Infection control and the burden of tuberculosis infection and disease in health care workers in china: A cross-sectional study

National Center for TB control and prevention, China Center for Disease Control and Prevention, Changping District 102206, Beijing, China.
BMC Infectious Diseases (Impact Factor: 2.61). 10/2010; 10(1):313. DOI: 10.1186/1471-2334-10-313
Source: PubMed


Hospitals with inadequate infection control are risky environments for the emergence and transmission of tuberculosis (TB). We evaluated TB infection control practices, and the prevalence of latent TB infection (LTBI) and TB disease and risk factors in health care workers (HCW) in TB centers in Henan province in China.
A cross-sectional survey was conducted in 2005. To assess TB infection control practices in TB centers, checklists were used. HCW were tuberculin skin tested (TST) to measure LTBI prevalence, and were asked for sputum smears and chest X-rays to detect TB disease, and questionnaires to assess risk factors. Differences between groups for categorical variables were analyzed by binary logistic regression. The clustered design of the study was taken into account by using a multilevel logistic model.
The assessment of infection control practices showed that only in a minority of the centers the patient consultation areas and X-ray areas were separated from the waiting areas and administrative areas. Mechanical ventilation was not available in any of the TB centers. N95 respirators were not available for HCW and surgical masks were not available for TB patients and suspects. The LTBI prevalence of HCW with and without BCG scar was 55.6% (432/777) and 49.0% (674/1376), respectively (P = 0.003). Older HCW, HCW with longer duration of employment, and HCW who worked in departments with increased contact with TB patients had a higher prevalence of LTBI. HCW who work in TB centers at the prefecture level, or with an inpatient ward also had a higher prevalence of LTBI. Twenty cases of pulmonary TB were detected among 3746 HCW. The TB prevalence was 6.7/1000 among medical staff and 2.5/1000 among administrative/logistic staff.
TB infection control in TB centers in Henan, China, appears to be inadequate and the prevalence of LTBI and TB disease among HCW was high. TB infection control practices in TB centers should be strengthened in China, including administrative measures, renovation of buildings, and use of respirators and masks. Regular screening of HCW for TB disease and LTBI needs to be considered, offering preventive therapy to those with TST conversions.

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    • "Among variables analyzed (gender, occupation, time since hire, history of BCG vaccination, positive sputum smear of index patient), only older age was associated with PEARTI. Age is a known risk factor for LTBI infection among HCWs [22,23], possibly because it is associated with a longer period of direct contact with patients. This observation might suggest a limitation of the study, as PEARTI was measured as TST conversion three months after the exposure following a first negative TST result. "
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    BMC Infectious Diseases 06/2014; 14(1):324. DOI:10.1186/1471-2334-14-324 · 2.61 Impact Factor
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    • "There are numerous therapeutic strategies for combining radiotherapy with chemotherapy, and the optimal regimen continues to be explored. In recent years, epidemiological evidence has shown that the tuberculosis epidemic situation in China is not optimistic, and although the incidence has declined, the level remains high (3,4). In addition, there has been a marked increase in the prevalence of gout, which highly correlates with economic development as manifested by dietary and lifestyle changes (5,6). "
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    Oncology letters 05/2014; 8(2). DOI:10.3892/ol.2014.2180 · 1.55 Impact Factor
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    • "History of contact with a known TB case was significantly associated with TB infection. This finding has also been shown by previous studies [12,13]. Persons in close contact with a case of pulmonary TB disease stand a great chance of infection with TB. "
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    ABSTRACT: Background Uganda’s Ministry of Health registered a 12% increase in new Tuberculosis (TB) cases between 2001 and 2005. Of these, 20% were from Kampala district and most from Mulago national referral hospital where the largest and the oldest medical school is found. Medical students are likely to have an increased exposure to TB infection due to their training in hospitals compared to other university students. The study compared the prevalence of TB infection and associated factors among undergraduate medical and veterinary students in Makerere University, Uganda. Methods This was a cross-sectional study with 232 medical and 250 veterinary undergraduate students. Socio-demographic and past medical history data was collected using questionnaires. A tuberculin skin test was performed on the volar aspect of the left forearm. An induration ≥10 mm in diameter after 48-72 hrs was considered positive. Logistic regression was used to determine association of independent variables with TB infection. Results The prevalence of TB infection was higher in medical students (44.8%, 95% C.I= 38.4-51.3%) compared to veterinary students (35.2%, 95% C.I = 29.3-41.1%). The significant predictors of TB infection were: being a medical student (aOR=1.56, 95% CI = 1.05-2.31), male sex (aOR=1.75, 95% CI = 1.17-2.63), history of contact with a confirmed TB case (aOR=1.57, 95% CI = 1.06-2.31) and residing at home (aOR=2.08, 95% CI = 1.20-3.61). Among the medical students, having gone to a day compared to boarding high school (aOR=2.31, 95% CI = 1.06-5.04), involvement in extracurricular clinical exposure (aOR=3.39 95% CI = 1.60-7.16), male sex, residence at home, and history of contact with a TB case predicted TB infection. Conclusion Medical students have a higher prevalence of TB infection than veterinary students probably due to increased exposure during training. There is a need to emphasize TB infection control measures in hospitals and the general community.
    Archives of Public Health 04/2013; 71(1):7. DOI:10.1186/0778-7367-71-7
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