High incidence of latent tuberculous infection among South African health workers: an urgent call for action

Details

• Personal Author:
  Gous N ; McCarthy KM ; Scott LE ; Stevens WS ; Tellie M ; Van Rie A ; Venter WDF
• Description:
  SETTING: In South Africa, health care workers (HCWs) are at two-fold greater risk of acquiring tuberculosis (TB) disease than the general population. Few studies have evaluated the risk of incident tuberculous infection. OBJECTIVE: To determine the incidence and risk factors for latent tuberculous infection (LTBI) among HCWs and to compare the results of the interferon-gamma release assay (IGRA) with those of the tuberculin skin test (TST). DESIGN: HCWs, including medical students, underwent a TST and human immunodeficiency virus (HIV) and IGRA testing at baseline and 12 months, and IGRA at 6 months. The participants kept 12-month TB exposure logs. RESULTS: Among 199 participants (150 [76%] females, median age 31 years [range 20-61]), incident LTBI was documented using IGRA in 25/97 (26%; incident rate 29 cases/100 person-years [py], 95%CI 20-44) and using TST in 25/93 (27%; incident rate 29 cases/100 py, 95%CI 19-42). Agreement between TST and IGRA was poor (44.8%, k = 0.23). Higher annual exposure to TB cases was reported among persons with LTBI than in those who were persistently IGRA-negative (81 cases, 95%CI 61-102 vs. 50 cases, 95%CI 43-57, P < 0.01). CONCLUSION: The high LTBI incidence and the association of incident LTBI with annual TB caseload among HCWs indicate that more effective TB infection control should be implemented in South African health care facilities. [Description provided by NIOSH]
• Subjects:
  Biological Assay Communicable Diseases Health Care Facilities Workforce And Services Health Personnel HIV Lung Diseases Men Occupational Health Respiratory Tract Diseases Risk Assessment Risk Factors Safety Skin Women

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• Keywords:
  Author Keywords: IGRA Bioassays Health-care Health-care-facilities Health-care-personnel Health-protection Immunological-tests Infection-control Infectious-diseases Lung-disorders Medical-screening Occupational-health Occupational Health Pulmonary-system-disorders Respiratory-system-disorders Risk-analysis Risk-factors Skin-tests TB Infection Control TST

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• ISSN:
  1027-3719
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  North Carolina ; OSHA Region 4
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  19
• Issue:
  6
• NIOSHTIC Number:
  nn:20047493
• Citation:
  Int J Tuberc Lung Dis 2015 Jun; 19(6):647-653
• Contact Point Address:
  Kerrigan M McCarthy, Aurum Institute, Post Net Suite 300, Private Bag X30500, Houghton 2041, South Africa
• Email:
  KMcCarthy@auruminstitute.org
• Federal Fiscal Year:
  2015
• Performing Organization:
  University of North Carolina, Chapel Hill
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  The International Journal of Tuberculosis and Lung Disease
• End Date:
  20270630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:5c3f3053a376df7754318c70d67b9ba2c0cf1f0984a56e1ed5f885d11a78c6a1dbd21bbb5b10a8598397e4ba3fbc3075749ce6184c4e288591ee346a40e8a024
• Download URL:
  https://stacks.cdc.gov/view/cdc/202546/cdc_202546_DS1.pdf
• File Type:
  [PDF - 203.25 KB ]