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Tuberculosis and latent tuberculosis infection among healthcare workers in K isumu, K enya
Author(s) -
Agaya Janet,
Nnadi Chimeremma D.,
Odhiambo Joseph,
Obonyo Charles,
Obiero Vincent,
Lipke Virginia,
Okeyo Elisha,
Cain Kevin,
Oeltmann John E.
Publication year - 2015
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12601
Subject(s) - tuberculosis , latent tuberculosis , medicine , mycobacterium tuberculosis , immunology , pathology
Objective To assess prevalence and occupational risk factors of latent TB infection and history of TB disease ascribed to work in a healthcare setting in western K enya. Methods We conducted a cross‐sectional survey among healthcare workers in western K enya in 2013. They were recruited from dispensaries, health centres and hospitals that offer both TB and HIV services. School workers from the health facilities' catchment communities were randomly selected to serve as the community comparison group. Latent TB infection was diagnosed by tuberculin skin testing. HIV status of participants was assessed. Using a logistic regression model, we determined the adjusted odds of latent TB infection among healthcare workers compared to school workers; and among healthcare workers only, we assessed work‐related risk factors for latent TB infection. Results We enrolled 1005 healthcare workers and 411 school workers. Approximately 60% of both groups were female. A total of 22% of 958 healthcare workers and 12% of 392 school workers tested HIV positive. Prevalence of self‐reported history of TB disease was 7.4% among healthcare workers and 3.6% among school workers. Prevalence of latent TB infection was 60% among healthcare workers and 48% among school workers. Adjusted odds of latent TB infection were 1.5 times higher among healthcare workers than school workers (95% confidence interval 1.2–2.0). Healthcare workers at all three facility types had similar prevalence of latent TB infection ( P = 0.72), but increasing years of employment was associated with increased odds of LTBI ( P < 0.01). Conclusion Healthcare workers at facilities in western K enya which offer TB and HIV services are at increased risk of latent TB infection, and the risk is similar across facility types. Implementation of WHO ‐recommended TB infection control measures are urgently needed in health facilities to protect healthcare workers.