Prevalence and Risk Factors of Latent Tuberculosis Infection among Healthcare Workers

Sunhong Lee; Ye Li Lee; Yong Chan Kim; Eun Jin Kim; Jung Yeon Heo; Young Hwa Choi

doi:10.14192/kjicp.2019.24.2.52

Journal List > Korean J Healthc Assoc Infect Control Prev > v.24(2) > 1140852

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Lee, Lee, Kim, Kim, Heo, and Choi: Prevalence and Risk Factors of Latent Tuberculosis Infection among Healthcare Workers

Original Article

Korean Journal of Healthcare-Associated Infection Control and Prevention 2019; 24(2): 52-59.

Published online: 31 December 2019

DOI: https://doi.org/10.14192/kjicp.2019.24.2.52

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

¹Department of Infectious Diseases, Ajou University School of Medicine, Suwon, Korea.

²Infection Control Unit, Ajou University Medical Center, Suwon, Korea.

Corresponding author: Young Hwa Choi. yhwa1805@ajou.ac.kr

Received 25 October 2019 Revised 23 November 2019 Accepted 6 December 2019

Korean Society for Healthcare-Associated Infection Control and Prevention

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/).

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) 3.43-5.29], 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

Figures and Tables

Fig. 1

Flow chart of the study.

Abbreviations: See Table 1.

Fig. 2

Distribution of people by group.

Fig. 3

IGRA positive rate by work period in each risk group.

Fig. 4

IGRA positive rate according to age group.

Fig. 5

IGRA positive rate by occupation.

Fig. 6

Age, total work period and work period in TB related department according to occupation.

Fig. 7

Cumulative risk of active tuberculosis in healthcare workers with latent tuberculosis infection by age group.

Fig. 8

Treatment status by risk group.

Table 1

Comparison of studies for latent tuberculosis infection prevalence among healthcare workers and other groups in South Korea

Abbreviations: LTBI, latent tuberculosis infection; IGRA, interferon gamma release assay; TST, tuberculin skin test.

Table 2

Demographical characteristics and IGRA results of participants

Abbreviations: IGRA, interferon gamma release assay; BMI, body mass index; DM, diabetes mellitus; CKD, chronic kidney disease.

Table 3

Occupational risk factors of latent tuberculosis IGRA by univariate analysis

Table 4

Risk factors of LTBI using IGRA among HCWs by multivariate analysis

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ORCID iDs: Young Hwa Choi
https://orcid.org/0000-0001-5254-3101
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