Prevalence and incidence of latent tuberculosis infection in georgian healthcare workers.

<h4>Background</h4>Tuberculosis is a major occupational hazard in low and middle-income countries. Limited data exist on serial testing of healthcare workers (HCWs) with interferon-γ release assays (IGRAs) for latent tuberculosis infection (LTBI), especially in low and middle-income coun...

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Autores principales:	Jennifer A Whitaker, Veriko Mirtskhulava, Maia Kipiani, Drew A Harris, Nino Tabagari, Russell R Kempker, Henry M Blumberg
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/39c6f5af05094219a675c8a45b26a351
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spelling	oai:doaj.org-article:39c6f5af05094219a675c8a45b26a3512021-11-18T07:52:11ZPrevalence and incidence of latent tuberculosis infection in georgian healthcare workers.1932-620310.1371/journal.pone.0058202https://doaj.org/article/39c6f5af05094219a675c8a45b26a3512013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23536789/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Tuberculosis is a major occupational hazard in low and middle-income countries. Limited data exist on serial testing of healthcare workers (HCWs) with interferon-γ release assays (IGRAs) for latent tuberculosis infection (LTBI), especially in low and middle-income countries. We sought to evaluate the rates of and risk factors for LTBI prevalence and LTBI test conversion among HCWs using the tuberculin skin test (TST) and QuantiFERON-TB Gold In-tube assay (QFT-GIT).<h4>Methods</h4>A prospective longitudinal study was conducted among HCWs in the country of Georgia. Subjects completed a questionnaire, and TST and QFT-GIT tests were performed. LTBI testing was repeated 6-26 months after baseline testing.<h4>Results</h4>Among 319 HCWs enrolled, 89% reported prior BCG vaccination, and 60% worked in TB healthcare facilities (HCFs). HCWs from TB HCFs had higher prevalence of positive QFT-GIT and TST than those from non-TB HCFs: 107/194 (55%) vs. 30/125 (31%) QFT-GIT positive (p<0.0001) and 128/189 (69%) vs. 64/119 (54%) TST positive (p = 0.01). There was fair agreement between TST and QFT-GIT (kappa = 0.42, 95% CI 0.31-0.52). In multivariate analysis, frequent contact with TB patients was associated with increased risk of positive QFT-GIT (aOR 3.04, 95% CI 1.79-5.14) but not positive TST. Increasing age was associated with increased risk of positive QFT-GIT (aOR 1.05, 95% CI 1.01-1.09) and TST (aOR 1.05, 95% CI 1.01-1.10). High rates of HCW conversion were seen: the QFT-GIT conversion rate was 22.8/100 person-years, and TST conversion rate was 17.1/100 person-years. In multivariate analysis, female HCWs had decreased risk of TST conversion (aOR 0.05, 95% CI 0.01-0.43), and older HCWs had increased risk of QFT-GIT conversion (aOR 1.07 per year, 95% CI 1.01-1.13).<h4>Conclusion</h4>LTBI prevalence and LTBI test conversion rates were high among Georgian HCWs, especially among those working at TB HCFs. These data highlight the need for increased implementation of TB infection control measures.Jennifer A WhitakerVeriko MirtskhulavaMaia KipianiDrew A HarrisNino TabagariRussell R KempkerHenry M BlumbergPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 3, p e58202 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jennifer A Whitaker Veriko Mirtskhulava Maia Kipiani Drew A Harris Nino Tabagari Russell R Kempker Henry M Blumberg Prevalence and incidence of latent tuberculosis infection in georgian healthcare workers.
description	<h4>Background</h4>Tuberculosis is a major occupational hazard in low and middle-income countries. Limited data exist on serial testing of healthcare workers (HCWs) with interferon-γ release assays (IGRAs) for latent tuberculosis infection (LTBI), especially in low and middle-income countries. We sought to evaluate the rates of and risk factors for LTBI prevalence and LTBI test conversion among HCWs using the tuberculin skin test (TST) and QuantiFERON-TB Gold In-tube assay (QFT-GIT).<h4>Methods</h4>A prospective longitudinal study was conducted among HCWs in the country of Georgia. Subjects completed a questionnaire, and TST and QFT-GIT tests were performed. LTBI testing was repeated 6-26 months after baseline testing.<h4>Results</h4>Among 319 HCWs enrolled, 89% reported prior BCG vaccination, and 60% worked in TB healthcare facilities (HCFs). HCWs from TB HCFs had higher prevalence of positive QFT-GIT and TST than those from non-TB HCFs: 107/194 (55%) vs. 30/125 (31%) QFT-GIT positive (p<0.0001) and 128/189 (69%) vs. 64/119 (54%) TST positive (p = 0.01). There was fair agreement between TST and QFT-GIT (kappa = 0.42, 95% CI 0.31-0.52). In multivariate analysis, frequent contact with TB patients was associated with increased risk of positive QFT-GIT (aOR 3.04, 95% CI 1.79-5.14) but not positive TST. Increasing age was associated with increased risk of positive QFT-GIT (aOR 1.05, 95% CI 1.01-1.09) and TST (aOR 1.05, 95% CI 1.01-1.10). High rates of HCW conversion were seen: the QFT-GIT conversion rate was 22.8/100 person-years, and TST conversion rate was 17.1/100 person-years. In multivariate analysis, female HCWs had decreased risk of TST conversion (aOR 0.05, 95% CI 0.01-0.43), and older HCWs had increased risk of QFT-GIT conversion (aOR 1.07 per year, 95% CI 1.01-1.13).<h4>Conclusion</h4>LTBI prevalence and LTBI test conversion rates were high among Georgian HCWs, especially among those working at TB HCFs. These data highlight the need for increased implementation of TB infection control measures.
format	article
author	Jennifer A Whitaker Veriko Mirtskhulava Maia Kipiani Drew A Harris Nino Tabagari Russell R Kempker Henry M Blumberg
author_facet	Jennifer A Whitaker Veriko Mirtskhulava Maia Kipiani Drew A Harris Nino Tabagari Russell R Kempker Henry M Blumberg
author_sort	Jennifer A Whitaker
title	Prevalence and incidence of latent tuberculosis infection in georgian healthcare workers.
title_short	Prevalence and incidence of latent tuberculosis infection in georgian healthcare workers.
title_full	Prevalence and incidence of latent tuberculosis infection in georgian healthcare workers.
title_fullStr	Prevalence and incidence of latent tuberculosis infection in georgian healthcare workers.
title_full_unstemmed	Prevalence and incidence of latent tuberculosis infection in georgian healthcare workers.
title_sort	prevalence and incidence of latent tuberculosis infection in georgian healthcare workers.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/39c6f5af05094219a675c8a45b26a351
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Prevalence and incidence of latent tuberculosis infection in georgian healthcare workers.

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