Bin Chen1, Hua Gu2, Xiaomeng Wang1, Fei Wang1, Ying Peng1, Erjia Ge3, Ross Upshur3, Ruixue Dai3, Xiaolin Wei4, Jianmin Jiang5. 1. Department of TB Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China. 2. ZheJiang Provincial Center for Medical Science Research, Hangzhou, China. 3. Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. 4. Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. Electronic address: xiaolin.wei@utoronto.ca. 5. Department of TB Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China. Electronic address: jmjiang@cdc.zj.cn.
Abstract
OBJECTIVES: Healthcare workers (HCWs) are at high risk of latent tuberculosis infection (LTBI), and the baseline prevalence of LTBI among frontline TB HCWs in southeastern China remains unknown. The aim of this study was to assess the prevalence of LTBI among TB HCWs and to analyze factors associated with LTBI at both the individual and institutional level. METHODS: Based on a cross-sectional study design, 31 out of 89 TB-designated hospitals in Zhejiang Province of China were selected. Information on TB infection control measures was collected through field visits to each of the selected hospitals. All TB HCWs from the selected hospitals were recruited to answer a questionnaire and to undergo LTBI testing by TB interferon gamma release assay. Univariate analyses and a generalized linear mixed model were applied to analyze factors associated with LTBI at both the individual and hospital level. RESULTS: A total of 487 TB HCWs were recruited at the 31 TB-designated hospitals; 33.9% of them tested positive for LTBI. At the institutional level, a low TB epidemic level, regular infection control training for HCWs, and regular maintenance of ultraviolet disinfection equipment were found to be significantly associated with a lower LTBI rate among HCWs. At the individual level, alcohol use, a greater number of years working on TB, and a longer weekly duration of contact with TB patients were identified as associated factors for LTBI among HCWs. CONCLUSIONS: The LTBI rate among frontline TB HCWs was found to be high in southeastern China. Factors at the institutional and individual level could both affect the prevalence of LTBI among HCWs.
OBJECTIVES: Healthcare workers (HCWs) are at high risk of latent tuberculosis infection (LTBI), and the baseline prevalence of LTBI among frontline TB HCWs in southeastern China remains unknown. The aim of this study was to assess the prevalence of LTBI among TB HCWs and to analyze factors associated with LTBI at both the individual and institutional level. METHODS: Based on a cross-sectional study design, 31 out of 89 TB-designated hospitals in Zhejiang Province of China were selected. Information on TB infection control measures was collected through field visits to each of the selected hospitals. All TB HCWs from the selected hospitals were recruited to answer a questionnaire and to undergo LTBI testing by TB interferon gamma release assay. Univariate analyses and a generalized linear mixed model were applied to analyze factors associated with LTBI at both the individual and hospital level. RESULTS: A total of 487 TB HCWs were recruited at the 31 TB-designated hospitals; 33.9% of them tested positive for LTBI. At the institutional level, a low TB epidemic level, regular infection control training for HCWs, and regular maintenance of ultraviolet disinfection equipment were found to be significantly associated with a lower LTBI rate among HCWs. At the individual level, alcohol use, a greater number of years working on TB, and a longer weekly duration of contact with TBpatients were identified as associated factors for LTBI among HCWs. CONCLUSIONS: The LTBI rate among frontline TB HCWs was found to be high in southeastern China. Factors at the institutional and individual level could both affect the prevalence of LTBI among HCWs.