medical and oncology wards, four of 867 admitted patients and two of 240 had laboratory-confirmed TB at admission (prevalence = 461.4 and 833.3 per 100,000, respectively.) The post-admission TB rate from the medical wards was 28.3 cases per 1,000 person-year during 424.5 follow-up years (post-admission TB rate among HIV-positive versus. -negative = 54.1 and 9.8 per 1,000 person-year, respectively [Rate Ratio = 5.5]). No post-admission TB case was detected from the oncology ward. High rates of undetected TB at admission at both medical and oncology wards, and high rate of newly diagnosed TB after admission at medical wards suggest that TB screening and diagnostic evaluation should target all patients admitted to a hospital in high-burden settings.
Highlights
Nosocomial transmission of tuberculosis (TB) has remained a persistent problem in low resource settings.[1, 2] Overcrowding and limited implementation of infection control practices make healthcare facilities highly vulnerable to TB transmission.[3]
Botswana is a country of hyper-endemic for TB and HIV, with the TB incidence rate of 326 per 100,000 and about 70% of TB patients were co-infected with HIV/AIDS.(9, 10) According to the Botswana National TB Program (BNTP) guidelines, all patients aged 15 years or older are screened for TB symptoms at healthcare facilities on their admission
This corresponds to a yield of lab-confirmed TB at admission of 0.5% (4/867) or 461.4 per 100,000 and 0.8% (2/240) or 833.3 per 100,000 (95%confidence intervals (CI) = 139.6–2726) in the medical and oncology wards, respectively. (Fig 1) Among the six prevalent TB cases, two patients from the medical wards were HIV positive
Summary
Nosocomial transmission of tuberculosis (TB) has remained a persistent problem in low resource settings.[1, 2] Overcrowding and limited implementation of infection control practices make healthcare facilities highly vulnerable to TB transmission.[3].
Sign-in/Register to view highlights & summary 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 callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
