Veriko Mirtskhulava1, Jennifer A Whitaker2, Maia Kipiani1, Drew A Harris3, Nino Tabagari4, Ashli A Owen-Smith5, Russell R Kempker6, Henry M Blumberg6. 1. 1National Center for Tuberculosis and Lung Diseases,Tbilisi,Georgia. 2. 2Divisions of General Internal Medicine and Infectious Diseases,Mayo Clinic,Rochester,Minnesota,USA. 3. 3Department of Pulmonary,Critical Care and Sleep Medicine,Yale University New Haven,Connecticut,USA. 4. 4"AIETI" Medical School,David Tvildiani Medical University,Tbilisi,Georgia. 5. 5Department of Behavioral Sciences and Health Education,Rollins School of Public Health,Emory University,Atlanta,Georgia,USA. 6. 6Division of Infectious Diseases,Department of Medicine,School of Medicine,Emory University,Atlanta,Georgia,USA.
Abstract
OBJECTIVE: To better understand tuberculosis (TB) infection control (IC) in healthcare facilities (HCFs) in Georgia. DESIGN: A cross-sectional evaluation of healthcare worker (HCW) knowledge, beliefs and behaviors toward TB IC measures including latent TB infection (LTBI) screening and treatment of HCWs. SETTING: Georgia, a high-burden multidrug-resistant TB (MDR-TB) country. PARTICIPANTS: HCWs from the National TB Program and affiliated HCFs. METHODS: An anonymous self-administered 55-question survey developed based on the Health Belief Model (HBM) conceptual framework. RESULTS: In total, 240 HCWs (48% physicians; 39% nurses) completed the survey. The overall average TB knowledge score was 61%. Only 60% of HCWs reported frequent use of respirators when in contact with TB patients. Only 52% of HCWs were willing to undergo annual LTBI screening; 48% were willing to undergo LTBI treatment. In multivariate analysis, HCWs who worried about acquiring MDR-TB infection (adjusted odds ratio [aOR], 1.7; 95% confidence interval [CI], 1.28-2.25), who thought screening contacts of TB cases is important (aOR, 3.4; 95% CI, 1.35-8.65), and who were physicians (aOR, 1.7; 95% CI, 1.08-2.60) were more likely to accept annual LTBI screening. With regard to LTBI treatment, HCWs who worked in an outpatient TB facility (aOR, 0.3; 95% CI, 0.11-0.58) or perceived a high personal risk of TB reinfection (aOR, 0.5; 95% CI, 0.37-0.64) were less likely to accept LTBI treatment. CONCLUSION: The concern about TB reinfection is a major barrier to HCW acceptance of LTBI treatment. TB IC measures must be strengthened in parallel with or prior to the introduction of LTBI screening and treatment of HCWs.
OBJECTIVE: To better understand tuberculosis (TB) infection control (IC) in healthcare facilities (HCFs) in Georgia. DESIGN: A cross-sectional evaluation of healthcare worker (HCW) knowledge, beliefs and behaviors toward TB IC measures including latent TB infection (LTBI) screening and treatment of HCWs. SETTING: Georgia, a high-burden multidrug-resistant TB (MDR-TB) country. PARTICIPANTS: HCWs from the National TB Program and affiliated HCFs. METHODS: An anonymous self-administered 55-question survey developed based on the Health Belief Model (HBM) conceptual framework. RESULTS: In total, 240 HCWs (48% physicians; 39% nurses) completed the survey. The overall average TB knowledge score was 61%. Only 60% of HCWs reported frequent use of respirators when in contact with TB patients. Only 52% of HCWs were willing to undergo annual LTBI screening; 48% were willing to undergo LTBI treatment. In multivariate analysis, HCWs who worried about acquiring MDR-TB infection (adjusted odds ratio [aOR], 1.7; 95% confidence interval [CI], 1.28-2.25), who thought screening contacts of TB cases is important (aOR, 3.4; 95% CI, 1.35-8.65), and who were physicians (aOR, 1.7; 95% CI, 1.08-2.60) were more likely to accept annual LTBI screening. With regard to LTBI treatment, HCWs who worked in an outpatient TB facility (aOR, 0.3; 95% CI, 0.11-0.58) or perceived a high personal risk of TB reinfection (aOR, 0.5; 95% CI, 0.37-0.64) were less likely to accept LTBI treatment. CONCLUSION: The concern about TB reinfection is a major barrier to HCW acceptance of LTBI treatment. TB IC measures must be strengthened in parallel with or prior to the introduction of LTBI screening and treatment of HCWs.
Authors: V Mirtskhulava; R Kempker; K L Shields; M K Leonard; T Tsertsvadze; C del Rio; A Salakaia; H M Blumberg Journal: Int J Tuberc Lung Dis Date: 2008-05 Impact factor: 2.373
Authors: Hyun Lee; Gun Woo Koo; Ji-Hee Min; Tai Sun Park; Dong Won Park; Ji-Yong Moon; Sang-Heon Kim; Tae Hyung Kim; Ho Joo Yoon; Jang Won Sohn Journal: Sci Rep Date: 2019-01-11 Impact factor: 4.379