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基层医疗工作者中的结核病感染情况。

Tuberculosis infection among primary health care workers.

作者信息

Lacerda Thamy Carvalho, Souza Fernanda Mattos de, Prado Thiago Nascimento do, Locatelli Rodrigo Leite, Fregona Geisa, Lima Rita de Cássia Duarte, Maciel Ethel Leonor

机构信息

. Laboratório de Epidemiologia, Universidade Federal do Espírito Santo, Vitória (ES) Brasil.

. Programa de Pós-Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo, Vitória (ES) Brasil.

出版信息

J Bras Pneumol. 2017 Nov-Dec;43(6):416-423. doi: 10.1590/S1806-37562016000000211.

Abstract

OBJECTIVE

To estimate the prevalence of and determine the risk factors associated with latent Mycobacterium tuberculosis infection (LTBI) among primary health care workers in the city of Vitória, Brazil.

METHODS

This was a cross-sectional study with data collected through a survey regarding socio-demographic, occupational, clinical, and exposure characteristics, as well as knowledge about tuberculosis, conducted between 2011 and 2012. All participants underwent a tuberculin skin test (TST), and TSTs were read at 72 h by a trained professional.

RESULTS

A total of 218 primary health care workers participated in the study. The prevalence of TST positivity at the ≥ 10-mm and ≥ 5-mm cut-off points was, respectively, 39.4% (95% CI: 32.9-45.9) and 54.1% (95% CI: 47.4-60.7). Regarding occupational categories, community health agents had the highest proportion of TST positivity, regardless of the cut-off point (≥ 10 mm: 47.5%; and ≥ 5 mm: 60.5%). Regarding factors associated with TST results, "having had a previous TST" showed a statistically significant association with TST positivity at the ≥ 10-mm and ≥ 5-mm cut-off points (OR = 2.5 [95% CI: 1.17-5.30] and OR = 2.18 [95% CI: 1.23-3.87], respectively).

CONCLUSIONS

The prevalence of LTBI was found to be high among the primary health care workers in this sample. Therefore, we recommend the establishment of a periodic screening program for LTBI and implementation of effective biosafety policies for the prevention of this infection among primary health care workers.

摘要

目的

评估巴西维多利亚市基层医疗工作者中潜伏性结核分枝杆菌感染(LTBI)的患病率,并确定与之相关的危险因素。

方法

这是一项横断面研究,于2011年至2012年期间通过一项关于社会人口学、职业、临床和暴露特征以及结核病知识的调查收集数据。所有参与者均接受结核菌素皮肤试验(TST),并由经过培训的专业人员在72小时读取结果。

结果

共有218名基层医疗工作者参与了该研究。在≥10毫米和≥5毫米切点处TST阳性的患病率分别为39.4%(95%可信区间:32.9 - 45.9)和54.1%(95%可信区间:47.4 - 60.7)。在职业类别方面,无论切点如何,社区卫生工作者的TST阳性比例最高(≥10毫米:47.5%;≥5毫米:60.5%)。关于与TST结果相关的因素,“既往曾接受TST”在≥10毫米和≥5毫米切点处与TST阳性显示出统计学上的显著关联(优势比分别为2.5 [95%可信区间:1.17 - 5.30]和2.18 [95%可信区间:1.23 - 3.87])。

结论

在该样本中的基层医疗工作者中发现LTBI的患病率很高。因此,我们建议为LTBI建立定期筛查计划,并实施有效的生物安全政策以预防基层医疗工作者中的这种感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9921/5792040/4d2a41b0c0a5/1806-3713-jbpneu-43-06-00416-gf1.jpg

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