Institute for Medical Research, Environmental Health Research Centre, Occupational Health Unit, Jalan Pahang, 50588 Kuala Lumpur, Malaysia.
BMC Infect Dis. 2011 Jan 18;11:19. doi: 10.1186/1471-2334-11-19.
Health care workers are exposed to patients with tuberculosis and are at risk of nosocomial infection. The aim of this study was to determine the prevalence and factors associated with latent tuberculosis infection among health care workers in Malaysia and also to evaluate the agreement between Quantiferon TB Gold in tube test with Tuberculin Skin Test.
A cross sectional study was conducted at four randomly selected hospitals in the Klang Valley from December 2008 to May 2009. Self administered questionnaire was used to obtain information on health care workers and possible risk factors. The response rate for this study was 90.8% with 954 respondents completed the questionnaire and were tested with Quantiferon TB Gold in tube for latent tuberculosis infection. Agreement between Quantiferon TB Gold in tube and Tuberculin Skin Test was assessed among 95 health care workers who consented to undergo both tests.
The overall prevalence of latent tuberculosis infection among health care workers was 10.6% (CI: 8.6%; 12.6%). Factors significantly associated with latent tuberculosis infection were aged 35 years and older [9.49 (CI: 2.22; 40.50)], history of living in the same house with close family members or friends who had active tuberculosis [8.69 (CI: 3.00; 25.18)], worked as a nurse [4.65 (CI: 1.10; 19.65)] and being male [3.70 (CI: 1.36; 10.02)]. Agreement between Quantiferon TB Gold in tube test and tuberculin skin test at cut-off points of 10 mm and 15 mm was 50.5% and 82.1% respectively. However, Kappa-agreement was poor for both cut-off points.
The prevalence of latent tuberculosis infection in Malaysia was relatively low for an intermediate TB burden country. We could not comment on the occupational risk of latent tuberculosis infection among health care worker compared to the general population as there were no prevalence data available for latent tuberculosis infection in the general population. Kappa agreement between Quantiferon TB gold in-tube and tuberculin skin test was poor.
医护人员接触结核病患者，存在医院感染的风险。本研究旨在确定马来西亚医护人员中潜伏性结核感染的流行率和相关因素，并评估 Quantiferon TB Gold in tube 试验与结核菌素皮肤试验之间的一致性。
2008 年 12 月至 2009 年 5 月，在吉隆坡四个随机选定的医院进行了横断面研究。采用自填式问卷获取医护人员信息和可能的危险因素。本研究的应答率为 90.8%，954 名应答者完成了问卷，并接受了 Quantiferon TB Gold in tube 检测潜伏性结核感染。同意同时进行两项检测的 95 名医护人员之间评估了 Quantiferon TB Gold in tube 与结核菌素皮肤试验之间的一致性。
医护人员潜伏性结核感染的总体流行率为 10.6%（置信区间：8.6%；12.6%）。与潜伏性结核感染显著相关的因素为年龄 35 岁及以上[9.49（置信区间：2.22；40.50）]、与有活动性肺结核的亲密家庭成员或朋友同住[8.69（置信区间：3.00；25.18）]、护士职业[4.65（置信区间：1.10；19.65）]和男性[3.70（置信区间：1.36；10.02）]。Quantiferon TB Gold in tube 检测与结核菌素皮肤试验在 10mm 和 15mm 截断点的一致性分别为 50.5%和 82.1%。然而，两种截断点的 Kappa 一致性均较差。
马来西亚潜伏性结核感染的流行率相对较低，处于中度结核病负担国家之列。由于缺乏一般人群潜伏性结核感染的流行率数据，我们无法对医护人员与一般人群相比的潜伏性结核感染职业风险进行评论。Quantiferon TB Gold in-tube 与结核菌素皮肤试验之间的 Kappa 一致性较差。
