1
|
Meregildo-Rodriguez ED, Ortiz-Pizarro M, Asmat-Rubio MG, Rojas-Benites MJ, Vásquez-Tirado GA. Prevalence of latent tuberculosis infection (LTBI) in healthcare workers in Latin America and the Caribbean: systematic review and meta-analysis. LE INFEZIONI IN MEDICINA 2024; 32:292-311. [PMID: 39282545 PMCID: PMC11392545 DOI: 10.53854/liim-3203-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 08/14/2024] [Indexed: 09/19/2024]
Abstract
Background Tuberculosis remains a significant global health concern, and healthcare workers (HCWs) face a high risk of acquiring latent tuberculosis infection (LTBI) through occupational exposure. In the Latin American and Caribbean (LAC) region, where the burden of tuberculosis is substantial, understanding the prevalence of LTBI among HCWs is crucial for effective infection control measures. Therefore, we conducted a systematic review and meta-analysis to estimate the prevalence of LTBI among HCWs in LAC countries. Methods Our search included MEDLINE, Scopus, EMBASE, Web of Science, and Google Scholar databases, focusing on relevant English-language records. We looked for observational studies from inception until December 2023. Results Our analysis included 38 studies representing 15,236 HCWs and 6,728 LTBI cases. These studies spanned the period from 1994 to 2023 and were conducted in Brazil, Peru, Cuba, Colombia, Trinidad and Tobago, Mexico, and Chile. The mean prevalence of LTBI among HCWs was 35.32% (range 17.86-56.00%) for interferon-gamma release assay (IGRA) and 43.67% (range 6.68-70.29%) for tuberculin skin test (TST). The pooled prevalence of LTBI among HCWs was 34.5% (95% CI 25.4-44.1%) for IGRA and 43.0% (95% CI 35.5-50.7%) for TST. When considering both IGRA and TST tests, the overall prevalence of LTBI among HCWs was 40.98% (95% CI 34.77-47.33%). LTBI was associated with longer lengths of employment and exposure to patients, family members, or any person with TB. Additionally, older HCWs faced a higher risk of LTBI. Specific professional roles (such as nurses, nurse technicians, or physicians), smoking, and deficient TB infection control measures increased the likelihood of LTBI. However, information regarding gender and BCG vaccination status showed discordance among studies. Conclusion Our findings underscore a substantial burden of LTBI among HCWs in LAC countries. Implementing adequate infection control measures is essential to prevent and control transmission within healthcare settings.
Collapse
Affiliation(s)
- Edinson Dante Meregildo-Rodriguez
- Escuela de Medicina, Universidad César Vallejo, Trujillo, Perú
- Infectious and Communicable Diseases Research Group (ICDRG), Universidad César Vallejo, Trujillo, Perú
- Hospital Regional Lambayeque, Chiclayo, Perú
| | - Mariano Ortiz-Pizarro
- Escuela de Odontología, Universidad Católica Santo Toribio de Mogrovejo, Chiclayo, Perú
| | - Martha Genara Asmat-Rubio
- Hospital Regional Lambayeque, Chiclayo, Perú
- Escuela de Farmacia y Bioquímica, Universidad Nacional de Trujillo, Trujillo, Perú
| | - Mayra Janett Rojas-Benites
- Escuela de Posgrado, Universidad Privada Antenor Orrego, Trujillo, Perú
- Hospital Regional Docente de Trujillo, Trujillo, Perú
| | - Gustavo Adolfo Vásquez-Tirado
- Hospital Regional Docente de Trujillo, Trujillo, Perú
- Escuela de Medicina, Universidad Privada Antenor Orrego, Trujillo, Perú
| |
Collapse
|
2
|
Biswas A, Tiong M, Irvin E, Zhai G, Sinkins M, Johnston H, Yassi A, Smith PM, Koehoorn M. Gender and sex differences in occupation-specific infectious diseases: a systematic review. Occup Environ Med 2024; 81:425-432. [PMID: 39168602 PMCID: PMC11420758 DOI: 10.1136/oemed-2024-109451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 07/27/2024] [Indexed: 08/23/2024]
Abstract
Occupational infectious disease risks between men and women have often been attributed to the gendered distribution of the labour force, with limited comparative research on occupation-specific infectious disease risks. The objective of this study was to compare infectious disease risks within the same occupations by gender. A systematic review of peer-reviewed studies published between 2016 and 2021 was undertaken. To be included, studies were required to report infectious disease risks for men, women or non-binary people within the same occupation. The included studies were appraised for methodological quality. A post hoc power calculation was also conducted. 63 studies were included in the systematic review. Among high-quality studies with statistical power (9/63), there was evidence of a higher hepatitis risk for men than for women among patient-facing healthcare workers (HCWs) and a higher parasitic infection risk for men than for women among farmers (one study each). The rest of the high-quality studies (7/63) reported no difference between men and women, including for COVID-19 risk among patient-facing HCWs and physicians, hepatitis risk among swine workers, influenza risk among poultry workers, tuberculosis risk among livestock workers and toxoplasmosis risk among abattoir workers. The findings suggest that occupational infectious disease risks are similarly experienced for men and women within the same occupation with a few exceptions showing a higher risk for men. Future studies examining gender/sex differences in occupational infectious diseases need to ensure adequate sampling by gender.
