Faculty of Medicine, Department of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Emerging Infectious Diseases Clinical Center, Thai Red Cross Society, Bangkok, Thailand.
PLoS One. 2022 Aug 24;17(8):e0273027. doi: 10.1371/journal.pone.0273027. eCollection 2022.
There are a few reports of TB disease among healthcare workers (HCWs) in Thailand. The authors assessed the demographic data and incidence of overall TB disease including specific profession among HCWs in order to reduce the incidence rate.
This was a descriptive, cross-sectional study of 195 HCWs at King Chulalongkorn Memorial Hospital (KCMH), Bangkok, Thailand, who had TB disease from 2003-2020.
The average incidence of TB disease in HCWs at KCMH was 164 per 100,000 HCWs with 95% confidential interval [CI], 107 to 220; (94.4% had pulmonary TB). Most of the HCWs were from a young age group (43.08% were 20-29 years old) and the duration of work was short (58.82% had worked at KCMH for less than 5 years). Radiological technicians had the highest incidence of TB, followed by supportive teams, scientists, and physicians (429, 241, 205, and 193 per 100,000 HCWs according to their profession, respectively). Seventy five percent of TB disease was found in physicians who worked at KCMH within 2 years. TB incidence was highest among residents (688 per 100,000 residents) in a subgroup of physicians.
The incidence of TB disease in HCWs was close to the general population of Thailand (153 per 100,000 population with 95% CI, 116 to 195). A higher incidence was observed in the profession that had contact with TB patients and their specimens. A high proportion of asymptomatic HCWs also had TB disease and TB incidence was found in a new generation of HCWs who have worked for less than 5 years. More rigorous epidemiology investigations are needed to establish a definitive relation to subsequently developing TB after working in a hospital. The authors suggest active surveillance in all new incoming HCWs and TB preventive therapy should also be provided to recent converters.
泰国曾有少数几例医护人员（HCWs）结核病病例的报告。作者评估了 HCWs 中总体结核病发病情况，包括特定职业，以便降低发病率。
这是一项对泰国曼谷朱拉隆功国王纪念医院（KCMH）195 名 HCWs 的描述性、横断面研究，这些 HCWs 在 2003-2020 年间患有结核病。
KCMH 的 HCWs 的结核病平均发病率为每 100,000 名 HCWs 中有 164 例，95%置信区间[CI]为 107 至 220 例；（94.4%为肺结核）。大多数 HCWs 年龄较轻（43.08%为 20-29 岁），工作时间较短（58.82%在 KCMH 的工作时间不到 5 年）。放射技师的结核病发病率最高，其次是支持团队、科学家和医生（分别为每 100,000 名 HCWs 中有 429、241、205 和 193 例）。75%的结核病是在 KCMH 工作不到 2 年的医生中发现的。在医生亚组中，住院医师的结核病发病率最高（每 100,000 名住院医师中有 688 例）。
HCWs 的结核病发病率接近泰国的一般人群（每 100,000 人中有 153 例，95%CI 为 116 至 195 例）。与结核病患者及其标本接触的职业发病率较高。相当比例的无症状 HCWs 也患有结核病，并且在工作时间不到 5 年的新一代 HCWs 中发现了结核病。需要更严格的流行病学调查来确定与随后在医院工作后发生结核病的明确关系。作者建议对所有新入职的 HCWs 进行主动监测，并为最近转化的人员提供结核病预防性治疗。
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