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Original Article

Korean J healthc assoc Infect Control Prev 2019; 24(2): 52-59

Published online December 31, 2019 https://doi.org/10.14192/kjicp.2019.24.2.52

Copyright © Korean Society for Healthcare-associated Control and Prevention.

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Prevalence and Risk Factors of Latent Tuberculosis Infection among Healthcare Workers

Sunhong Lee1, Ye Li Lee2, Yong Chan Kim1, Eun Jin Kim1, Jung Yeon Heo1, Young Hwa Choi1

Department of Infectious Diseases, Ajou University School of Medicine1, Infection Control Unit, Ajou University Medical Center2, Suwon, Korea

Received: October 25, 2019; Revised: November 23, 2019; Accepted: December 6, 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Due to occupational exposure, healthcare workers (HCW) face an increased risk of tuberculosis (TB) infection. This study was conducted to assess the prevalence and risk factors of latent tuberculosis infection (LTBI), and to estimate the cumulative risk of active TB among HCWs.
Methods: We conducted a cross-sectional study among HCWs in Ajou university medical center. A standard questionnaire was used for data collection, and LTBI was detected using the Interferon gamma-release assay (IGRA). The biographical information was collected from the electronic database. A computerized algorithm was used to evaluate the predicted cumulative risk of active TB in HCWs with LTBI.
Results: Of a total of 1,407 HCWs, a positive IGRA result was detected in 138 HCWs. The prevalence of LTBI in HCWs was found to be 9.8% [95% confidence interval (CI) 8.2-11.4]. It was observed that the prevalence of LTBI increased with age (P value<0.001). However, it was also observed that duration of the working periods in a TB-related department was not associated with LTBI (P value=0.369). According to the multivariate analysis, an increased risk of LTBI was observed among participants aged ≥ 50 years [odds ratio (OR) 7.522, 95% CI 3.56-15.89] and nursing assistants (OR 2.912, 95% CI 1.283-6.608). The median cumulative risk of active TB with LTBI was estimated to be 4.31% [interquartile range (IQR) 3.435.29], and 4.41% (IQR 3.14-5.29) in HCWs with and without work experience in TB-related department, respectively. No significant difference was observed between two groups (P value=0.715).
Conclusion: The prevalence of LTBI among HCWs may not be higher than that of individuals in other group facilities. It may be necessary to revise the treatment recommendations, which are classified based on the risk for LTBI associated with departments and locations of work.

Keywords: Healthcare workers, IGRA, Latent tuberculosis infection, Risk factor, Tuberculosis

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