Collapse
Affiliation(s)
- Aviroop Biswas
- Institute for Work & Health, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Maggie Tiong
- Institute for Work & Health, Toronto, Ontario, Canada
| | - Emma Irvin
- Institute for Work & Health, Toronto, Ontario, Canada
| | - Glenda Zhai
- Western University Faculty of Health Sciences, London, Ontario, Canada
| | - Maia Sinkins
- McGill University Faculty of Science, Montreal, Quebec, Canada
| | | | - Annalee Yassi
- Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Peter M Smith
- Institute for Work & Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Mieke Koehoorn
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
3
|
de Lima RS, da Silva RN, André SR, Pinheiro AKC, Sousa AI, da Silva IFS, dos Santos J, Nogueira LMV, Zeitoune RCG. Mycobacterium tuberculosis latent infection in healthcare students: systematic review of prevalence. Rev Esc Enferm USP 2024; 58:e20230238. [PMID: 38488508 PMCID: PMC10941757 DOI: 10.1590/1980-220x-reeusp-2023-0238en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 01/12/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVE The aim of this study was to synthesize the evidence on the prevalence of latent Mycobacterium tuberculosis infection (LTBI) among undergraduate health care students. METHODS A systematic review of prevalence with meta-analysis was conducted. Prospective and retrospective cohorts and cross-sectional studies involving probable exposure to M. tuberculosis during undergraduate education, along with the tuberculin skin test (TST) or interferon-γ release assay (IGRA) for investigation of latent tuberculosis were searched. Searches were conducted in MEDLINE, CINAHL, EMBASE, LILACS, Scopus, and Web of Science databases. Independent reviewers were responsible for the selection and inclusion of studies. Data were extracted, critically appraised, and synthesized using the JBI approach. PRISMA was used to report the study. RESULTS Twenty-two studies were analyzed. The overall prevalence in healthcare undergraduate students was 12.53%. CONCLUSION The prevalence of LTBI in undergraduate health students was high for such a highly educated population. Screening with TST and/or IGRA and chemoprophylaxis, when necessary, should be provided to undergraduate health students when in contact with respiratory symptomatic patients.
