Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES, Brasil.
Rev Saude Publica. 2010 Apr;44(2):332-8. doi: 10.1590/s0034-89102010000200014.
To estimate the risk of tuberculosis infection among community health agents involved in disease control.
A prospective cohort was followed up from April 2007 to May 2008 in the municipality of Cachoeiro de Itapemirim, Southeastern Brazil. The cohort was composed of 61 community agents, divided between unexposed individuals (n = 37) and exposed individuals (who were following up tuberculosis patients; n = 24). Over the 12-month follow-up, the tuberculin test was performed, using the tuberculin PPD RT23. The relative risk and 95% confidence interval were calculated, and the correlation between tuberculin response and the agents' occupational history was evaluated by means of Pearson's correlation.
The incidence of the response was 41.7% in the exposed group and 13.5% in the unexposed group. The annual risk of infection was 52.8% in the exposed group and 14.4% in the unexposed group (p = 0.013). An association between tuberculin response and exposure to patients with tuberculosis was observed (RR = 3.08; 95% CI: 1.201;7.914).
The agents who followed up tuberculosis patients during their routine work presented a greater risk of infection than did those who were not following up such patients. Implementation of routine administrative biosafety measures, among which the tuberculin test, should be prioritized, given the high risk of acquiring tuberculous infection among community health agents.
评估参与疾病控制的社区卫生工作者的结核感染风险。
2007 年 4 月至 2008 年 5 月，在巴西东南部卡舒埃鲁伊塔佩米林姆市对一个前瞻性队列进行了随访。该队列由 61 名社区工作者组成，分为未暴露个体（n=37）和暴露个体（随访结核患者；n=24）。在 12 个月的随访期间，使用结核菌素 PPD RT23 进行结核菌素试验。计算相对风险和 95%置信区间，并通过皮尔逊相关评估结核菌素反应与工作者职业史之间的相关性。
暴露组的反应发生率为 41.7%，未暴露组为 13.5%。暴露组的年感染率为 52.8%，未暴露组为 14.4%（p=0.013）。观察到结核菌素反应与接触结核患者之间存在关联（RR=3.08；95%CI：1.201；7.914）。
在常规工作中随访结核病患者的工作者比未随访此类患者的工作者感染的风险更大。应优先实施常规行政生物安全措施，包括结核菌素试验，因为社区卫生工作者感染结核的风险很高。
