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Apriani L, McAllister S, Sharples K, Alisjahbana B, Ruslami R, Hill PC, Menzies D. Latent tuberculosis infection in healthcare workers in low- and middle-income countries: an updated systematic review. Eur Respir J 2019; 53:13993003.01789-2018. [PMID: 30792341 DOI: 10.1183/13993003.01789-2018] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 01/17/2019] [Indexed: 12/13/2022]
Abstract
Healthcare workers (HCWs) are at increased risk of latent tuberculosis (TB) infection (LTBI) and TB disease.We conducted an updated systematic review of the prevalence and incidence of LTBI in HCWs in low- and middle-income countries (LMICs), associated factors, and infection control practices. We searched MEDLINE, Embase and Web of Science (January 1, 2005-June 20, 2017) for studies published in any language. We obtained pooled estimates using random effects methods and investigated heterogeneity using meta-regression.85 studies (32 630 subjects) were included from 26 LMICs. Prevalence of a positive tuberculin skin test (TST) was 14-98% (mean 49%); prevalence of a positive interferon-γ release assay (IGRA) was 9-86% (mean 39%). Countries with TB incidence ≥300 per 100 000 had the highest prevalence (TST: pooled estimate 55%, 95% CI 41-69%; IGRA: pooled estimate 56%, 95% CI 39-73%). Annual incidence estimated from the TST was 1-38% (mean 17%); annual incidence estimated from the IGRA was 10-30% (mean 18%). The prevalence and incidence of a positive test was associated with years of work, work location, TB contact and job category. Only 15 studies reported on infection control measures in healthcare facilities, with limited implementation.HCWs in LMICs in high TB incidence settings remain at increased risk of acquiring LTBI. There is an urgent need for robust implementation of infection control measures.
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Affiliation(s)
- Lika Apriani
- TB-HIV Research Centre, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia .,Dept of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.,Centre for International Health, Dept of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Susan McAllister
- Centre for International Health, Dept of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Katrina Sharples
- Centre for International Health, Dept of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.,Dept of Mathematics and Statistics, University of Otago, Dunedin, New Zealand
| | - Bachti Alisjahbana
- TB-HIV Research Centre, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.,Dept of Internal Medicine, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Rovina Ruslami
- TB-HIV Research Centre, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia.,Dept of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Philip C Hill
- Centre for International Health, Dept of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Dick Menzies
- Montreal Chest Institute, McGill University Montreal, Montreal, QC, Canada
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Johnkennedy N, Onyinyechi AS, Chukwunyere NE. The antioxidant status and lipid peroxidation product of newly diagnosed and 6 weeks follow–up patients with pulmonary tuberculosis in Owerri, Imo state, Nigeria. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2011. [DOI: 10.1016/s2222-1808(11)60069-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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