Collapse
Affiliation(s)
- Renata Silva de Lima
- Universidade Federal do Rio de Janeiro, Escola de Enfermagem Anna
Nery, Rio de Janeiro, RJ, Brazil
| | | | - Suzana Rosa André
- Universidade Federal do Rio de Janeiro, Escola de Enfermagem Anna
Nery, Rio de Janeiro, RJ, Brazil
| | | | - Ana Inês Sousa
- Universidade Federal do Rio de Janeiro, Escola de Enfermagem Anna
Nery, Rio de Janeiro, RJ, Brazil
| | | | | | | | | |
Collapse
|
4
|
Meregildo-Rodriguez ED, Yuptón-Chávez V, Asmat-Rubio MG, Vásquez-Tirado GA. Latent tuberculosis infection (LTBI) in health-care workers: a cross-sectional study at a northern Peruvian hospital. Front Med (Lausanne) 2023; 10:1295299. [PMID: 38098842 PMCID: PMC10720426 DOI: 10.3389/fmed.2023.1295299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 11/13/2023] [Indexed: 12/17/2023] Open
Abstract
Background Healthcare workers (HCWs) have a higher risk of latent tuberculosis infection (LTBI) and active tuberculosis than the general population. In HCWs, the risk of tuberculosis infection depends on the local tuberculosis prevalence, HCWs' characteristics, the healthcare facility, and prevention and control measures. We aimed to estimate the prevalence and risk factors for LTBI in HCWs at a northern Peruvian hospital. Methods This study had two phases: (1) a cross-sectional phase involving recruitment, history taking, and sampling for the Interferon-Gamma Release Assays (IGRA test), and (2) a prospective follow-up of IGRA-positive participants. We enrolled direct and non-direct patient caregivers among HCWs. We defined an LTBI case if the IGRA test was positive and clinical, laboratory, and radiological evaluations for active tuberculosis were negative. Results We recruited 308 participants between November 2022 and May 2023. The mean age was 38.6 ± 8.3 years. Over 75% of the participants were female. The most common job category was technicians (30.5%), physicians (22.7%), nurses (20.5%), and other HCWs groups (17.5%). Most participants worked in hospital wards (28.2%), diagnostics departments (16.9%), and critical care departments (15.6%). The LTBI prevalence among HCWs was 17.86% (95% CI 13.84-22.70). In multivariate analysis, after adjusting for age, time working in our hospital, and family history of tuberculosis, males had a higher risk of LTBI (aPR 1.69, 95% CI 1.01-2.77) than females. Working for more than 10 years increased the risk of LBTI (aPR 2.4, 95% CI 1.44-3.97) compared to working for ≤10 years. Even further, participants who had worked for more than 20 years had an aPR of 4.31 (95% CI 1.09-13.65) compared to those with ≤10 years. Similarly, occupational exposure increased the risk of LTBI (aPR 2.21, 95% CI 1.27-4.08) compared to those HCWs not occupationally exposed. Conclusion The LTBI prevalence in HCWs at a northern Peruvian hospital was lower compared to other Peruvian cities. Males, more experienced, and occupational exposed HCWs are at higher risk of LTBI. LTBI prevalence in Peruvian HCWs is still high. More studies are needed to address some aspects this study has not examined.
Collapse
|
5
|
d’Ettorre G, Karaj S, Piscitelli P, Maiorano O, Attanasi C, Tornese R, Carluccio E, Giannuzzi P, Greco E, Ceccarelli G, d’Ettorre G, Lobreglio G, Congedo P, Broccolo F, Miani A. Right to Occupational Safety: Prevalence of Latent Tuberculosis Infection in Healthcare Workers. A 1-Year Retrospective Survey Carried out at Hospital of Lecce (Italy). EPIDEMIOLOGIA 2023; 4:454-463. [PMID: 37987310 PMCID: PMC10660459 DOI: 10.3390/epidemiologia4040038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Prevention of latent tuberculosis infection (LTBI) in healthcare workers (HCWs) to ensure the "Right to Occupational Safety" is a special challenge globally, as HCWs have a higher risk of acquiring the infection in hospital settings because of frequent close exposure to patients suffering from tuberculosis (TB). METHODS Aretrospective study was performed with the aim of assessing the prevalence of LTBI related to demographical and occupational risk factors among HCWs employed in a large hospital in Italy. The study involved 1461 HCWs screened for LTBI by Mantoux tuberculin skin test (TST) and then confirmed with Interferon Gamma Release Assay (IGRA) test in case of positivity. Immunosuppressed and BGC-vaccinated workers were tested directly with IGRA. RESULTS LTBI was diagnosed in 4.1% of the HCWs and the prevalence resulted lower than other studies conducted in low TB incidence countries. The variables significantly linked with higher frequency of the infection were: age ≥40 years (OR = 3.14; 95% CI: 1.13-8.74; p < 0.05), length of service ≥15 years (OR = 4.11; 95% CI: 1.48-11.43; p < 0.05) and not being trained on TB prevention (OR = 3.46; 95% CI: 1.85-6.46; p < 0.05). Not trained HCWs presented a higher risk of LTBI also after adjustment for age and length of service, compared to trained HCWs. CONCLUSIONS screening of HCWs for LTBI should be always considered in routinely occupational surveillance in order to early diagnose the infection and prevent its progression. Safety policies in hospital settings centered on workers' training on TB prevention is crucial to minimize LTBI occurrence in HCWs.
