Lacerda Thamy Carvalho, Souza Fernanda Mattos de, Prado Thiago Nascimento do, Locatelli Rodrigo Leite, Fregona Geisa, Lima Rita de Cássia Duarte, Maciel Ethel Leonor
. 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.
J Bras Pneumol. 2017 Nov-Dec;43(6):416-423. doi: 10.1590/S1806-37562016000000211.
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.
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.
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).
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.
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。
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。
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]）。
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。
