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2015, Number 1

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Rev Cubana Med Trop 2015; 67 (1)

Tuberculosis risk in the staff of three clinical surgical hospitals at Havana city

Borroto GS, Martínez AAM, Guanche GH, Madiedo FM, Morejón DY, Giró LI, Toledano PM, Díaz HY, González OE

Language: Spanish
References: 30
Page: 59-74
PDF size: 166.44 Kb.


ABSTRACT

Introduction: Nosocomial tuberculosis transmission has been recognized worldwide as a problem for TB control.
Objectives: To estimate the prevalence of Latent Tuberculosis Infection and to evaluate the risk of Tuberculosis Infection in Health Care Workers of three Surgical Clinical Hospitals at Havana City.
Methods: A cross sectional study in a sample of 804 Health Care Workers out of 5737 staff of three hospitals at Havana City was carried out; a tuberculin skin test was applied along with an interview on personal data, labor location and exposition to M. tuberculosis. A 10 mm cut-off point was used. To prove the possible influence of predictor variables on the presence of infection, a bivariate analysis and a multivariate model were applied. The individual risk was classified as high, Intermediate, Low and Minimum. The Collective Risk was measured by departments and were classified as High, Intermediate, Low, Very Low and Minimum Risk.
Results: The prevalence of Latent Tuberculosis Infection was 28.8 %, lower in Albarrán (26.6 %) and higher in Allende (31.5 %). Induration mean: 10.4 mm excluding non-reactors. A possible association of Latent Tuberculosis Infection with the categories: nurses and services workers, having contact with tuberculosis cases, and ≥ 6 years working in the hospital was found. 28.6 % of workers were evaluated as high risk; 33.6 % of the departments were evaluated as High Risk, 31 % Intermediate and none as Minimum risk.
Conclusions: The risk of Micobacterium tuberculosis Infection for Health Care Workers of 3 hospitals at Havana city was evaluated among intermediate and high, with a third of their areas constituting a potential tuberculosis risk for the personnel working in them.


REFERENCES

  1. Joshi R, Reingold AL, Menzies D, Pai M. Tuberculosis among health-care workers in low- and middle-income countries: a systemic review. PLoS Med 2006;3:e494.

  2. Bock NN, Jensen PA, Miller B, Nardell E. Tuberculosis control in resource-limited settings in the era of expanding HIV care and treatment. J Infect Dis 2007;196 (Suppl):S108-S113.

  3. Menzies D, Joshi R, Pai M. Risk of tuberculosis infection and disease associated with work in health care settings. Int J Tuberc Lung Dis 2007;11:593-605.

  4. World Health Organization. Anti-tuberculosis drug resistance in the world. WHO/HTM/TB/2008.394. Geneva, Switzerland: WHO; 2008.

  5. CDC. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005. MMWR 2005;54(RR-17):1-151.

  6. Federación Internacional de Hospitales. Control de la infección tuberculosa. En: Manual de formación para el control de la TB y de la TB-MDR para directores de hospitales/clínicas/centros de salud. Ginebra, Suiza: The Lilly MDR-TB Partnership; 2010. p. 44-48.

  7. Ministerio de Salud Pública. Anuarios Estadísticos de Salud 2010-2014. La Habana: MINSAP; 2015 [citado 17 Feb 2015]. Disponible en: http://www.sld.cu/servicios/estadisticas

  8. Montoro E, Lemus D, Echemendía M, Llop A, Llanes MJ. Multidrug-resistant tuberculosis in Cuba, 2000-2008. IJTLD 2010;14(11):S236.

  9. Lemus D, Echemendía M, Díaz R, Llop A, Llanes MJ. Vigilancia de la resistencia a los medicamentos antituberculosos en Cuba, 2010-2011. Biomédica 2014;34(Suppl 1):108-13.

  10. Martínez AI, Pérez L, González E. El diagnóstico por autopsia en Ciudad de La Habana como indicador de la calidad el programa de control de la tuberculosis. 1998-2002. Rev Esp Salud Pública 2007;81(2):221-5.