Collapse
Affiliation(s)
- Gabriele d’Ettorre
- Vito Fazzi Hospital, Local Health Authority ASL Le, 73100 Lecce, Italy; (G.d.); (O.M.); (C.A.); (R.T.); (E.C.); (P.G.); (G.L.); (P.C.)
| | - Stela Karaj
- Faculty of Social Sciences, European University of Tirana, 1000 Tirana, Albania;
| | - Prisco Piscitelli
- Vito Fazzi Hospital, Local Health Authority ASL Le, 73100 Lecce, Italy; (G.d.); (O.M.); (C.A.); (R.T.); (E.C.); (P.G.); (G.L.); (P.C.)
- Department of Experimental Medicine, University of Salento, 73100 Lecce, Italy;
- Italian Society of Environmental Medicine, 20123 Milan, Italy; (E.G.); (A.M.)
| | - Osvaldo Maiorano
- Vito Fazzi Hospital, Local Health Authority ASL Le, 73100 Lecce, Italy; (G.d.); (O.M.); (C.A.); (R.T.); (E.C.); (P.G.); (G.L.); (P.C.)
| | - Carmen Attanasi
- Vito Fazzi Hospital, Local Health Authority ASL Le, 73100 Lecce, Italy; (G.d.); (O.M.); (C.A.); (R.T.); (E.C.); (P.G.); (G.L.); (P.C.)
| | - Roberta Tornese
- Vito Fazzi Hospital, Local Health Authority ASL Le, 73100 Lecce, Italy; (G.d.); (O.M.); (C.A.); (R.T.); (E.C.); (P.G.); (G.L.); (P.C.)
| | - Eugenia Carluccio
- Vito Fazzi Hospital, Local Health Authority ASL Le, 73100 Lecce, Italy; (G.d.); (O.M.); (C.A.); (R.T.); (E.C.); (P.G.); (G.L.); (P.C.)
| | - Paolo Giannuzzi
- Vito Fazzi Hospital, Local Health Authority ASL Le, 73100 Lecce, Italy; (G.d.); (O.M.); (C.A.); (R.T.); (E.C.); (P.G.); (G.L.); (P.C.)
| | - Enrico Greco
- Italian Society of Environmental Medicine, 20123 Milan, Italy; (E.G.); (A.M.)
| | - Giancarlo Ceccarelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (G.C.); (G.d.)
| | - Gabriella d’Ettorre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (G.C.); (G.d.)
| | - Giambattista Lobreglio
- Vito Fazzi Hospital, Local Health Authority ASL Le, 73100 Lecce, Italy; (G.d.); (O.M.); (C.A.); (R.T.); (E.C.); (P.G.); (G.L.); (P.C.)
| | - Pierpaolo Congedo
- Vito Fazzi Hospital, Local Health Authority ASL Le, 73100 Lecce, Italy; (G.d.); (O.M.); (C.A.); (R.T.); (E.C.); (P.G.); (G.L.); (P.C.)
| | - Francesco Broccolo
- Department of Experimental Medicine, University of Salento, 73100 Lecce, Italy;
| | - Alessandro Miani
- Italian Society of Environmental Medicine, 20123 Milan, Italy; (E.G.); (A.M.)
