Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.
Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru.
BMC Public Health. 2020 May 3;20(1):612. doi: 10.1186/s12889-020-08756-9.
Tuberculosis (TB) transmission has long been recognized as an important occupational hazard for healthcare workers (HCWs). HCWs have a 5.8% annual risk of exposure and three times greater risk of developing active TB than the general population.
We conducted an observational cross-sectional study between September 2014 and March 2015 among HCWs in a high-burden TB setting in Lima to estimate the prevalence of positive Tuberculin Skin Test (TST) and to investigate factors associated with a positive TST.
Two hundred forty participants were included in the analysis; TST was administered to 190 (79.2%) while the rest were exempt due to a previous positive TST result, history of TB, or test refusal. A positive TST result was found among 56.2% of participants to whom the TST was applied (95% CI: 49.22-63.55%). When considering those who had a previous positive TST result and those with a history of TB, the prevalence of a positive TST result was 64.3% (95% CI: 57.8-70.3%). No significant differences were observed between clinical/paramedical and administrative staff in the health center. The use of N95 masks during work hours was reported by 142 (69.9%) participants. Prevalence ratios (PR) show that workers with more than 120 months as a HCW were 1.44 times more likely to be TST positive. The multivariate analysis found that HCWs with over 10 years of service were 1.52 times more likely to be TST positive.
This study supports previous reports that TB infection is an occupational hazard for HCWs. Prevention of TB transmission through control measures, as well as timely diagnosis of LTBI in this particular high-risk group, is critical for individual and public health.
结核病（TB）传播长期以来一直被认为是医护人员（HCWs）的重要职业危害。HCWs 的暴露风险为每年 5.8%，比普通人群患活动性结核病的风险高 3 倍。
我们于 2014 年 9 月至 2015 年 3 月在利马的一个结核病高负担地区对 HCWs 进行了一项观察性横断面研究，以估计结核菌素皮肤试验（TST）阳性率，并调查与 TST 阳性相关的因素。
240 名参与者被纳入分析；190 人接受了 TST（79.2%），其余人因以前的 TST 阳性结果、TB 病史或拒绝测试而免于测试。对接受 TST 的参与者中，有 56.2%（95%可信区间：49.22-63.55%）的 TST 结果为阳性。考虑到以前有 TST 阳性结果和 TB 病史的人，TST 阳性率为 64.3%（95%可信区间：57.8-70.3%）。在卫生中心，临床/辅助医务人员和行政人员之间没有观察到显著差异。142 名（69.9%）参与者报告在工作时间使用 N95 口罩。患病比值（PR）显示，作为 HCW 工作超过 120 个月的工人 TST 阳性的可能性是前者的 1.44 倍。多变量分析发现，服务超过 10 年的 HCWs 更有可能 TST 阳性，患病比值为 1.52。
本研究支持了以前的报告，即结核病感染是 HCWs 的职业危害。通过控制措施预防结核病传播，以及及时诊断这一特定高危人群的 LTBI，对个人和公共卫生都至关重要。
