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Mohammed EA, Alotaibi HA, Alnemari JF, Althobiti MS, Alotaibi SS, Ewis AA, El-Sheikh AAK, Abdelwahab SF. Assessment of Knowledge, Attitude, and Practice towards Tuberculosis among Taif University Students. Healthcare (Basel) 2023; 11:2807. [PMID: 37893881 PMCID: PMC10606274 DOI: 10.3390/healthcare11202807] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/29/2023] [Accepted: 10/21/2023] [Indexed: 10/29/2023] Open
Abstract
Tuberculosis (TB) remains a significant public health concern worldwide. Given the dense living and interactive nature of university environments, students may be at higher risk. This cross-sectional study assessed tuberculosis-related knowledge, attitudes, and practices (KAP) among students at Taif University (TU) from November 2022 to May 2023. Using a self-administered online questionnaire with 40 items, 1155 students participated. Key demographics: 68.2% females, 96.9% Saudi citizens, 94.5% unmarried, and 87.5% non-smokers. Of the respondents, 26.5% had no knowledge of TB. The TB-related KAP scores among the aware students were 64.9%, 74.8%, and 81%, respectively. Medical college students exhibited significantly higher TB-related knowledge and attitudes than their non-medical peers (p < 0.001). The findings indicate a commendable level of TB-awareness among TU students, but there remains a substantial uninformed segment. Campaigns to enhance TB knowledge among TU students are suggested.
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Affiliation(s)
- Eilaf A. Mohammed
- College of Pharmacy, Taif University, Taif 21944, Saudi Arabia; (E.A.M.); (H.A.A.); (J.F.A.); (M.S.A.); (S.S.A.)
| | - Huriyyah A. Alotaibi
- College of Pharmacy, Taif University, Taif 21944, Saudi Arabia; (E.A.M.); (H.A.A.); (J.F.A.); (M.S.A.); (S.S.A.)
| | - Joud F. Alnemari
- College of Pharmacy, Taif University, Taif 21944, Saudi Arabia; (E.A.M.); (H.A.A.); (J.F.A.); (M.S.A.); (S.S.A.)
| | - Meznah S. Althobiti
- College of Pharmacy, Taif University, Taif 21944, Saudi Arabia; (E.A.M.); (H.A.A.); (J.F.A.); (M.S.A.); (S.S.A.)
| | - Shumukh S. Alotaibi
- College of Pharmacy, Taif University, Taif 21944, Saudi Arabia; (E.A.M.); (H.A.A.); (J.F.A.); (M.S.A.); (S.S.A.)
| | - Ashraf A. Ewis
- Department of Public Health, Faculty of Health Sciences, Umm Al-Qura University, Makkah 21912, Saudi Arabia;
| | - Azza A. K. El-Sheikh
- Basic Health Sciences Department, College of Medicine, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia;
| | - Sayed F. Abdelwahab
- Department of Pharmaceutics and Industrial Pharmacy, College of Pharmacy, Taif University, Taif 21944, Saudi Arabia
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Almugti HS, Alfaleh HM, Alshehri TM, Mokili KQ, Al Qahtani AAM, Al Qahtani HS, Alsayed MZ, Al Asmari MA, Al Asiri MM, Al Amri MA, Al Fadhil AF, Al Qahtani BA, Al Bakrah ES, Shaikh HA, Al Shiq MG, Al Shaik YA. Management of Latent Tuberculosis Infection in Saudi Arabia: Knowledge and Perceptions Among Healthcare Workers. Cureus 2022; 14:e29134. [PMID: 36259033 PMCID: PMC9564560 DOI: 10.7759/cureus.29134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2022] [Indexed: 11/05/2022] Open
Abstract
Background Tuberculosis (TB) continues to pose a serious threat to public health despite great efforts. For many years, management and screening for active TB cases have been the main focus of TB control programs. Latent TB is a stage where TB can be prevented and controlled. Therefore, designing a comprehensive TB control program that includes latent tuberculosis infection (LTBI) management diseases is needed to be implemented among the healthcare workers (HCWs) who have been found to be at a higher risk for active TB compared to the general population. The objective of the study The objective of the study is to assess the knowledge and perceptions of LTBI among HCWs. In addition to estimating the