| |
Collapse
|
6
|
Yuan Y, Wang X, Zhou Y, Zhou C, Li S. Prevalence and risk factors of latent tuberculosis infection among college students: a systematic review and meta-analysis. Public Health 2022; 213:135-146. [PMID: 36410119 DOI: 10.1016/j.puhe.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/11/2022] [Accepted: 10/04/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES College students are at increased risk of tuberculosis (TB), which increases their likelihood of developing latent tuberculosis infections (LTBI). This study aimed to estimate the pooled prevalence of LTBI and identify its risk factors. STUDY DESIGN Systematic review and meta-analysis. METHODS We searched PubMed, Embase, Scopus, Web of Science, CNKI, Wanfang and CBM databases (10 March 2022) for studies published in any language. The pooled prevalence of LTBI was estimated using random effects methods. Factors associated with LTBI were evaluated by determining standardised mean difference (SMD) with 95% confidence interval (CI). All analyses were performed using the Stata 15.1. RESULTS A total of 50 studies from 18 countries were included, with 44 tuberculin skin test (n = 623,732) and 19 interferon gamma release assay (n = 38,266) estimates. The prevalence of a positive tuberculin skin test was 20% (95% CI: 17-23%), and the prevalence of a positive interferon gamma release assay was 9% (95% CI: 7%-11%) among college students. Older age (SMD: 1.67, 95% CI: 1.31-2.13), no Bacillus Calmette-Guérin vaccination/scar (SMD: 1.51, 95% CI: 1.06-2.16), contact with TB cases (SMD: 1.34, 95% CI: 1.11-1.62), clinical training (SMD: 1.93, 95% CI: 1.65-2.26) and overweight/obesity (SMD: 1.17, 95% CI: 1.06-1.30) were associated with a higher prevalence of LTBI. Sex was not associated with LTBI prevalence. CONCLUSION College students have an increased risk of LTBI, although it varies by geographical area. This meta-analysis provides evidence of risk factors for LTBI in college students. Infection control measures should be conducted for college students with LTBI.
Collapse
Affiliation(s)
- Yemin Yuan
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Xiyuan Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Yanxin Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
| | - Shixue Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China; NHC Key Laboratory of Health Economics and Policy Research, Shandong University, Jinan, 250012, China.
| |
Collapse
|
7
|
Compagno M, Navarra A, Campogiani L, Coppola L, Rossi B, Iannetta M, Malagnino V, Parisi SG, Mariotti B, Cerretti R, Arcese W, Goletti D, Andreoni M, Sarmati L. Latent Tuberculosis Infection in Haematopoietic Stem Cell Transplant Recipients: A Retrospective Italian Cohort Study in Tor Vergata University Hospital, Rome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710693. [PMID: 36078409 PMCID: PMC9518118 DOI: 10.3390/ijerph191710693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 05/17/2023]
Abstract
The results of tuberculosis (TB) screening and reactivation in a cohort of 323 adult patients undergoing haematopoietic stem cell transplantation (HSCT) from 2015 to 2019 at the University Hospital of Tor Vergata, Rome, Italy, were reported. A total of 260 patients, 59 (18.3%) autologous and 264 (81.7%) allogeneic transplants, underwent Interferon Release (IFN)-γ (IGRA) test screening: 228 (87.7%) were negative, 11 (4.2%) indeterminate and 21 (8.1%) positive. Most of the IGRA-positive patients were of Italian origin (95.2%) and significantly older than the IGRA-negative (p < 0.001); 22 (8.5%) patients underwent a second IGRA during the first year after transplantation, and 1 tested positive for IGRA. Significantly lower monocyte (p = 0.044) and lymphocyte counts (p = 0.009) were detected in IGRA negative and IGRA indeterminate patients, respectively. All latent TB patients underwent isoniazid prophylaxis, and none of them progressed to active TB over a median follow-up period of 63.4 months. A significant decline in TB screening practices was shown from 2015 to 2019, and approximately 19% of patients were not screened. In conclusion, 8.1% of our HSCT population had LTBI, all received INH treatment, and no reactivation of TB was observed during the follow-up period. In addition, 19% escaped screening and 8% of these came from countries with a medium TB burden, therefore at higher risk of possible development of TB.
