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The Prevalence and Incidence of Latent Tuberculosis Infection and Its Associated Factors among Village Doctors in China.

He G, Li Y, Zhao F, Wang L, Cheng S, Guo H, Klena JD, Fan H, Gao F, Gao F, Han G, Ren L, Song Y, Xiong Y, Geng M, Hou Y, He G, Li J, Guo S, Yang J, Yan D, Wang Y, Gao H, An J, Duan X, Wu C, Duan F, Hu D, Lu K, Zhao Y, Rao CY, Wang Y - PLoS ONE (2015)

Bottom Line: Factors associated with TST prevalence included having a BCG scar (OR = 1.45, 95%CI 1.03-2.04) and smoking (OR = 1.69, 95%CI 1.17-2.44).Risk factors associated with QFT-GIT prevalence included being male (OR = 2.17, 95%CI 1.63-2.89), below college education (OR=1.42, 95%CI 1.01-1.97), and working for ≥25 years as a village doctor (OR = 1.64, 95%CI 1.12-2.39).QFT-GIT conversion was associated with spending 15 minutes or more per patient on average (OR = 2.62, 95%CI 1.39-4.97) and having BCG scar (OR = 0.53, 95%CI 0.28-1.00).

View Article: PubMed Central - PubMed

Affiliation: Chinese Center for Disease Control and Prevention, Beijing, China.

ABSTRACT

Background: China is a high tuberculosis (TB) burden country. More than half of acute TB cases first seek medical care in village doctors' clinics or community health centers. Despite being responsible for patient referral and management, village doctors are not systematically evaluated for TB infection or disease. We assessed prevalence and incidence of latent TB infection (LTBI) among village doctors in China.

Methods and findings: A longitudinal study was conducted in Inner Mongolia Autonomous Region. We administered a questionnaire on demographics and risk factors for TB exposure and disease; Tuberculin skin testing (TST) and QuantiFERON-TB Gold in-tube assay (QFT-GIT) was conducted at baseline and repeated 12 months later. We used a logistic regression model to calculate adjusted odds ratios (ORs) for risk factors for TST and QFT-GIT prevalence and incidence. At the time of follow up, 19.5% of the 880 participating village doctors had a positive TST and 46.0% had a positive QFT-GIT result. Factors associated with TST prevalence included having a BCG scar (OR = 1.45, 95%CI 1.03-2.04) and smoking (OR = 1.69, 95%CI 1.17-2.44). Risk factors associated with QFT-GIT prevalence included being male (OR = 2.17, 95%CI 1.63-2.89), below college education (OR=1.42, 95%CI 1.01-1.97), and working for ≥25 years as a village doctor (OR = 1.64, 95%CI 1.12-2.39). The annual incidence of LTBI was 11.4% by TST and 19.1% by QFT-GIT. QFT-GIT conversion was associated with spending 15 minutes or more per patient on average (OR = 2.62, 95%CI 1.39-4.97) and having BCG scar (OR = 0.53, 95%CI 0.28-1.00).

Conclusions: Prevalence and incidence of LTBI among Chinese village doctors is high. TB infection control measures should be strengthened among village doctors and at village healthcare settings.

No MeSH data available.


Related in: MedlinePlus

The QFT-GIT results of a baseline cross-sectional survey in December 2011 and the follow-up survey in December 2012 of village doctors in two counties in the Inner Mongolia Autonomous Region, China.
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pone.0124097.g001: The QFT-GIT results of a baseline cross-sectional survey in December 2011 and the follow-up survey in December 2012 of village doctors in two counties in the Inner Mongolia Autonomous Region, China.

Mentions: Of the 875 village doctors who completed TST at follow up, 618 had a baseline TST result. Of the 866 village doctors who had QFT-GIT results at follow up, 619 had a baseline QFT-GIT performed and one with an indeterminate QFT-GIT result was excluded at baseline. For baseline TST results, 75.2% (465/618) were negative (had TST induration size < 10 mm). For baseline QFT-GIT results, 58.4% (361/618) had negative results. A total of 613 participants had QFT-GIT results both at baseline (in 2011) and at follow-up (in 2012) (Fig 1).