prevalence of LTBI among HCWs using closed-end questions in a self-administered questionnaire. Subjects and methods Through a cross-sectional study and non-random sampling technique, 324 (84%) healthcare workers who met the inclusion criteria completed and submitted the electronic questionnaire. Results Among all participants, the study reported a good knowledge about LTBI; however, a third of HCWs had poor knowledge about the difference between LTBI and active TB. Eighteen percent of participants were diagnosed with LTBI, and two-thirds accepted the treatment. Of all participants who started the treatment, 55% completed the treatment course. The compliance rate was high among young HCWs and physicians who had a short course of LTB treatment regimen. Conclusion The study reported a low acceptance and completion rate of LTBI therapy among HCWs. Low knowledge about some clinical facts of LTBI, the long duration of treatment, and being the treatment optional in Saudi health institutes were all barriers to accepting and completing the treatment of LTBI. All of these factors need to be addressed to increase the compliance rate to LTBI treatment.
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Corbett C, Kalmambetova G, Umetalieva N, Ahmedov S, Antonenka U, Myrzaliev B, Sahalchyk E, Vogel M, Kadyrov A, Hoffmann H. QuantiFERON-TB Gold plus testing for the detection of LTBI among health care workers in major TB hospitals of the Northern Kyrgyz Republic. BMC Infect Dis 2022; 22:180. [PMID: 35197008 PMCID: PMC8867784 DOI: 10.1186/s12879-022-07149-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 02/12/2022] [Indexed: 11/24/2022] Open
Abstract
Background Health care workers (HCW) are at increased risk of TB infection due to their close contact with infected patients with active TB. The objectives of the study were (1) to assess the prevalence of LTBI among HCW in the Northern Kyrgyz Republic, and (2) to determine the association of LTBI with job positions or departments. Methods HCWs from four TB hospitals in the Northern Kyrgyz Republic were tested with the interferon-gamma release assay (IGRA) Quantiferon-TB Gold plus (QFT) for the detection of an immune response to TB as marker of TB infection. Age was controlled for as a confounder. Univariate and multivariable analysis were performed using logistic regression to assess the association of the risk factors (job position, and department) with having a QTF positive result. Firth’s penalized-likelihood estimates were used to account for the small-sample size. Pairwise comparisons using the Bonferroni correction (conservative) and comparisons without adjusting for multiple comparisons (unadjusted) were used to identify the categories where differences occurred. Results QFT yielded valid results for 404 HCW, with 189 (46.7%) having a positive test. In the National Tuberculosis Center there was an increased odds to have a positive QFT test for the position of physician (OR = 8.7, 95%, CI = 1.2–60.5, p = 0.03) and laboratory staff (OR = 19.8, 95% CI = 2.9–135.4, p < 0.01) when administration staff was used as the baseline. When comparing departments for all hospitals combined, laboratories (OR 7.65; 95%CI 2.3–24.9; p < 0.001), smear negative TB (OR 5.90; 95%CI 1.6–21.8; p = 0.008), surgery (OR 3.79; 95%CI 1.3–11.4; p = 0.018), and outpatient clinics (OR 3.80; 95%CI 1.1–13.0; p = 0.03) had higher odds of a positive QFT result than the admin department. Fifteen of the 49 HCW with follow-up tests converted from negative to positive at follow-up testing. Conclusions This is the first report on prevalence and risk factors of LTBI for HCW in the Kyrgyz republic, and results indicate there may be an increased risk for LTBI among physicians and laboratory personnel. Further research should investigate gaps of infection control measures particularly for physicians and laboratory staff and lead to further improvement of policies.
