From the Infectious Diseases Unit, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
From the Occupational Health Unit, Family Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Ann Saudi Med. 2020 May-Jun;40(3):191-199. doi: 10.5144/0256-4947.2020.191. Epub 2020 Jun 4.
Health-care workers (HCW) are susceptible to latent tuberculosis infection (LTBI). The prevalence of LTBI in HCW in Saudi Arabia has not been reported using the fourth-generation interferon gamma release assay QuantiFERON-TB Gold Plus (QFT-Plus).
Determine the prevalence of LTBI in a large heterogeneous HCW population and assess risk factors for LTBI.
Cross-sectional and case-control study.
Tertiary academic hospital, Riyadh, Saudi Arabia.
Medical records of HCWs who had QFT-Plus performed between January to December 2018 were reviewed and included in the cross-sectional study. In a subset analysis, randomly selected positive QFT-Plus cases were compared with controls selected from the same areas of work. Univariate and binary logistic regression analyses were performed to assess the significance of other factors to QFT-PLus positivity.
Prevalence of LTBI in HCWs and potential risk factors for LTBI.
3024 HCWs in the cross-sectional analysis; 294 cases and 294 controls in the case-control analysis.
Twenty-four percent (n=733) of the HCWs had a positive QFT-Plus. The median (interquartile range) age was 34.0 (31.0-37.1) years, 71% were female, and only 24.8% were of Saudi nationals. Nursing represented 57.7% of HCWs, and 24.7% were working in a non-clinical area. Only 20.3% worked in TB-related departments. A higher risk of LTBI was present in HCWs who were older than 50 years (OR=1.95), from either Philippines (OR=4.7) or the Indian subcontinent (OR=4.1), working as a nurse (OR=2.7), allied health profession (OR=2.1), radiology technician (OR=3.1), or in the emergency room (OR=2.4) or intensive care unit (OR=2.1). In the binary logistic regression, independent predictors for positive QFT-Plus were age group older than 50 years (aOR=2.96), known TB exposure (aOR=1.97), and not receiving BCG at birth (aOR=3.08).
Single-center, retrospective, possible recall bias for BCG vaccination.
The high prevalence of LTBI among HCW emphasizes the need to continue pre-employment screening, especially for employed personnel from high endemic areas, with targeted annual screening for the same group and other identified high-risk groups. These findings can aid in the development of national screening guidelines for LTBI in HCW.
None.
医疗保健工作者（HCW）易感染潜伏性结核感染（LTBI）。沙特阿拉伯 HCW 中 LTBI 的患病率尚未通过第四代干扰素伽马释放试验 QuantiFERON-TB Gold Plus（QFT-Plus）进行报道。
在大型异质 HCW 人群中确定 LTBI 的患病率，并评估 LTBI 的危险因素。
横断面和病例对照研究。
沙特阿拉伯利雅得的一家三级学术医院。
对 2018 年 1 月至 12 月期间进行 QFT-Plus 检测的 HCW 的病历进行了回顾性分析，并纳入了横断面研究。在亚组分析中，随机选择 QFT-Plus 阳性病例，并与同一工作区域选择的对照进行比较。采用单变量和二元逻辑回归分析评估其他因素对 QFT-PLus 阳性的意义。
HCW 中 LTBI 的患病率和 LTBI 的潜在危险因素。
横断面分析中 3024 名 HCW；病例对照分析中 294 例病例和 294 例对照。
24%（n=733）的 HCW 出现 QFT-Plus 阳性。HCW 的中位（四分位距）年龄为 34.0（31.0-37.1）岁，71%为女性，仅有 24.8%为沙特国民。护士占 HCW 的 57.7%，24.7%在非临床区域工作。仅有 20.3%的人在与结核病相关的部门工作。年龄大于 50 岁（OR=1.95）、来自菲律宾（OR=4.7）或印度次大陆（OR=4.1）、护士（OR=2.7）、辅助医疗专业人员（OR=2.1）、放射技师（OR=3.1）、急诊室（OR=2.4）或重症监护病房（OR=2.1）的 HCW 发生 LTBI 的风险更高。在二元逻辑回归中，QFT-Plus 阳性的独立预测因素为年龄大于 50 岁（aOR=2.96）、已知的 TB 暴露（aOR=1.97）和出生时未接种卡介苗（aOR=3.08）。
单中心、回顾性研究，卡介苗接种可能存在回忆偏倚。
HCW 中 LTBI 的高患病率强调了继续进行入职前筛查的必要性，特别是对来自高流行地区的在职人员进行筛查，同时对同一人群和其他确定的高危人群进行有针对性的年度筛查。这些发现可以帮助制定 HCW 中 LTBI 的国家筛查指南。
无。
