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Review
. 2011 Mar;17(3):488-94.
doi: 10.3201/eid1703.100947.

Tuberculosis among health care workers

Iacopo Baussano  1 , Paul Nunn, Brian Williams, Emanuele Pivetta, Massimiliano Bugiani, Fabio Scano
Affiliations
Review

Tuberculosis among health care workers

Iacopo Baussano et al. Emerg Infect Dis. 2011 Mar.

Abstract

To assess the annual risk for latent tuberculosis infection (LTBI) among health care workers (HCWs), the incidence rate ratio for tuberculosis (TB) among HCWs worldwide, and the population-attributable fraction of TB to exposure of HCWs in their work settings, we reviewed the literature. Stratified pooled estimates for the LTBI rate for countries with low (<50 cases/100,000 population), intermediate (50-100/100,000 population), and high (>100/100,000 population) TB incidence were 3.8% (95% confidence interval [CI] 3.0%-4.6%), 6.9% (95% CI 3.4%-10.3%), and 8.4% (95% CI 2.7%-14.0%), respectively. For TB, estimated incident rate ratios were 2.4 (95% CI 1.2-3.6), 2.4 (95% CI 1.0-3.8), and 3.7 (95% CI 2.9-4.5), respectively. Median estimated population-attributable fraction for TB was as high as 0.4%. HCWs are at higher than average risk for TB. Sound TB infection control measures should be implemented in all health care facilities with patients suspected of having infectious TB.

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Figures

Figure 1
Figure 1
Flow diagram for selection of studies of tuberculosis (TB) in health care workers (HCWs) published during January 2005–July 2010. INF, interferon.
Figure 2
Figure 2
Forrest plot showing study-specific and pooled estimates of the annual incidence of latent Mycobacteria tuberculosis infection (LTBI) among health care workers (HCWs), by tuberculosis incidence groups according to the World Health Organization. Studies are sorted by incidence category: low, <50 cases/100,000 population; intermediate, 50–99 cases/100,000 population; high, >100 cases/100,000 population. CI, confidence interval. A complete list of references is provided in the Technical Appendix.
Figure 3
Figure 3
Forrest plot showing the study-specific and pooled estimates of incidence rate ratios (RR) for tuberculosis (TB) among health care workers (HCWs) compared with the corresponding general populations, by TB incidence group according to the World Health Organization. Studies are sorted by incidence category: low, <50 cases/100,000 population; intermediate, 50–99 cases/100,000 population; high, >100 cases/100,000 population. CI, confidence interval. A complete list of references is provided in the Technical Appendix.
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