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Affiliation(s)
- Caroline Corbett
- Institute of Microbiology and Laboratory Medicine, Department IML Red GmbH, WHO, Supranational Tuberculosis Reference Laboratory, Robert-Koch-Allee 2, Gauting, 82131, Munich, Germany.
| | | | - Nagira Umetalieva
- Institute of Microbiology and Laboratory Medicine, Department IML Red GmbH, WHO, Supranational Tuberculosis Reference Laboratory, Robert-Koch-Allee 2, Gauting, 82131, Munich, Germany.,Republican Tuberculosis Reference Laboratory, Bishkek, Kyrgyzstan
| | - Sevim Ahmedov
- USAID, Bureau for Global Health, TB Division, Washington, DC, USA
| | - Uladzimir Antonenka
- Institute of Microbiology and Laboratory Medicine, Department IML Red GmbH, WHO, Supranational Tuberculosis Reference Laboratory, Robert-Koch-Allee 2, Gauting, 82131, Munich, Germany
| | - Bakyt Myrzaliev
- KNCV Branch Office in the Kyrgyz Republic, Bishkek, Kyrgyzstan
| | - Evgeni Sahalchyk
- Institute of Microbiology and Laboratory Medicine, Department IML Red GmbH, WHO, Supranational Tuberculosis Reference Laboratory, Robert-Koch-Allee 2, Gauting, 82131, Munich, Germany
| | - Monica Vogel
- Institute of Microbiology and Laboratory Medicine, Department IML Red GmbH, WHO, Supranational Tuberculosis Reference Laboratory, Robert-Koch-Allee 2, Gauting, 82131, Munich, Germany
| | - Abdylat Kadyrov
- Republican Tuberculosis Center, National TB Program, Bishkek, Kyrgyzstan
| | - Harald Hoffmann
- Institute of Microbiology and Laboratory Medicine, Department IML Red GmbH, WHO, Supranational Tuberculosis Reference Laboratory, Robert-Koch-Allee 2, Gauting, 82131, Munich, Germany.,SYNLAB Gauting, SYNLAB MVZ Humane Genetics, Munich, Germany
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Tuberculosis infection status and risk factors among health workers: an updated systematic review. Ann Occup Environ Med 2021; 33:e17. [PMID: 34754478 PMCID: PMC8205617 DOI: 10.35371/aoem.2021.33.e17] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 05/14/2021] [Indexed: 11/20/2022] Open
Abstract
Tuberculosis (TB) infection is a common occupational risk for health workers (HWs) and poses a threat to the patients under their care and to other HWs. Hence, the development of a prevention strategy is crucial. We conducted a study to understand the status and risk factors of TB infection among HWs. The existing literature was searched for all published reports from 1 August 2010 to 31 December 2018, related to TB among HWs according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The inclusion criteria were: (1) study participants working in a health care facility; (2) TB cases diagnosed by medical professionals; (3) original research articles; and (4) English reports in a peer-reviewed journal. We finally included 61 studies from 642 articles searched initially. The TB infection rate in HWs was higher than that of the general population. Based on 39 studies, the prevalence of TB in HWs (tuberculin skin test positive) was 29.94%. In contrast, the global burden of latent TB infection was 23.0% (95% uncertainty interval: 20.4%–26.4%) in 2014. The risk factors of TB among HWs were aging, long duration of employment, nursing professionals, lack of Bacillus Calmette-Guerin vaccination, and low body mass index. HWs have an increased risk for TB infection, which can cause secondary infections in patients or other HWs. An effective prevention strategy must be developed to enable early diagnosis and prompt treatment.
