BACKGROUND: Tuberculin skin test (TST) and interferon gamma release assays (IGRAs) are both recommended for routine screening of healthcare workers (HCWs) in low tuberculosis (TB)-burden countries. More recently, based on scarce data, the World Health Organization strongly recommended that IGRA should not be used for occupational screening in high-burden settings. OBJECTIVE: To assess the prevalence of latent tuberculosis infection (LTBI) determined among highly exposed HCWs and low-exposed medical students in Johannesburg, South Africa. Methods. We performed a cross-sectional study using both TSTs and IGRAs to determine the prevalence rate of LTBI in 79 medical students and 120 HCWs providing HIV and/or TB care. RESULTS: The prevalence of LTBI among HCWs was 2- to 4-fold higher than that among medical students (56.7% v. 26.6% TST-positive; 69.2% v.15.2% IGRA-positive, respectively), with 3-fold higher odds for TST positivity and 12-fold higher odds for IGRA positivity among HCWs compared with students. Despite the perception of being at high risk, few HCWs protected themselves against LTBI. The majority of HCWs reported that they would participate in annual TST or IGRA screening. CONCLUSION: Infection control strategies and occupational screening programmes for professional and lay HCWs, as well as medical students, should be implemented in all high-burden settings. Further research is needed to determine whether IGRA or TST is the optimal assay for periodical screening of HCWs in high-burden settings.
BACKGROUND: Tuberculin skin test (TST) and interferon gamma release assays (IGRAs) are both recommended for routine screening of healthcare workers (HCWs) in low tuberculosis (TB)-burden countries. More recently, based on scarce data, the World Health Organization strongly recommended that IGRA should not be used for occupational screening in high-burden settings. OBJECTIVE: To assess the prevalence of latent tuberculosis infection (LTBI) determined among highly exposed HCWs and low-exposed medical students in Johannesburg, South Africa. Methods. We performed a cross-sectional study using both TSTs and IGRAs to determine the prevalence rate of LTBI in 79 medical students and 120 HCWs providing HIV and/or TB care. RESULTS: The prevalence of LTBI among HCWs was 2- to 4-fold higher than that among medical students (56.7% v. 26.6% TST-positive; 69.2% v.15.2% IGRA-positive, respectively), with 3-fold higher odds for TST positivity and 12-fold higher odds for IGRA positivity among HCWs compared with students. Despite the perception of being at high risk, few HCWs protected themselves against LTBI. The majority of HCWs reported that they would participate in annual TST or IGRA screening. CONCLUSION: Infection control strategies and occupational screening programmes for professional and lay HCWs, as well as medical students, should be implemented in all high-burden settings. Further research is needed to determine whether IGRA or TST is the optimal assay for periodical screening of HCWs in high-burden settings.
Authors: Ruvandhi R Nathavitharana; Patricia Bond; Angela Dramowski; Koot Kotze; Philip Lederer; Ingrid Oxley; Jurgens A Peters; Chanel Rossouw; Helene-Mari van der Westhuizen; Bart Willems; Tiong Xun Ting; Arne von Delft; Dalene von Delft; Raquel Duarte; Edward Nardell; Alimuddin Zumla Journal: Presse Med Date: 2017-02-28 Impact factor: 1.228
Authors: Mark Hatherill; Thomas J Scriba; Zarir F Udwadia; Jai B Mullerpattan; Anthony Hawkridge; Hassan Mahomed; Christopher Dye Journal: Clin Infect Dis Date: 2016-05-15 Impact factor: 9.079
Authors: Liesl Grobler; Shaheen Mehtar; Keertan Dheda; Shahieda Adams; Sanni Babatunde; Martie van der Walt; Muhammad Osman Journal: BMC Health Serv Res Date: 2016-08-20 Impact factor: 2.655
Authors: Jabulani R Ncayiyana; Jean Bassett; Nora West; Daniel Westreich; Eustasius Musenge; Michael Emch; Audrey Pettifor; Colleen F Hanrahan; Sheree R Schwartz; Ian Sanne; Annelies van Rie Journal: BMC Infect Dis Date: 2016-11-08 Impact factor: 3.090