Not Tb-proof: Latent tuberculosis in Kuala Lumpur hospital health care workers

Abstract

Background Health care workers are commonly exposed to tuberculosis (TB) in the workplace, especially in low- and middle-income countries. They are susceptible to latent TB infection (LTBI) which may progress to active infection.Aims To determine the prevalence and factors associated with LTBI in health care workers in a hospital in Kuala Lumpur, Malaysia.Methods A cross-sectional study was carried out among health care workers in Kuala Lumpur Hospital,Malaysia's largest tertiary public hospital. A two-step sampling procedure was used to obtain a proportionate sample of workers from each hospital department. Those selected underwent a selfadministered questionnaire on possible occupational risk factors and a standardized tuberculin sensitivity test (TST). TST induration of =15 mm was considered positive for LTBI. Logistic regression analysis was used to assess the association of possible work factors with LTBI.Results In the 399 study subjects, the overall rate of LTBI was 46%. The odds of contracting LTBI were higher for staff working in jobs other than management positions, staff in clinical areas as opposed to non-clinical areas, staff working for =5 years compared with those working for shorter periods and staff with diagnosed diabetes mellitus or other chronic diseases compared with those without.Conclusions LTBI point prevalence was nearly 50% in health care workers at Malaysia's major tertiary hospital.Our results suggest that there may be additional LTBI risk factors for health care workers and these at-risk populations should have regular screening.