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Al-Sohaim A, Bawazir AS, Al-Turki T, Alsafi EO, Al-Roqy A, Layqah L, Baharoone SA. The risk of tuberculosis infection in 410 Saudipatients receiving adalimumab therapy. Ann Saudi Med 2021; 41:285-292. [PMID: 34618606 PMCID: PMC8497010 DOI: 10.5144/0256-4947.2021.285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Adalimumab is a fully humanized monoclonal antibody inhibitor of tumor necrosis factor-a used to treat various autoimmune disorders. Adalimumab poses a risk for tuberculosis (TB) infection, especially in countries where TB is endemic. OBJECTIVE Determine the rate of TB infection after adalimumab therapy in Saudi Arabia. DESIGN Medical record review. SETTINGS Tertiary care center in Riyadh. PATIENTS AND METHODS Demographic and clinical data were retrieved from the electronic healthcare records of all patients who received adalimumab treatment from 2015 to 2019. MAIN OUTCOME MEASURES Occurrence of TB after adalimumab therapy. SAMPLE SIZE 410 patients (median ([QR] age, 37 [28], range 4-81 years), 40% males RESULTS: Rheumatoid arthritis was the most frequent indication (n=153, 37%). The patients were followed for a mean of 36 (8.9) months. No case of TB infection or reactivation was observed. An inter-feron-gamma release assay (IGRA) was requested in 353/391 (90.3%) patients, prior to initiating therapy. The IGRA was positive in 26 cases (6.6%). The IGRA-positive patients received isoniazid prophylactically. Bacterial infectious complications of adalimumab therapy occurred in 12 (2.9%) patients. Urinary tract infection was the most frequent complication (culture requested in 48 patients, positive in 8). CONCLUSION Adalimumab treatment was not associated with a risk of TB disease or TB reactivation in our cohort over the follow-up observation period. No TB reactivation occurred with adalimumab therapy when TB prophylaxis was used. The positive IGRA rate in patients on adalimumab treatment was low (7%). LIMITATIONS Single center and one geographical area in Saudi Arabia. CONFLICT OF INTEREST None.
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Affiliation(s)
- Abdullah Al-Sohaim
- From the Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | | | - Turki Al-Turki
- From the Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Eiman Omar Alsafi
- From the Department of Quality Management, King Saud Chest Specialty Hospital, Riyadh, Saudi Arabia
| | - Abdullah Al-Roqy
- From the Department of Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Layla Layqah
- From the Research Office, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,From the King Saud bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Salim Alawi Baharoone
- From the Department of Intensive Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia
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Kadivar M, Kabir-Mokamelkhah E, Habibi-Shams Z. Work-related Hazards Among Pathologists and Residents of Pathology:Results of a Cross-sectional Study in Iran. IRANIAN JOURNAL OF PATHOLOGY 2021; 16:274-283. [PMID: 34306123 PMCID: PMC8298058 DOI: 10.30699/ijp.2021.132380.2473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/11/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND & OBJECTIVE Pathologists as medical professionals involved in the diagnosis and planning of therapies in many diseases are exposed to occupational hazards in workplaces. Hence, we aimed to determine the occupational health problems among Iranian pathologists in this cross-sectional study. METHODS This cross-sectional study was conducted among the Iranian pathologists. The data required for this study was collected through a self-reported questionnaire containing 48 questions about major occupational health problems, including musculoskeletal problems, visual disorders, workplace characteristics, health behavior, and other medical conditions. RESULTS Among the study participants (N=350), 87.4% presented with musculoskeletal disorders in the past year, with the neck as the most common location of pain (71%). Musculoskeletal pain was significantly higher in those working with the computer for more than 5 hours per day (P=0.007). Furthermore, 273 (78%) participants reported visual refractive errors, and myopia was the most common error (53%). Acute injuries were reported in 263 (75%) participants, and the cutting injury had the highest frequency (56.6%). Depression was reported in 54 (15.4%) of the participants, followed by burnout (10.3%) and hypertension (4%). Intolerance reactions to formalin were reported by 222 (63.6%) and were significantly more frequent among the residents (P<0.001). The residents were more prone to musculoskeletal pain (P=0.002) and injury (P=0.026). CONCLUSION We observed a noticeable prevalence of health risks, including musculoskeletal problems, visual disturbances, injuries, and ergonomic problems among the Iranian pathologists. Solving these problems demands thorough prevention and personal protection, as well as educational programs with more attention toward optimization of ergonomics in the workplace and awareness about chemical and biological hazards.
