Tuberculosis among Health-Care Workers in Low- and Middle-Income Countries: A Systematic Review

By Rajnish P Joshi, A. Reingold, D. Menzies, Madhukar Pai. PLoS Medicine, 2006

610 citations recorded by the source corpus.

Background The risk of transmission of Mycobacterium tuberculosis from patients to health-care workers (HCWs) is a neglected problem in many low- and middle-income countries (LMICs). Most health-care facilities in these countries lack resources to prevent nosocomial transmission of tuberculosis (TB). Methods and Findings We conducted a systematic review to summarize the evidence on the incidence and prevalence of latent TB infection (LTBI) and disease among HCWs in LMICs, and to evaluate the impact of various preventive strategies that have been attempted. To identify relevant studies, we searched electronic databases and journals, and contacted experts in the field. We identified 42 articles, consisting of 51 studies, and extracted data on incidence, prevalence, and risk factors for LTBI and disease among HCWs. The prevalence of LTBI among HCWs was, on average, 54% (range 33% to 79%). Estimates of the annual risk of LTBI ranged from 0.5% to 14.3%, and the annual incidence of TB disease in HCWs ranged from 69 to 5,780 per 100,000. The attributable risk for TB disease in HCWs, compared to the risk in the general population, ranged from 25 to 5,361 per 100,000 per year. A higher risk of acquiring TB disease was associated with certain work locations (inpatient TB facility, laboratory, internal medicine, and emergency facilities) and occupational categories (radiology technicians, patient attendants, nurses, ward attendants, paramedics, and clinical officers). Conclusions In summary, our review demonstrates that TB is a significant occupational problem among HCWs in LMICs. Available evidence reinforces the need to design and implement simple, effective, and affordable TB infection-control programs in health-care facilities in these countries.

Subfields: Infectious Diseases, Urban Studies

View Paper: https://www.semanticscholar.org/paper/2afa5db68aee53e86ca0daa2b52fd918b7805aed

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Citations in the corpus

• Risk Factors for Tuberculosis (2013, background): “Close contacts of infectious TB cases including household contacts and care givers/health care workers [33] are at a higher risk of becoming infected with Mycobacterium tuberculosis and development of primary active tuberculosis.”