Tuberculosis Among Health Care Workers

Overview

Journal Emerg Infect Dis

Specialty Infectious Diseases

Date 2011 Mar 12

PMID 21392441

Citations 140

Authors

Iacopo Baussano

Paul Nunn

Brian Williams

Emanuele Pivetta

Massimiliano Bugiani

Fabio Scano

Affiliations

Soon will be listed here.

Abstract

To assess the annual risk for latent tuberculosis infection (LTBI) among health care workers (HCWs), the incidence rate ratio for tuberculosis (TB) among HCWs worldwide, and the population-attributable fraction of TB to exposure of HCWs in their work settings, we reviewed the literature. Stratified pooled estimates for the LTBI rate for countries with low (<50 cases/100,000 population), intermediate (50-100/100,000 population), and high (>100/100,000 population) TB incidence were 3.8% (95% confidence interval [CI] 3.0%-4.6%), 6.9% (95% CI 3.4%-10.3%), and 8.4% (95% CI 2.7%-14.0%), respectively. For TB, estimated incident rate ratios were 2.4 (95% CI 1.2-3.6), 2.4 (95% CI 1.0-3.8), and 3.7 (95% CI 2.9-4.5), respectively. Median estimated population-attributable fraction for TB was as high as 0.4%. HCWs are at higher than average risk for TB. Sound TB infection control measures should be implemented in all health care facilities with patients suspected of having infectious TB.

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References

Menzies D, Joshi R, Pai M . Risk of tuberculosis infection and disease associated with work in health care settings. Int J Tuberc Lung Dis. 2007; 11(6):593-605. View

Babus V . Tuberculosis morbidity risk in medical nurses in specialized institutions for the treatment of lung diseases in Zagreb. Int J Tuberc Lung Dis. 1997; 1(3):254-8. View

Rao K, Aggarwal A, Behera D . Tuberculosis among physicians in training. Int J Tuberc Lung Dis. 2004; 8(11):1392-4. View

Menzies D, Fanning A, Yuan L, Fitzgerald M . Tuberculosis among health care workers. N Engl J Med. 1995; 332(2):92-8. DOI: 10.1056/NEJM199501123320206. View

Raviglione M, Uplekar M . WHO's new Stop TB Strategy. Lancet. 2006; 367(9514):952-5. DOI: 10.1016/S0140-6736(06)68392-X. View

Jensen P, Lambert L, Iademarco M, Ridzon R . Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005. MMWR Recomm Rep. 2005; 54(RR-17):1-141. View

Seidler A, Nienhaus A, Diel R . Review of epidemiological studies on the occupational risk of tuberculosis in low-incidence areas. Respiration. 2005; 72(4):431-46. DOI: 10.1159/000086261. View

Wright A, Zignol M, Van Deun A, Falzon D, Gerdes S, Feldman K . Epidemiology of antituberculosis drug resistance 2002-07: an updated analysis of the Global Project on Anti-Tuberculosis Drug Resistance Surveillance. Lancet. 2009; 373(9678):1861-73. DOI: 10.1016/S0140-6736(09)60331-7. View

Joshi R, Reingold A, Menzies D, Pai M . Tuberculosis among health-care workers in low- and middle-income countries: a systematic review. PLoS Med. 2006; 3(12):e494. PMC: 1716189. DOI: 10.1371/journal.pmed.0030494. View

10.

Kim S, Lee S, Kim I, Kim H, Kim S, Rieder H . Risk of occupational tuberculosis in National Tuberculosis Programme laboratories in Korea. Int J Tuberc Lung Dis. 2007; 11(2):138-42. View

11.

Menzies D, Fanning A, Yuan L, FitzGerald J . Factors associated with tuberculin conversion in Canadian microbiology and pathology workers. Am J Respir Crit Care Med. 2002; 167(4):599-602. DOI: 10.1164/rccm.200208-873BC. View

12.

Boudreau A, Baron S, Steenland N, Van Gilder T, Decker J, Galson S . Occupational risk of Mycobacterium tuberculosis infection in hospital workers. Am J Ind Med. 1997; 32(5):528-34. DOI: 10.1002/(sici)1097-0274(199711)32:5<528::aid-ajim14>3.0.co;2-4. View

13.

Yanai H, Limpakarnjanarat K, Uthaivoravit W, Mastro T, Mori T, Tappero J . Risk of Mycobacterium tuberculosis infection and disease among health care workers, Chiang Rai, Thailand. Int J Tuberc Lung Dis. 2003; 7(1):36-45. View

14.

Sepkowitz K . Tuberculosis and the health care worker: a historical perspective. Ann Intern Med. 1994; 120(1):71-9. DOI: 10.7326/0003-4819-120-1-199401010-00012. View

15.

Levin M . The occurrence of lung cancer in man. Acta Unio Int Contra Cancrum. 1953; 9(3):531-41. View

16.

Normand S . Meta-analysis: formulating, evaluating, combining, and reporting. Stat Med. 1999; 18(3):321-59. DOI: 10.1002/(sici)1097-0258(19990215)18:3<321::aid-sim28>3.0.co;2-p. View

17.

Gopinath K, Siddique S, Kirubakaran H, Shanmugam A, Mathai E, Chandy G . Tuberculosis among healthcare workers in a tertiary-care hospital in South India. J Hosp Infect. 2004; 57(4):339-42. DOI: 10.1016/j.jhin.2004.03.029. View

18.

Dimitrova B, Hutchings A, Atun R, Drobniewski F, Marchenko G, Zakharova S . Increased risk of tuberculosis among health care workers in Samara Oblast, Russia: analysis of notification data. Int J Tuberc Lung Dis. 2005; 9(1):43-8. View

19.

Fica C A, Cifuentes D M, Ajenjo H M, Jemenao P M, Zambrano O A, Febre V N . [Tuberculosis in healthcare workers]. Rev Chilena Infectol. 2008; 25(4):243-55. DOI: /S0716-10182008000400001. View

20.

Harries A, Kamenya A, Namarika D, Msolomba I, Salaniponi F, Nyangulu D . Delays in diagnosis and treatment of smear-positive tuberculosis and the incidence of tuberculosis in hospital nurses in Blantyre, Malawi. Trans R Soc Trop Med Hyg. 1997; 91(1):15-7. DOI: 10.1016/s0035-9203(97)90376-x. View