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Affiliation(s)
- Maryam Kadivar
- Department of Pathology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Zohreh Habibi-Shams
- Department of Pathology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Prevalence of Latent Tuberculosis Infection in the Middle East and North Africa: A Systematic Review. Pulm Med 2021; 2021:6680651. [PMID: 33564476 PMCID: PMC7864757 DOI: 10.1155/2021/6680651] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 01/08/2021] [Accepted: 01/12/2021] [Indexed: 11/25/2022] Open
Abstract
Objective Data on the prevalence of latent tuberculosis infection (LTBI) in Middle Eastern and North African countries are scarce. We aimed to review all relevant published data in countries belonging to this region to determine the overall prevalence of LTBI in the Middle East and North Africa (MENA) region. Methods In this systematic review PubMed and Google Scholar databases were searched for observational, prospective, retrospective, cross-sectional, and cohort studies providing prevalence data of LTBI in any MENA country. Studies fulfilling the search criteria were incorporated in the review. Overall prevalence of LTBI with 95% confidence intervals (CI) was calculated using the random-effects model; heterogeneity was assessed using I2 statistics. Gender and age group-based subgroup analyses were performed to evaluate the basis of heterogeneity. Results The total number of overall LTBI studies identified was 956, of which 31 studies from ten countries within the MENA region were included that represented 12,439 subjects. The overall prevalence was 41.78% (95% CI 31.18% to 52.78%, I2 = 99.31%). By gender-based subgroup analysis, the prevalence of LTBI was 33.12% (95% CI 18.97% to 49.04%, I2 = 99.25%) and 32.65% (95% CI 19.79% to 47%, I2 = 98.89%) in males and females, respectively, while in the age-based subgroup analysis, the prevalence of LTBI was 0.44% (95% CI -0.05% to 0.9%), 3.37% (95% CI 2.23% to 4.74%, I2 = 0%), and 43.81% (95% CI 33.09% to 54.82%, I2 = 99.18%) for children, adolescents, and adults, respectively. Conclusion This systematic review reveals a high prevalence of LTBI in the MENA region; enhanced LTBI surveillance and prompt infection prevention steps are urgently needed to prevent active tuberculosis, this would help achieve the World Health Organization End TB Strategy 2035, and the United Nations Sustainable Development Goals 2030 target in the MENA region.
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Wardani HR, Mertaniasih NM, Soedarsono S. RISK FACTORS OF LATENT TUBERCULOSIS INFECTION IN HEALTHCARE WORKERS AT HOSPITALS IN JEMBER CITY INDONESIA. Afr J Infect Dis 2020; 15:34-40. [PMID: 33884356 PMCID: PMC8047285 DOI: 10.21010/ajid.v15i1.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/16/2020] [Accepted: 10/19/2020] [Indexed: 12/24/2022] Open
Abstract
Background: Healthcare workers in Tuberculosis (TB) and non-TB units in hospitals have a high risk of experiencing Latent Tuberculosis Infection (LTBI), because of exposure to droplets containing Mycobacterium tuberculosis. This study aims to prove LTBI incidence and risk factors to healthcare workers at the hospital in Jember City. Material and Methods: a cross-sectional study, from January to March 2020 in two hospitals in Jember City. Healthcare workers in the TB care and non-TB care unit were examined using Tuberculin skin test (TST) with a cut off ≥ 10 mm for positive LTBI. Chest x-ray and clinical examination to rule out active TB and a standardized questionnaire were also used. Results: 128 healthcare workers completed the questionnaires, clinical, tuberculin skin test (TST), and chest x-ray data. LTBI incidence of positive results 61.7% (n = 79). Contacts TB in the workplace (p value = 0.219; OR = 1.643; CI = 0.742-3.641) and a unit of work (p value = 0.102; OR = 0.760; CI = 0.559-1.031) has no relationship with LTBI. The profession (p value = 0.020; OR = 1.112; CI = 0.896-1.403), the duration of the work (p value = 0.039; OR = 2.984; CI = 1.067-8.342), and BCG immunization (p value =0.000; OR = 0.151; CI = 0.052-0.438) have important relationships with LTBI. Conclusion: TB infection with a high incidence, a risk of transmission to healthcare workers, and a relationship between occupational risk factors and LTBI among healthcare workers in Jember City, Indonesia have been established in this study.
