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泰国东北部医护人员潜伏性结核感染的风险因素

RISK FACTORS FOR LATENT TUBERCULOSIS INFECTION AMONG HEALTH-CARE WORKERS IN NORTHEASTERN THAILAND.

作者信息

Nonghanphithak Ditthawat, Reechaipichitkul Wipa, Chaiyasung Tassamonwan, Faksri Kiatichai

出版信息

Southeast Asian J Trop Med Public Health. 2016 Nov;47(6):1198-1208.

Abstract

Health-care workers (HCWs) are a high-risk population for acquiring Mycobacterium tuberculosis infection. Understanding the risk factors for latent tuberculosis infection (LTBI) could provide information to facilitate an appropriate tuberculosis (TB) control program. We aimed to determine the prevalence of, and risk factors for LTBI among HCWs in northeastern Thailand. Between 1 November 2013 and 30 September 2015, we examined 112 HCWs at Srinagarind Hospital, Khon Kaen Province in northeastern Thailand using the QuantiFERON®-TB Gold In-Tube (QFT) assay. Twenty-one [18.8%; 95% confidence interval (CI): 11.5- 26.0%] HCWs had a positive QFT result — all of whom were determined to have LTBI. The exposure risks and demographic data obtained from a questionnaire were compared between the 21 subjects who had a positive QFT assay and the 91 subjects who had a negative QFT assay. Multivariate analysis showed factors significantly associated with a positive QFT assay were: age ≥30 years (OR=18.88; 95%CI: 1.52-234.36), having worked as a nurse (OR=2.78; 95%CI: 1.19-6.49), having been employed at that job for ≥10 years (OR=8.78; 95%CI: 1.26-61.29) and having been exposed to known TB patients (OR=13.32: 95%CI: 1.61-110.04). Appropriate guidelines need to be developed, especially for these at-risk workers to prevent LTBI. These high-risk workers should also be considered for regular TB screening.

摘要

医护人员是感染结核分枝杆菌的高危人群。了解潜伏性结核感染(LTBI)的危险因素可为制定适当的结核病(TB)控制计划提供信息。我们旨在确定泰国东北部医护人员中LTBI的患病率及其危险因素。在2013年11月1日至2015年9月30日期间,我们使用全血γ-干扰素释放试验(QFT)对泰国东北部孔敬府诗里拉吉医院的112名医护人员进行了检测。21名医护人员(18.8%;95%置信区间[CI]:11.5%-26.0%)的QFT检测结果呈阳性,所有这些人都被判定为LTBI。对QFT检测呈阳性的21名受试者和QFT检测呈阴性的91名受试者的问卷中获得的暴露风险和人口统计学数据进行了比较。多因素分析显示,与QFT检测呈阳性显著相关的因素为:年龄≥30岁(比值比[OR]=18.88;95%CI:1.52-234.36)、曾担任护士(OR=2.78;95%CI:1.19-6.49)、从事该工作≥10年(OR=8.78;95%CI:1.26-61.29)以及曾接触已知结核病患者(OR=13.32:95%CI:1.61-110.04)。需要制定适当的指南,尤其是针对这些高危工作人员以预防LTBI。还应考虑对这些高危工作人员进行定期结核病筛查。

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