The Prevalence and Incidence of Latent Tuberculosis Infection and Its Associated Factors among Village Doctors in China.

He G, Li Y, Zhao F, Wang L, Cheng S, Guo H, Klena JD, Fan H, Gao F, Gao F, Han G, Ren L, Song Y, Xiong Y, Geng M, Hou Y, He G, Li J, Guo S, Yang J, Yan D, Wang Y, Gao H, An J, Duan X, Wu C, Duan F, Hu D, Lu K, Zhao Y, Rao CY, Wang Y - PLoS ONE (2015)

The QFT-GIT results of a baseline cross-sectional survey in December 2011 and the follow-up survey in December 2012 of village doctors in two counties in the Inner Mongolia Autonomous Region, China.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4440671&req=5

pone.0124097.g001: The QFT-GIT results of a baseline cross-sectional survey in December 2011 and the follow-up survey in December 2012 of village doctors in two counties in the Inner Mongolia Autonomous Region, China.
Mentions: Of the 875 village doctors who completed TST at follow up, 618 had a baseline TST result. Of the 866 village doctors who had QFT-GIT results at follow up, 619 had a baseline QFT-GIT performed and one with an indeterminate QFT-GIT result was excluded at baseline. For baseline TST results, 75.2% (465/618) were negative (had TST induration size < 10 mm). For baseline QFT-GIT results, 58.4% (361/618) had negative results. A total of 613 participants had QFT-GIT results both at baseline (in 2011) and at follow-up (in 2012) (Fig 1).

Bottom Line: Factors associated with TST prevalence included having a BCG scar (OR = 1.45, 95%CI 1.03-2.04) and smoking (OR = 1.69, 95%CI 1.17-2.44).Risk factors associated with QFT-GIT prevalence included being male (OR = 2.17, 95%CI 1.63-2.89), below college education (OR=1.42, 95%CI 1.01-1.97), and working for ≥25 years as a village doctor (OR = 1.64, 95%CI 1.12-2.39).QFT-GIT conversion was associated with spending 15 minutes or more per patient on average (OR = 2.62, 95%CI 1.39-4.97) and having BCG scar (OR = 0.53, 95%CI 0.28-1.00).

View Article: PubMed Central - PubMed

Affiliation: Chinese Center for Disease Control and Prevention, Beijing, China.

ABSTRACT

Background: China is a high tuberculosis (TB) burden country. More than half of acute TB cases first seek medical care in village doctors' clinics or community health centers. Despite being responsible for patient referral and management, village doctors are not systematically evaluated for TB infection or disease. We assessed prevalence and incidence of latent TB infection (LTBI) among village doctors in China.

Methods and findings: A longitudinal study was conducted in Inner Mongolia Autonomous Region. We administered a questionnaire on demographics and risk factors for TB exposure and disease; Tuberculin skin testing (TST) and QuantiFERON-TB Gold in-tube assay (QFT-GIT) was conducted at baseline and repeated 12 months later. We used a logistic regression model to calculate adjusted odds ratios (ORs) for risk factors for TST and QFT-GIT prevalence and incidence. At the time of follow up, 19.5% of the 880 participating village doctors had a positive TST and 46.0% had a positive QFT-GIT result. Factors associated with TST prevalence included having a BCG scar (OR = 1.45, 95%CI 1.03-2.04) and smoking (OR = 1.69, 95%CI 1.17-2.44). Risk factors associated with QFT-GIT prevalence included being male (OR = 2.17, 95%CI 1.63-2.89), below college education (OR=1.42, 95%CI 1.01-1.97), and working for ≥25 years as a village doctor (OR = 1.64, 95%CI 1.12-2.39). The annual incidence of LTBI was 11.4% by TST and 19.1% by QFT-GIT. QFT-GIT conversion was associated with spending 15 minutes or more per patient on average (OR = 2.62, 95%CI 1.39-4.97) and having BCG scar (OR = 0.53, 95%CI 0.28-1.00).

Conclusions: Prevalence and incidence of LTBI among Chinese village doctors is high. TB infection control measures should be strengthened among village doctors and at village healthcare settings.

No MeSH data available.


Related in: MedlinePlus