Referrals for positive tuberculin tests in new health care workers and students: a retrospective cohort study
نویسندگان
چکیده
BACKGROUND Documentation of test results for latent tuberculosis (TB) infection is important for health care workers and students before they begin work. A negative result provides a baseline for comparison with future tests. A positive result affords a potential opportunity for treatment of latent infection when appropriate. We sought to evaluate the yield of the referral process for positive baseline tuberculin tests, among persons beginning health care work or studies. METHODS Retrospective cohort study. We reviewed the charts of all new health care students and workers referred to the Montreal Chest Institute in 2006 for positive baseline tuberculin skin tests (> or =10 mm). Health care workers and students evaluated for reasons other than positive baseline test results were excluded. RESULTS 630 health care students and workers were evaluated. 546 (87%) were foreign-born, and 443 (70%) reported previous Bacille Calmette-Guérin (BCG) vaccination. 420 (67%) were discharged after their first evaluation without further treatment. 210 (33%) were recommended treatment for latent TB infection, of whom 165 (79%) began it; of these, 115 (70%) completed adequate treatment with isoniazid or rifampin. Treatment discontinuation or interruption occurred in a third of treated subjects, and most often reflected loss to follow-up, or abdominal discomfort. No worker or student had active TB. CONCLUSIONS Only a small proportion of health care workers and students with positive baseline tuberculin tests were eligible for, and completed treatment for latent TB infection. We discuss recommendations for improving the referral process, so as to better target workers and students who require specialist evaluation and treatment for latent TB infection. Treatment adherence also needs improvement.
منابع مشابه
A Comparison of Two-Step Tuberculin Skin Test between Health-Care Workers and Nonhospital Employees
Background: The tuberculin test is widely used to identify tuberculosis infection. Some individuals infected with Mycobacterium tuberculosis may have an initial negative skin test reaction to tuberculin. The two step purified protein derivative skin test can decrease misinterpretation of tuberculin test .This study was aimed at comparing the two- step tuberculin skin test and booster phenomenon...
متن کاملDetection of Latent Tuberculosis Infection in Nursing Students by Combined TST and IGRA Serial Testing
Nursing students are Occupationally at risk group for tuberculosis. Tuberculosis can either be as Latent tuberculosis (LTBI) or as active tuberculosis infection (TBI). Lack of awareness and not taking appropriate self defence exposes this group to acquire tuberculosis. it is the prime responsibility of governments and the managements of hospitals must take care of the health care workers. There...
متن کاملMycobacterium tuberculosis infection in health care workers in rural India: comparison of a whole-blood interferon gamma assay with tuberculin skin testing.
CONTEXT Mycobacterium tuberculosis infection in health care workers has not been adequately studied in developing countries using newer diagnostic tests. OBJECTIVES To estimate latent tuberculosis infection prevalence in health care workers using the tuberculin skin test (TST) and a whole-blood interferon gamma (IFN-gamma) assay; to determine agreement between the tests; and to compare their ...
متن کاملLatent Mycobacterium tuberculosis Infection.
To the Editor: In their review article, Getahun et al. (May 28 issue)1 provide a useful overview of issues surrounding latent tuberculosis infection. However, newly published data regarding the performance of the T-SPOT.TB assay call into question the supposition that false conversions and reversions are more common with interferon-γ release assays (IGRAs) than with tuberculin skin tests.2 Spec...
متن کاملTuberculosis Infection Among Medical Students before and After Clinical Rotations
Abstract Introduction: Considering the importance of screening for diagnosis of tuberculosis (TB) infection among medical students and the necessity of annual TB tests and effectiveness of preventive programs, there is an ever increasing need for undertaking research to investigate the effect of residence in hospital on the risk of tuberculosis infection among students, and planning strategies...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 10 شماره
صفحات -
تاریخ انتشار 2010