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Affiliation(s)
- Hamidah Retno Wardani
- Student of Master Program of Tropical Medicine, Faculty of Medicine, Universitas Airlangga, Jl. Mayjen. Prof. Dr. Moestopo No. 47, Surabaya 60131, Indonesia
| | - Ni Made Mertaniasih
- Department of Clinical Microbiology, Faculty of Medicine, Universitas Airlangga, Jl. Mayjen. Prof. Dr. Moestopo No. 47, Surabaya 60131, Indonesia
| | - Soedarsono Soedarsono
- Department of Pulmonology, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo Hospital, Jl. Mayjen. Prof. Dr. Moestopo No. 47, Surabaya 60131, Indonesia
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Risk Analysis of Latent Tuberculosis Infection among Health Workers Compared to Employees in Other Sectors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134643. [PMID: 32605191 PMCID: PMC7370114 DOI: 10.3390/ijerph17134643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/22/2020] [Accepted: 06/24/2020] [Indexed: 11/16/2022]
Abstract
Latent tuberculosis infection (LTBI) represents a work-related risk for health workers (HWs). Tuberculosis remains the second most common occupational infectious disease among HWs in Germany. Comparative figures on LTBI prevalence in the general population are missing because testing is only carried out in the context of an outbreak situation. The objective of this study is to investigate whether HWs are at greater risk of LTBI than workers in other sectors. This study is based on two samples. The first sample is a database of HWs who were examined by the German Occupational Physicians Network using an interferon-gamma release assay (IGRA). The second sample consists of general employees (non-health workers, non-HWs) from Hamburg who had no professional contact with the health care system. Propensity score matching (PS matching) was performed to ensure better comparability of the groups. The differences in the prevalence of positive test results from IGRAs were examined using univariate and multivariate analyses. After the PS matching of 1:10, 100 test subjects in the non-HW group and 1000 HWs remained to form the analysis collective. The HWs tended to exhibit higher IGRA values than non-HWs. The univariate analysis showed an odds ratio (OR) of 3.86 for the HWs (95% confidence interval (CI): 0.99 to 32.5; p = 0.056) with respect to a positive test result. The multivariate analysis produced an OR of 4.92, (95% CI: 1.3 to 43.7; p = 0.013) for HWs born in Germany. Despite the declining tuberculosis incidence rates in Germany, a comparison with non-exposed professional groups showed that HWs are at greater risk of LTBI. Preventive medical check-ups still seem to be indicated.
