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Tuberculosis among health care workers.

Baussano I, Nunn P, Williams B, Pivetta E, Bugiani M, Scano F - Emerging Infect. Dis. (2011)

Bottom Line: For TB, estimated incident rate ratios were 2.4 (95% CI 1.2-3.6), 2.4 (95% CI 1.0-3.8), and 3.7 (95% CI 2.9-4.5), respectively.Median estimated population-attributable fraction for TB was as high as 0.4%.HCWs are at higher than average risk for TB.

View Article: PubMed Central - PubMed

Affiliation: University A. Avogadro, Novara, Italy. i.baussano06@imperial.ac.uk

ABSTRACT
To assess the annual risk for latent tuberculosis infection (LTBI) among health care workers (HCWs), the incidence rate ratio for tuberculosis (TB) among HCWs worldwide, and the population-attributable fraction of TB to exposure of HCWs in their work settings, we reviewed the literature. Stratified pooled estimates for the LTBI rate for countries with low (<50 cases/100,000 population), intermediate (50-100/100,000 population), and high (>100/100,000 population) TB incidence were 3.8% (95% confidence interval [CI] 3.0%-4.6%), 6.9% (95% CI 3.4%-10.3%), and 8.4% (95% CI 2.7%-14.0%), respectively. For TB, estimated incident rate ratios were 2.4 (95% CI 1.2-3.6), 2.4 (95% CI 1.0-3.8), and 3.7 (95% CI 2.9-4.5), respectively. Median estimated population-attributable fraction for TB was as high as 0.4%. HCWs are at higher than average risk for TB. Sound TB infection control measures should be implemented in all health care facilities with patients suspected of having infectious TB.

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Forrest plot showing study-specific and pooled estimates of the annual incidence of latent Mycobacteria tuberculosis infection (LTBI) among health care workers (HCWs), by tuberculosis incidence groups according to the World Health Organization. Studies are sorted by incidence category: low, <50 cases/100,000 population; intermediate, 50–99 cases/100,000 population; high, >100 cases/100,000 population. CI, confidence interval. A complete list of references is provided in the Technical Appendix.
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F-2-2: Forrest plot showing study-specific and pooled estimates of the annual incidence of latent Mycobacteria tuberculosis infection (LTBI) among health care workers (HCWs), by tuberculosis incidence groups according to the World Health Organization. Studies are sorted by incidence category: low, <50 cases/100,000 population; intermediate, 50–99 cases/100,000 population; high, >100 cases/100,000 population. CI, confidence interval. A complete list of references is provided in the Technical Appendix.

Mentions: The median estimated ARTI among HCWs was 2.9% (IQR 1.8%–8.2%) for studies from countries with low TB incidence, 8.7% (IQR 3.9%–10.5%) for studies from countries with intermediate TB incidence (in the present study only Brazil), and 7.2% (IQR 4.1%–14.3%) for studies from countries with high TB incidence. Consistently, the stratified pooled estimates for the ARTI were 3.8% (95% CI 3.0%–4.6%, I2 = 98%), 6.9% (95% CI 3.4%–10.3, I2 = 78%), and 8.4% (95% CI 2.7%–14.0%, I2 = 89%), respectively (Figure 2). Given that most studies in the meta-analysis were from countries with low TB incidence and that the variability of estimates was higher from countries with intermediate and high TB incidence, the overall (pooled) estimates of ARTI was 4.6% (95% CI 4.1%–5.6%, I2 = 97%).


Tuberculosis among health care workers.

Baussano I, Nunn P, Williams B, Pivetta E, Bugiani M, Scano F - Emerging Infect. Dis. (2011)

Forrest plot showing study-specific and pooled estimates of the annual incidence of latent Mycobacteria tuberculosis infection (LTBI) among health care workers (HCWs), by tuberculosis incidence groups according to the World Health Organization. Studies are sorted by incidence category: low, <50 cases/100,000 population; intermediate, 50–99 cases/100,000 population; high, >100 cases/100,000 population. CI, confidence interval. A complete list of references is provided in the Technical Appendix.
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Related In: Results  -  Collection

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F-2-2: Forrest plot showing study-specific and pooled estimates of the annual incidence of latent Mycobacteria tuberculosis infection (LTBI) among health care workers (HCWs), by tuberculosis incidence groups according to the World Health Organization. Studies are sorted by incidence category: low, <50 cases/100,000 population; intermediate, 50–99 cases/100,000 population; high, >100 cases/100,000 population. CI, confidence interval. A complete list of references is provided in the Technical Appendix.
Mentions: The median estimated ARTI among HCWs was 2.9% (IQR 1.8%–8.2%) for studies from countries with low TB incidence, 8.7% (IQR 3.9%–10.5%) for studies from countries with intermediate TB incidence (in the present study only Brazil), and 7.2% (IQR 4.1%–14.3%) for studies from countries with high TB incidence. Consistently, the stratified pooled estimates for the ARTI were 3.8% (95% CI 3.0%–4.6%, I2 = 98%), 6.9% (95% CI 3.4%–10.3, I2 = 78%), and 8.4% (95% CI 2.7%–14.0%, I2 = 89%), respectively (Figure 2). Given that most studies in the meta-analysis were from countries with low TB incidence and that the variability of estimates was higher from countries with intermediate and high TB incidence, the overall (pooled) estimates of ARTI was 4.6% (95% CI 4.1%–5.6%, I2 = 97%).

Bottom Line: For TB, estimated incident rate ratios were 2.4 (95% CI 1.2-3.6), 2.4 (95% CI 1.0-3.8), and 3.7 (95% CI 2.9-4.5), respectively.Median estimated population-attributable fraction for TB was as high as 0.4%.HCWs are at higher than average risk for TB.

View Article: PubMed Central - PubMed

Affiliation: University A. Avogadro, Novara, Italy. i.baussano06@imperial.ac.uk

ABSTRACT
To assess the annual risk for latent tuberculosis infection (LTBI) among health care workers (HCWs), the incidence rate ratio for tuberculosis (TB) among HCWs worldwide, and the population-attributable fraction of TB to exposure of HCWs in their work settings, we reviewed the literature. Stratified pooled estimates for the LTBI rate for countries with low (<50 cases/100,000 population), intermediate (50-100/100,000 population), and high (>100/100,000 population) TB incidence were 3.8% (95% confidence interval [CI] 3.0%-4.6%), 6.9% (95% CI 3.4%-10.3%), and 8.4% (95% CI 2.7%-14.0%), respectively. For TB, estimated incident rate ratios were 2.4 (95% CI 1.2-3.6), 2.4 (95% CI 1.0-3.8), and 3.7 (95% CI 2.9-4.5), respectively. Median estimated population-attributable fraction for TB was as high as 0.4%. HCWs are at higher than average risk for TB. Sound TB infection control measures should be implemented in all health care facilities with patients suspected of having infectious TB.

Show MeSH
Related in: MedlinePlus