Rutanga Claude, Lowrance David W, Oeltmann John E, Mutembayire Grace, Willis Matt, Uwizeye Claude Bernard, Hinda Ruton, Bassirou Chitou, Gutreuter Steve, Gasana Michel
Division of Tuberculosis and Other Respiratory Communicable Diseases Rwanda Biomedical Centre, Kigali, Rwanda.
Division of Global HIV/AIDS, Centers for Disease Control and Prevention, Kigali, Rwanda.
PLoS One. 2015 Apr 28;10(4):e0124485. doi: 10.1371/journal.pone.0124485. eCollection 2015.
Data are limited regarding tuberculosis (TB) and latent TB infection prevalence in Rwandan health facilities.
We conducted a cross-sectional survey among healthcare workers (HCWs) in Kigali during 2010. We purposively selected the public referral hospital, both district hospitals, and randomly selected 7 of 17 health centers. School workers (SWs) from the nearest willing public schools served as a local reference group. We tested for latent TB infection (LTBI) using tuberculin skin testing (TST) and asked about past TB disease. We assessed risk of LTBI and past history of TB disease associated with hospital employment. Among HCWs, we assessed risk associated with facility type (district hospital, referral hospital, health center), work setting (inpatient, outpatient), and occupation.
Age, gender, and HIV status was similar between the enrolled 1,131 HCWs and 381 SWs. LTBI was more prevalent among HCWs (62%) than SWs (39%). Adjusted odds of a positive TST result were 2.71 (95% CI 2.01-3.67) times greater among HCWs than SWs. Among HCWs, there was no detectable difference between prevalence of LTBI according to facility type, work setting, or occupation.
HCWs are at greater risk of LTBI, regardless of facility type, work setting, or occupation. The current status of TB infection control practices should be evaluated in the entire workforce in all Rwandan healthcare facilities.
关于卢旺达医疗机构中结核病（TB）和潜伏性结核感染患病率的数据有限。
2010年期间，我们在基加利的医护人员（HCWs）中开展了一项横断面调查。我们有目的地选择了公立转诊医院、两家区级医院，并从17家卫生中心中随机选取了7家。来自最近愿意参与的公立学校的学校工作人员（SWs）作为当地参照组。我们采用结核菌素皮肤试验（TST）检测潜伏性结核感染（LTBI），并询问过去的结核病患病情况。我们评估了与医院工作相关的LTBI风险和既往结核病患病史。在医护人员中，我们评估了与医疗机构类型（区级医院、转诊医院、卫生中心）、工作环境（住院部、门诊部）和职业相关的风险。
1131名医护人员和381名学校工作人员在年龄、性别和艾滋病毒感染状况方面相似。医护人员中LTBI的患病率（62%）高于学校工作人员（39%）。医护人员结核菌素皮肤试验结果呈阳性的校正比值比是学校工作人员的2.71倍（95%置信区间2.01 - 3.67）。在医护人员中，根据医疗机构类型、工作环境或职业，LTBI患病率没有可检测到的差异。
无论医疗机构类型、工作环境或职业如何，医护人员发生LTBI的风险更高。应评估卢旺达所有医疗机构全体工作人员目前的结核感染控制措施状况。
