The IGRAs proves to be a more important screening instrument for LTBI diagnosis in low-incidence countries as it allows valid statements on the prevalence and incidence of LTBI.
Journal of Occupational Medicine and Toxicology
Anja Schablon (anja.schablon@bgw-online.de)
Gudrun Beckmann (drgudrunbeckmann@gmx.de)
Melanie Harling (melanie.harling@bgw-online.de)
Roland Diel (roland.diel@harburg.hamburg.de)
Albert Nienhaus (albert.nienhaus@bgw-online.
Abstract
Background: Little is known about the prevalence of latent tuberculosis infections (LTBI) in health care workers (HCW) in low-incidence countries especially in hospitals for pulmonary diseases. With Interferon-gamma release assays (IGRA), a new method for diagnosis of LTBI is available which is more specific than the tuberculin skin test (TST).
Objectives: The study was designed to estimate prevalence of LTBI among 270 HCW in a Hospital of Pulmonary Diseases routinely screened for TB.
Methods: LTBI was assessed by the QuantiFERON-Gold In Tube (QFT-IT). Information on gender, age, workplace, job title, BCG vaccination and history of both TB and TST were collected using a standardised questionnaire. Adjusted odds ratios for potential risk factors for LTBI were calculated.
Results: The prevalence of LTBI was 7.2%. In HCW younger than 30 years LTBI prevalence was 3.5% and in those older than 50 years 22%. Physicians and nurses showed a higher prevalence rate than other professions (10.8% to 4.5%). The putative risk factors for LTBI were age (>50 year OR 9.3, 95%CI 2.5-33.7), working as physicians/nurses (OR 3.6, 95%CI 1.2-10.4) and no previous TST in medical history (OR 4.4, 95%CI 1.01-18.9) when compared to those with a negative TST.
Conclusions: Prevalence of LTBI assessed by QFT-IT is low, this indicates a low infection risk even in hospitals for pulmonary diseases. No statement can be made regarding the occupational risk as compared to the general population because there are no LTBI prevalence data from Germany available. The higher LTBI prevalence rate in older HCWs might be due to the cohort effect or the longer time at risk.
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