Tuberculosis in Healthcare Workers: A Matched Cohort Study in Taiwan.
<h4>Background</h4>Proportional mortality ratio data indicate that healthcare workers (HCWs) have an elevated tuberculosis (TB) mortality. Whether this is caused by an increased TB incidence, a worse TB treatment outcome, or a combination of effects, remains unclear. To elucidate the haz...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2015-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0145047&type=printable |
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| author | Sung-Ching Pan Yee-Chun Chen Jann-Yuan Wang Wang-Huei Sheng Hsien-Ho Lin Chi-Tai Fang Shan-Chwen Chang |
| author_facet | Sung-Ching Pan Yee-Chun Chen Jann-Yuan Wang Wang-Huei Sheng Hsien-Ho Lin Chi-Tai Fang Shan-Chwen Chang |
| author_sort | Sung-Ching Pan |
| collection | DOAJ |
| description | <h4>Background</h4>Proportional mortality ratio data indicate that healthcare workers (HCWs) have an elevated tuberculosis (TB) mortality. Whether this is caused by an increased TB incidence, a worse TB treatment outcome, or a combination of effects, remains unclear. To elucidate the hazard components of occupational TB, we assessed TB incidence and TB treatment outcome among HCWs in Taiwan.<h4>Methods</h4>We compared the incidence of active TB among HCWs at a major medical center in Taiwan with that of Taiwan general population in 2004-2012. We also compared the TB treatment outcome of HCWs with that of age/sex-matched non-HCW patients treated at the same hospital, as well as that of nationally registered TB patients.<h4>Results</h4>The standardized TB incidence ratio of the HCWs was 1.9 (95% confidence interval [CI]: 1.2-2.9), compared with the general population. HCWs with pulmonary TB (n = 30) were less likely to have underlying diseases, delay in diagnosis, delay in treatment, or side effects of treatment, compared with age/sex-matched non-HCW TB patients (n = 120) (all Ps<0.05). The TB treatment outcome of HCWs was significantly better than that of non-HCW patients (TB-related mortality: 0.0% vs. 5.8%, P = 0.008, Mantel-Haenszel test). The standardized TB-related mortality rate was 1.08% [95% CI: 0.96% - 1.20%] for all of the nationally registered TB patients in Taiwan.<h4>Conclusions</h4>HCWs are at increased risk of active TB, compared with general population. To mitigate this occupational hazard, more efforts need to be directed towards the prevention of nosocomial TB transmission. Healthy worker effect, more rapid diagnosis, and less delay in treatment contribute to a lower TB-related mortality in HCWs. |
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| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2025-03-14T15:36:37Z |
| publishDate | 2015-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj.art-573d894df6e54bda913ed7f5102dd7232025-02-25T05:32:29ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-011012e014504710.1371/journal.pone.0145047Tuberculosis in Healthcare Workers: A Matched Cohort Study in Taiwan.Sung-Ching PanYee-Chun ChenJann-Yuan WangWang-Huei ShengHsien-Ho LinChi-Tai FangShan-Chwen Chang<h4>Background</h4>Proportional mortality ratio data indicate that healthcare workers (HCWs) have an elevated tuberculosis (TB) mortality. Whether this is caused by an increased TB incidence, a worse TB treatment outcome, or a combination of effects, remains unclear. To elucidate the hazard components of occupational TB, we assessed TB incidence and TB treatment outcome among HCWs in Taiwan.<h4>Methods</h4>We compared the incidence of active TB among HCWs at a major medical center in Taiwan with that of Taiwan general population in 2004-2012. We also compared the TB treatment outcome of HCWs with that of age/sex-matched non-HCW patients treated at the same hospital, as well as that of nationally registered TB patients.<h4>Results</h4>The standardized TB incidence ratio of the HCWs was 1.9 (95% confidence interval [CI]: 1.2-2.9), compared with the general population. HCWs with pulmonary TB (n = 30) were less likely to have underlying diseases, delay in diagnosis, delay in treatment, or side effects of treatment, compared with age/sex-matched non-HCW TB patients (n = 120) (all Ps<0.05). The TB treatment outcome of HCWs was significantly better than that of non-HCW patients (TB-related mortality: 0.0% vs. 5.8%, P = 0.008, Mantel-Haenszel test). The standardized TB-related mortality rate was 1.08% [95% CI: 0.96% - 1.20%] for all of the nationally registered TB patients in Taiwan.<h4>Conclusions</h4>HCWs are at increased risk of active TB, compared with general population. To mitigate this occupational hazard, more efforts need to be directed towards the prevention of nosocomial TB transmission. Healthy worker effect, more rapid diagnosis, and less delay in treatment contribute to a lower TB-related mortality in HCWs.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0145047&type=printable |
| spellingShingle | Sung-Ching Pan Yee-Chun Chen Jann-Yuan Wang Wang-Huei Sheng Hsien-Ho Lin Chi-Tai Fang Shan-Chwen Chang Tuberculosis in Healthcare Workers: A Matched Cohort Study in Taiwan. PLoS ONE |
| title | Tuberculosis in Healthcare Workers: A Matched Cohort Study in Taiwan. |
| title_full | Tuberculosis in Healthcare Workers: A Matched Cohort Study in Taiwan. |
| title_fullStr | Tuberculosis in Healthcare Workers: A Matched Cohort Study in Taiwan. |
| title_full_unstemmed | Tuberculosis in Healthcare Workers: A Matched Cohort Study in Taiwan. |
| title_short | Tuberculosis in Healthcare Workers: A Matched Cohort Study in Taiwan. |
| title_sort | tuberculosis in healthcare workers a matched cohort study in taiwan |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0145047&type=printable |
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