Collapse
Affiliation(s)
- Mirko Compagno
- Clinical Infectious Diseases Unit, Tor Vergata Hospital, 00133 Rome, Italy
| | - Assunta Navarra
- Clinical Epidemiology Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, 00161 Rome, Italy
| | - Laura Campogiani
- Clinical Infectious Diseases Unit, Tor Vergata Hospital, 00133 Rome, Italy
| | - Luigi Coppola
- Clinical Infectious Diseases Unit, Tor Vergata Hospital, 00133 Rome, Italy
| | - Benedetta Rossi
- Clinical Infectious Diseases, Department of System Medicine, Tor Vergata University, 00133 Rome, Italy
| | - Marco Iannetta
- Clinical Infectious Diseases, Department of System Medicine, Tor Vergata University, 00133 Rome, Italy
| | - Vincenzo Malagnino
- Clinical Infectious Diseases, Department of System Medicine, Tor Vergata University, 00133 Rome, Italy
| | - Saverio G. Parisi
- Department of Molecular Medicine, University of Padova, Via Gabelli, 63, 35100 Padova, Italy
| | - Benedetta Mariotti
- Department of Biomedicine and Prevention, University Tor Vergata of Roma, 00133 Rome, Italy
- Rome Transplant Network, Tor Vergata University Hospital, 00133 Rome, Italy
| | - Raffaella Cerretti
- Department of Biomedicine and Prevention, University Tor Vergata of Roma, 00133 Rome, Italy
- Rome Transplant Network, Tor Vergata University Hospital, 00133 Rome, Italy
| | - William Arcese
- Department of Biomedicine and Prevention, University Tor Vergata of Roma, 00133 Rome, Italy
- Rome Transplant Network, Tor Vergata University Hospital, 00133 Rome, Italy
| | - Delia Goletti
- Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, 00161 Rome, Italy
| | - Massimo Andreoni
- Clinical Infectious Diseases, Department of System Medicine, Tor Vergata University, 00133 Rome, Italy
| | - Loredana Sarmati
- Clinical Infectious Diseases, Department of System Medicine, Tor Vergata University, 00133 Rome, Italy
- Correspondence: ; Tel./Fax: +39-0672596873
| |
Collapse
|
8
|
Dinkar PK, Kumar S, Kumar S, Verma SK, Kumar S, Kamal A, Chaudhary E. To study the prevalence of latent tuberculosis infection among medical students. INDIAN JOURNAL OF COMMUNITY HEALTH 2022. [DOI: 10.47203/ijch.2022.v34i02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Background: Risk of developing latent tuberculosis infection increases in medical students with their higher exposure to TB care facilities. Objective: To study the prevalence of latent TB infection among students attending professional degrees MBBS, BDS, MD, MS, MDS at King George’s Medical University, India. Methods: This study was carried out with Tuberculin skin testing among students and active TB cases were excluded. A standard dose of 0.1?mL of purified protein derivative was slowly injected intra dermally into non-dominant forearm. After 48-72 hours, the reaction was estimated by measuring the transverse diameter of the induration. Results: Total 561 students had given consent to get enrolled. Prevalence of latent tuberculosis infection was significant with period of clinical exposure (p-value < 0.05), average size of induration (p-value < 0.001), and history of prior Tuberculin Skin Test (p-value < 0.001). However it was not significant with the age (p-value > 0.05), gender (p-value > 0.05), and history of contact with active cases of TB (p-value > 0.05). Conclusion: The prevalence of latent tuberculosis infection is higher in post graduate students followed by interns and final year students due to more exposure to patients in wards and clinics at King George’s Medical University, India.
Collapse
|
9
|
Malsam R, Nienhaus A. Occupational Infections among Dental Health Workers in Germany-14-Year Time Trends. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10128. [PMID: 34639430 PMCID: PMC8508029 DOI: 10.3390/ijerph181910128] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 12/25/2022]
Abstract
Dental health workers (DHW) are at increased risk of acquiring occupational infections. Due to various protective measures, it can be assumed that infections have decreased over the past 14 years. Secondary data from a German accident insurance company was analyzed in terms of reported and confirmed occupational diseases (OD) in DHW from 2006 to 2019. A total of 271 claims were reported, of which 112 were confirmed as OD, representing an average of eight per year. However, the number of claims and confirmed ODs has decreased by 65.6% and 85.7%, respectively. The decrease was most evident for hepatitis B (HBV) and C (HCV) infections, while tuberculosis (TB) infections were stable. A total of 44 HCV, 33 HBV, 6 TB and 24 latent TB infections were confirmed as ODs. For DHW, 0.05, and for hospital workers, 0.48 claims per 1000 full-time equivalents (FTE) were registered in 2019. In a separate documentation system, between March 2020 and February 2021, 155 COVID-19 claims were registered, and 47 cases were confirmed as ODs. For DHW, 0.7, and for hospital workers, 47.3 COVID-19 claims per 1000 FTE were registered since 2020. Occupational infectious diseases rarely occur among DHW. Nevertheless, new infectious diseases such as COVID-19 pose a major challenge for DHW. Continued attention should be paid to infectious disease prevention.
