Vigilância da Tuberculose nos Profissionais de Saúde como contributo na erradicação de uma Pandemia

Abstract

Introduction/Framework Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. Despite the available treatment, it’s an important driver of global morbidity and mortality. It reaches mainly the lungs but can reach any organ. The main route of infection is inhalation of aerosolized particles or contaminated micro-droplets. Global efforts for early diagnosis and adequate treatment have made it possible to remove Tuberculosis from the worldwide ten leading causes of death in 2019. The worldwide incidence is around ten million, probably underestimated. Tuberculosis represents an often-overlooked pandemic, which remains an important cause of death from an infectious disease whose, in contrast to other infections, incidence has recently risen as occupational disease. Methodology It’s a narrative review of the national and international guidelines about Tuberculosis in healthcare workers, with an adaptation to the Portuguese reality using estimations from countries with a similar disease incidence. Contents The World Health Organization argues that the benefit of screening and treating Latent Tuberculosis Infection outweighs the individual risks and therefore should be performed whenever possible. Following these guidelines, the Portuguese health council (Direção-Geral da Saúde) determined that health institutions, within the scope of health surveillance of their workers, must adopt procedures that allow for the early detection of Tuberculosis and Latent Tuberculosis Infection. Thus, the Occupational Medicine Services are responsible for assessing and manage the professional exposure to this biological agent. The End TB Strategy program aspires to the worldwide eradication of Tuberculosis by 2035, aiming to reduce Tuberculosis incidence and mortality by 80 and 95%, respectively, as well as universal access to proper treatment. Discussion and Conclusions The authors argue that the institutional contribution with the reinforcement of hospital infection control measures, the implementation of regular occupational Tuberculosis surveillance programs and the containment of the disease, through timely screening after unprotected exposure, are essentials measures for the achievement of the ambitious outlined goals. Regardless of their job model, these programs should be applied to all workers, contributing to the maintenance of their health, the main Occupational Medicine’s goal. Finally, the authors share ten common questions from daily basis clinical practice and present methodological suggestions. KEY-WORDS: Labor Health Surveillance; Healthcare workers; Prevention of Occupational Diseases; Screening; Tuberculosis; Latent Tuberculosis Infection.