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Almohaya A, Aldrees A, Akkielah L, Hashim AT, Almajid F, Binmoammar T, Barry MA. Latent tuberculosis infection among health-care workers using Quantiferon-TB Gold-Plus in a country with a low burden for tuberculosis: prevalence and risk factors. Ann Saudi Med 2020; 40:191-199. [PMID: 32493098 PMCID: PMC7270624 DOI: 10.5144/0256-4947.2020.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Health-care workers (HCW) are susceptible to latent tuberculosis infection (LTBI). The prevalence of LTBI in HCW in Saudi Arabia has not been reported using the fourth-generation interferon gamma release assay QuantiFERON-TB Gold Plus (QFT-Plus). OBJECTIVE Determine the prevalence of LTBI in a large heterogeneous HCW population and assess risk factors for LTBI. DESIGN Cross-sectional and case-control study. SETTING Tertiary academic hospital, Riyadh, Saudi Arabia. PATIENTS AND METHODS Medical records of HCWs who had QFT-Plus performed between January to December 2018 were reviewed and included in the cross-sectional study. In a subset analysis, randomly selected positive QFT-Plus cases were compared with controls selected from the same areas of work. Univariate and binary logistic regression analyses were performed to assess the significance of other factors to QFT-PLus positivity. MAIN OUTCOME MEASURES Prevalence of LTBI in HCWs and potential risk factors for LTBI. SAMPLE SIZE 3024 HCWs in the cross-sectional analysis; 294 cases and 294 controls in the case-control analysis. RESULTS Twenty-four percent (n=733) of the HCWs had a positive QFT-Plus. The median (interquartile range) age was 34.0 (31.0-37.1) years, 71% were female, and only 24.8% were of Saudi nationals. Nursing represented 57.7% of HCWs, and 24.7% were working in a non-clinical area. Only 20.3% worked in TB-related departments. A higher risk of LTBI was present in HCWs who were older than 50 years (OR=1.95), from either Philippines (OR=4.7) or the Indian subcontinent (OR=4.1), working as a nurse (OR=2.7), allied health profession (OR=2.1), radiology technician (OR=3.1), or in the emergency room (OR=2.4) or intensive care unit (OR=2.1). In the binary logistic regression, independent predictors for positive QFT-Plus were age group older than 50 years (aOR=2.96), known TB exposure (aOR=1.97), and not receiving BCG at birth (aOR=3.08). LIMITATION Single-center, retrospective, possible recall bias for BCG vaccination. CONCLUSION The high prevalence of LTBI among HCW emphasizes the need to continue pre-employment screening, especially for employed personnel from high endemic areas, with targeted annual screening for the same group and other identified high-risk groups. These findings can aid in the development of national screening guidelines for LTBI in HCW. CONFLICT OF INTEREST None.
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Affiliation(s)
- Abdulellah Almohaya
- From the Infectious Diseases Unit, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulwahab Aldrees
- From the Infectious Diseases Unit, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Layan Akkielah
- From the Infectious Diseases Unit, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Alshaima Talal Hashim
- From the Infectious Diseases Unit, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fahad Almajid
- From the Infectious Diseases Unit, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Turki Binmoammar
- From the Occupational Health Unit, Family Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mazin A Barry
- From the Infectious Diseases Unit, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Alsharif MH, Alsulami AA, Alsharef M, Albanna AS, Wali SO. Incidence of latent tuberculosis infection among health science students during clinical training. Ann Thorac Med 2020; 15:33-37. [PMID: 32002045 PMCID: PMC6967140 DOI: 10.4103/atm.atm_230_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 11/08/2019] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND: The prevalence of latent tuberculosis infection (LTBI) has been found to be high among students undergoing clinical training. The aim of this study is to determine the incidence of LTBI among undergraduate health science students after their clinical training and to compare the risk between different college specialties. METHODS: This is a retrospective cohort study of students who completed their clinical training from 2010 to 2017. The risk of LTBI was defined based on the conversion of tuberculin skin test (TST) results from negative at the start of training to positive after the completion of training. RESULTS: A total of 2000 students were evaluated, of whom 1997 were included in this analysis. Six percent tested positive in the first TST of the initial screening. Ten percent of students with a normal baseline TST converted to positive on the follow-up TST. Clinical training in the college of medicine increased the risk of LTBI by 76% (odds ratio: 1.76; 95% confidence interval: 1.04– 2.96; P = 0.03) compared to clinical training in other medical colleges. CONCLUSIONS: The risk of acquiring LTBI during clinical training in health science colleges is 10%. Students in the college of medicine are at significantly higher risk of LTBI than students of other health science specialties.
