印度尼西亚医科和护理专业学生中结核分枝杆菌感染的高风险：一项为期1年的前瞻性研究。

High risk of Mycobacterium tuberculosis infection among medical and nursing students in Indonesia: a 1-year prospective study.

作者信息

Apriani Lika, McAllister Susan, Sharples Katrina, Aini Isni Nurul, Nurhasanah Hanifah, Ratnaningsih Dwi Febni, Indrati Agnes Rengga, Ruslami Rovina, Alisjahbana Bachti, van Crevel Reinout, Hill Philip C

机构信息

TB Working Group, Infectious Disease Research Center, Faculty of Medicine, Universitas Padjadjaran, Jl. Prof Eykman, No. 38 Bandung 40161, Indonesia.

Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Jl. Prof Eykman, No. 38 Bandung 40161, Indonesia.

出版信息

Trans R Soc Trop Med Hyg. 2022 Jan 20;116(1):10-18. doi: 10.1093/trstmh/trab038.

DOI:10.1093/trstmh/trab038

PMID:33721022

Abstract

BACKGROUND

Medical and nursing students entering their clinical programmes are at increased risk for tuberculosis (TB) in TB-endemic settings. Relatively little is known about Mycobacterium tuberculosis infection among such students in high-endemic countries.

METHODS

We examined M. tuberculosis infection among medical and nursing students starting clinical training in Bandung, Indonesia using interferon-γ release assay (IGRA) QuantiFERON-TB Gold Plus. IGRA-negative students had a repeat test after 1 y and logistic regression was used to identify factors associated with IGRA positivity or conversion.

RESULTS

There were 379 students included in this study: 248 (65.4%) were medical students and 131 (34.6%) were nursing students. Of 379 students, 70 (18.5%) were IGRA positive at baseline. Of 293 IGRA-negative students with 1-y results, 26 (8.9%) underwent IGRA conversion. Being a medical student (adjusted relative risk [ARR] 5.15 [95% confidence interval {CI} 1.82 to 14.59], p=0.002) and participation in sputum collection or bronchoscopy were associated with IGRA conversion (ARR 2.74 [95% CI 1.29 to 5.79], p=0.008).

CONCLUSIONS

Medical and nursing students entering clinical training are at high risk of M. tuberculosis infection and need improved infection prevention and control strategies.

摘要

背景

在结核病流行地区，进入临床课程学习的医学生和护理专业学生感染结核病的风险增加。在结核病高流行国家，对于这类学生中结核分枝杆菌感染情况了解相对较少。

方法

我们使用γ-干扰素释放试验（IGRA）即结核感染T细胞检测（QuantiFERON-TB Gold Plus），对印度尼西亚万隆开始临床培训的医学生和护理专业学生的结核分枝杆菌感染情况进行了检测。IGRA检测结果为阴性的学生在1年后进行了重复检测，并采用逻辑回归分析来确定与IGRA阳性或血清转化相关的因素。

结果

本研究共纳入379名学生：248名（65.4%）为医学生，131名（34.6%）为护理专业学生。在379名学生中，70名（18.5%）在基线时IGRA检测呈阳性。在293名有1年检测结果的IGRA阴性学生中，26名（8.9%）发生了IGRA血清转化。成为医学生（调整后的相对风险[ARR]为5.15[95%置信区间{CI}为1.82至14.59]，p = 0.002）以及参与痰液采集或支气管镜检查与IGRA血清转化相关（ARR为2.74[95%CI为1.29至5.79]，p = 0.008）。