A multicenter evaluation of tuberculin skin test positivity and conversion among health care workers in Brazilian hospitals

A multicenter evaluation of tuberculin skin test positivity and conversion among health care workers in Brazilian hospitals

Author Roth, V. R. Google Scholar
Garrett, D. O. Google Scholar
Laserson, K. F. Google Scholar
Starling, C. E. Google Scholar
Kritski, Afranio Lineu Autor UNIFESP Google Scholar
Medeiros, Eduardo Alexandrino Servolo de Autor UNIFESP Google Scholar
Binkin, N. Google Scholar
Jarvis, W. R. Google Scholar
Institution Ctr Dis Control & Prevent
Universidade Federal de Minas Gerais (UFMG)
Universidade Federal do Rio de Janeiro (UFRJ)
Universidade Federal de São Paulo (UNIFESP)
Abstract SETTING: Four general Brazilian hospitals.OBJECTIVE: To assess the occupational risk of Mycobacterium tuberculosis (TB) in participating hospitals.DESIGN: In phase one of this longitudinal study, a cross-sectional survey documented baseline tuberculin skin test (TST) positivity rates. In phase two, TST conversion rates were evaluated in participants with an initial negative two-step TST. TST conversion data were analyzed to determine risk factors for TB infection using an increase of >= 10 mm compared to baseline TST.RESULTS: The initial TST positivity rate was 63.1%; the follow-up TST conversion rate was 10.7 per 1000 person-months (p-m). Hospital of employment, recent bacille Calmette-Guerin (BCG) vaccination, nosocomial TB exposure, and employment as a nurse were independent risk factors for TST conversion. Hospitals without TB infection control measures had higher conversion rates than those with control measures (16.0 vs. 7.8/1000 p-m, P < 0.001).CONCLUSIONS: This study indicates an important occupational risk of infection in health care settings with a high TB incidence. Longitudinal TST studies are a valuable tool to assess the occupational risk of TB, even in BCG-vaccinated populations, and should be used to direct limited resources for infection control.
Keywords tuberculin rest
PPD
tuberculosis
BCG
Brazil
Language English
Date 2005-12-01
Published in International Journal Of Tuberculosis And Lung Disease. Paris: Int Union Against Tuberculosis Lung Disease (i U A T L D), v. 9, n. 12, p. 1335-1342, 2005.
ISSN 1027-3719 (Sherpa/Romeo, impact factor)
Publisher Int Union Against Tuberculosis Lung Disease (i U A T L D)
Extent 1335-1342
Origin http://www.ingentaconnect.com/contentone/iuatld/ijtld/2005/00000009/00000012/art00007
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000234981300007
URI http://repositorio.unifesp.br/11600/44120

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