Collapse
Affiliation(s)
- Rebecca Malsam
- Competence Center for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany;
| | - Albert Nienhaus
- Competence Center for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany;
- Department for Occupational Medicine, Hazardous Substances and Health Sciences (AGG), Institution for Statutory Accident Insurance in the Health and Welfare Services (BGW), 22089 Hamburg, Germany
| |
Collapse
|
10
|
Matranga D, Bono F, Maniscalco L. Statistical Advances in Epidemiology and Public Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073549. [PMID: 33805510 PMCID: PMC8036932 DOI: 10.3390/ijerph18073549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 03/25/2021] [Indexed: 11/16/2022]
Abstract
The key role of statistical modeling in epidemiology and public health is unquestionable [...].
Collapse
Affiliation(s)
- Domenica Matranga
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy
- Correspondence:
| | - Filippa Bono
- Department of Economics, Business and Statistics, University of Palermo, 90128 Palermo, Italy;
| | - Laura Maniscalco
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90127 Palermo, Italy;
| |
Collapse
|
11
|
Corvino AR, Monaco MGL, Garzillo EM, Grimaldi E, Donnarumma G, Miraglia N, Di Giuseppe G, Lamberti M. Tuberculosis Infection Screening in 5468 Italian Healthcare Students: Investigation of a Borderline Zone Value for the QFT-Test. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6773. [PMID: 32957500 PMCID: PMC7557828 DOI: 10.3390/ijerph17186773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/04/2020] [Accepted: 09/15/2020] [Indexed: 06/11/2023]
Abstract
Healthcare workers are at an increased risk of contracting Mycobacterium tuberculosis infection. Tuberculin skin test (TST) and interferon gamma release assay (IGRA) represent the available tests most used for the diagnosis of latent tuberculosis infection (LTBI). Different borderline zones have been proposed for defining conversions and reversions to improve the interpretation of the IGRA test results as part of serial testing. From 2012 to 2017, 5468 health students of an Italian University Hospital were screened for tuberculosis infection through the execution of the TST and, in case of positivity, of the QuantiFERON-TB® Gold In-Tube assay (QFT-GIT). The QFT-GIT is considered "borderline" with values from 0.35 to 0.99 IU/mL. Among the students who performed the QFT-GIT assay, 27 subjects presented a range of values defined as borderline. The QFT-GIT was repeated after 90 days on 19 subjects with borderline values and showed a negativization of the values in 14 students and a positive conversion in three cases, while for two students, a borderline value was also found for the second test, with a 74% regression of the borderline cases. The introduction of QuantiFERON borderline values is a useful assessment tool to bring out LTBI case candidates for chemoprophylaxis.
Collapse
Affiliation(s)
- Anna Rita Corvino
- Experimental Medicine Department, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.R.C.); (E.G.); (G.D.); (N.M.); (G.D.G.); (M.L.)
| | | | - Elpidio Maria Garzillo
- Experimental Medicine Department, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.R.C.); (E.G.); (G.D.); (N.M.); (G.D.G.); (M.L.)
- Department of Prevention, Abruzzo Local Health Authority, 67100 L’Aquila, Italy
| | - Elena Grimaldi
- Experimental Medicine Department, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.R.C.); (E.G.); (G.D.); (N.M.); (G.D.G.); (M.L.)
| | - Giovanna Donnarumma
- Experimental Medicine Department, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.R.C.); (E.G.); (G.D.); (N.M.); (G.D.G.); (M.L.)
| | - Nadia Miraglia
- Experimental Medicine Department, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.R.C.); (E.G.); (G.D.); (N.M.); (G.D.G.); (M.L.)
| | - Gabriella Di Giuseppe
- Experimental Medicine Department, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.R.C.); (E.G.); (G.D.); (N.M.); (G.D.G.); (M.L.)
| | - Monica Lamberti
- Experimental Medicine Department, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (A.R.C.); (E.G.); (G.D.); (N.M.); (G.D.G.); (M.L.)
| |
Collapse
|