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Affiliation(s)
- Mada H Alsharif
- Department of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Atheer A Alsulami
- Department of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Malikah Alsharef
- Department of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Amr S Albanna
- Department of Medicine, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Siraj O Wali
- Department of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
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Risk of Occupational Latent Tuberculosis Infection among Health Personnel Measured by Interferon-Gamma Release Assays in Low Incidence Countries-A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020581. [PMID: 31963207 PMCID: PMC7027002 DOI: 10.3390/ijerph17020581] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 01/10/2020] [Accepted: 01/12/2020] [Indexed: 11/17/2022]
Abstract
Healthcare workers (HCWs) have increased risk for latent tuberculosis infection (LTBI) and tuberculosis (TB) disease due to their occupational exposure. For some years now, interferon-γ release assays (IGRAs) have replaced the tuberculin skin test for the diagnosis of LTBI in many countries. This review examined the occupational risk of LTBI in HCWs with IGRA testing in low incidence countries. A systematic review and meta-analysis of studies from 2005 onwards provide data regarding the prevalence of LTBI in HCWs. In addition, the pooled effect estimates were calculated for individual regions and occupational groups. 57 studies with 31,431 HCWs from four regions and a total of 25 countries were analysed. The prevalence of LTBI varied from 0.9 to 85.5%. The pooled estimation found the lowest prevalence of LTBI for North American and West Pacific countries (<5%), and the highest prevalence for Eastern Mediterranean countries (19.4%). An increased risk for LTBI was found only for administrative employees. Studies on the occupational risk of LTBI continue to show increased prevalence of HCWs, even in low-incidence countries. Good quality studies will continue to be needed to describe occupational exposure.
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Prihatiningsih S, Fajar JK, Tamara F, Mahendra AI, Rizqiansyah CY, Adianingsih OR, Suwandi T. Risk factors of tuberculosis infection among health care workers: A meta-analysis. Indian J Tuberc 2020; 67:121-129. [PMID: 32192605 DOI: 10.1016/j.ijtb.2019.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 10/11/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUNDS Health care workers (HCWs) are globally known to have high risk of tuberculosis (TB) infection while risk factors of TB infections among HCWs are still inconclusive. OBJECTIVES To perform a meta-analysis in effort to identify risk factors of TB infection among HCWs. METHODS A meta-analysis was conducted between February and July 2019. Papers were searched in Pubmed, Embase, Cochrane, and Web of science and information of interest were extracted. The correlation and effect estimation were analyzed using random or fixed effect model. RESULTS A total of 12 studies consisting of 2871 cases and 15,673 controls were included and six risk factors were available for meta-analysis. Cumulative calculation found that age, working duration, and types of job were significant risk factor of TB infection while gender, active TB contact, and types of workplace were not associated significantly with TB infection among HCWs. Our pooled data revealed that decreased risk of TB infection was observed in age less than 30 years (age < 30 years vs. age ≥ 30 years) and working duration less than five years (working duration < 5 years vs. ≥5 years). Being more than 40 years, working more than 10 years, and being physicians increased the risk of TB infection significantly compared to age ≤40 years, working duration ≤10 years, and other job types, respectively. CONCLUSIONS Our meta-analysis has identified the significant risk factors of TB infection among HCWs. Our results may be useful for establishing future TB prevention program among HCWs.
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Affiliation(s)
- Septyani Prihatiningsih
- Division of Occupational Health and Safety, Department of Health, Faculty of Vocational Studies, Universitas Airlangga, Surabaya, 60286, Indonesia.
| | - Jonny Karunia Fajar
- Rumah Sakit Islam Hasanah Muhammadiyah Mojokerto, 61313, Indonesia; Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia.
| | - Fredo Tamara
- Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, 65145, Indonesia
| | - Aditya Indra Mahendra
- Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, 65145, Indonesia
| | | | | | - Tjipto Suwandi
- Department of Occupational Health and Safety, Faculty of Public Health, Universitas Airlangga, Surabaya, 60286, Indonesia
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