  11. Martínez AI, De Mendoza J, González E. Valor del diagnóstico de la tuberculosis pulmonar por autopsia en Cuba. Ciencias Clínicas y Patológicas 2012 [citado 17 Feb 2015];11(1):[aprox. 6 p.]. Disponible en: http://bvs.sld.cu/revistas/rhab/rhcmv11n1.htm

  12. Borroto S, Fernández R, Castro O, González E, Armas L. Evaluación del riesgo de tuberculosis en los trabajadores del Instituto "Pedro Kourí". Medicina y Seguridad del Trabajo. 2000;187:69-76.

  13. Borroto S, Urbino A, Martínez AM. Prevalencia de reactores tuberculínicos en trabajadores del Instituto de Medicina Tropical “Pedro Kourí”, 1996-2000. Rev Cubana Med Trop. 2006;58(1):85-9.

  14. Borroto S, Sevy JI, Fumero M, González E, Machado D. Riesgo de ocurrencia de la tuberculosis en los trabajadores del Hospital Universitario Neumológico Benéfico Jurídico de La Habana. Rev Cubana Med Trop. 2012;64(1):55-60.

  15. Borroto S, Gámez D, Díaz D, Martínez Y, Ferrer AI, Velásquez Y, et al. Latent tuberculosis infection among health care workers at a general hospital in Santiago de Cuba. Int J Tuberc Lung Dis 2011;15(11):1510-14.

  16. Organización Mundial de la Salud. La Prueba Tuberculínica Estándar de la OMS. TB/Guía Técnica/3. Ginebra, Suiza: OMS; 1963.

  17. Martínez AM, Urbino A, Borroto S, Darnaud R, Fumero M. Habilidades en la realización y lectura de pruebas tuberculínicas. Rev Cubana Enfermer. 2002;18(3):160-4.

  18. CDC. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care facilities, 1994. MMWR 1994;43(RR-13):4-17.

  19. Deddens J, Petersen M. Approaches for estimating prevalence ratios. Occup Environ Med 2008;65:501-6.

  20. Caminero JA. Guía de la Tuberculosis para Médicos Especialistas. París: UICTER; 2003.

  21. Martínez D. Caracterización del Riesgo de Tuberculosis en trabajadores de Atención Primaria de Salud del municipio La Lisa 2009-2011 [tesis]. La Habana: Instituto "Pedro Kourí"; 2012.

  22. Joshi R, Reingold AL, Menzies D, Pai M. Tuberculosis among health-care workers in low and middle-income countries: a systematic review. PLoS Med 2006;3(12):494.

  23. Ministerio de Salud Pública. Dirección Nacional de Registros Médicos y Estadísticos de Salud. Anuario Estadístico 2013. La Habana: MINSAP; 2014.

  24. Vries G, Ebek MM, Langbregts-van Weezen C. Heath care workers with tuberculosis infected during work. Eur Resp J. 2006;28:1216-21.

  25. Zhang X, Jia H, Liu F, Pan L, Xing A. Prevalence and Risk Factors for Latent Tuberculosis Infection among Health Care Workers in China: A Cross-Sectional Study. PLoS ONE 2013;8(6):e66412. doi:10.1371/journal.pone.0066412.28.

  26. Franchi A, Richeldi L, Parrinello G, Franco R. Room size is the major determinant for tuberculin conversion. Int Arch Occupational Envir Health 2007;80:533-8.

  27. Keskiner R, Ergonul O, Demiroglu Z, Eren S, Baykan N, Dokuzoguz B. Risk of Tuberculous Infection Among Health Workers in a tertiary-Care Hospital in Ankara, Turkey. Infection Control and Hospital Epidemiology. 2004;25(12):1067-71.

  28. Lien LT, Hang NTL, Kobayashi N, Yanai H, Toyota E. Prevalence and Risk Factors for Tuberculosis Infection among Hospital Workers in Hanoi, Viet Nam. PLoS ONE 2009;4(8):e6798. doi:10.1371/journal.pone.0006798

  29. Rafiza S, Gomal K, Tahir A. Prevalence and risk factors of latent tuberculosis infection among health care workers in Malaysia. BMC Infectious Diseases 2011,11:19. doi:10.1186/1471-2334-11-19. Available from: http://www.biomedcentral.com/1471-2334/11/19

  30. World Health Organization. WHO policy on TB infection control in health-care facilities, congregate settings and households. Geneva, Switzerland: WHO; 2009.




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