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莫桑比克楠普拉中心医院医护人员中潜伏性结核感染的患病率及危险因素

Prevalence and risk factors for latent tuberculosis infection among healthcare workers in Nampula Central Hospital, Mozambique.

作者信息

Belo Celso, Naidoo Saloshni

机构信息

Department of Medicine, Faculty of Health Sciences, Lúrio University, Marrere campus, Street 4250, Km 2.3, Nampula, Mozambique.

Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, 2nd Floor, Room 236, George Campbell Building, Howard College, Durban, 4041, South Africa.

出版信息

BMC Infect Dis. 2017 Jun 8;17(1):408. doi: 10.1186/s12879-017-2516-4.

Abstract

BACKGROUND

Healthcare workers in high tuberculosis burdened countries are occupationally exposed to the tuberculosis disease with uncomplicated and complicated tuberculosis on the increase among them. Most of them acquire Mycobacterium tuberculosis but do not progress to the active disease - latent tuberculosis infection. The objective of this study was to assess the prevalence and risk factors associated with latent tuberculosis infection among healthcare workers in Nampula Central Hospital, Mozambique.

METHODS

This cross-sectional study of healthcare workers was conducted between 2014 and 2015. Participants (n = 209) were administered a questionnaire on demographics and occupational tuberculosis exposure and had a tuberculin skin test administered. Multivariate linear and logistic regression tested for associations between independent variables and dependent outcomes (tuberculin skin test induration and latent tuberculosis infection status).

RESULTS

The prevalence of latent tuberculosis infection was 34.4%. Latent tuberculosis infection was highest in those working for more than eight years (39.3%), those who had no BCG vaccination (39.6%) and were immunocompromised (78.1%). Being immunocompromised was significantly associated with latent tuberculosis infection (OR 5.97 [95% CI 1.89; 18.87]). Positive but non-significant associations occurred with working in the medical domain (OR 1.02 [95% CI 0.17; 6.37]), length of employment > eight years (OR 1.97 [95% CI 0.70; 5.53]) and occupational contact with tuberculosis patients (OR 1.24 [95% CI 0.47; 3.27]).

CONCLUSIONS

Personal and occupational factors were positively associated with latent tuberculosis infection among healthcare workers in Mozambique.

摘要

背景

在结核病负担较重的国家,医护人员面临职业性结核暴露风险,其中单纯性和复杂性结核病的发病率均呈上升趋势。他们中的大多数人感染了结核分枝杆菌,但并未发展为活动性疾病——即潜伏性结核感染。本研究的目的是评估莫桑比克楠普拉中心医院医护人员中潜伏性结核感染的患病率及其相关危险因素。

方法

本研究于2014年至2015年对医护人员进行了横断面调查。研究对象(n = 209)填写了一份关于人口统计学和职业性结核暴露情况的问卷,并接受了结核菌素皮肤试验。采用多变量线性回归和逻辑回归分析自变量与因变量结果(结核菌素皮肤试验硬结和潜伏性结核感染状态)之间的关联。

结果

潜伏性结核感染的患病率为34.4%。工作超过8年的人员(39.3%)、未接种卡介苗的人员(39.6%)以及免疫功能低下的人员(78.1%)中潜伏性结核感染率最高。免疫功能低下与潜伏性结核感染显著相关(比值比5.97 [95%可信区间1.89;18.87])。在医疗领域工作(比值比1.02 [95%可信区间0.17;6.37])、工作年限>8年(比值比1.97 [95%可信区间0.70;5.53])和与结核病患者有职业接触(比值比1.24 [95%可信区间0.47;3.27])与潜伏性结核感染呈正相关,但无统计学意义。

结论

个人因素和职业因素与莫桑比克医护人员潜伏性结核感染呈正相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f728/5465546/b204ddc8a9e3/12879_2017_2516_Fig1_HTML.jpg

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