Screening for tuberculosis and prediction of disease in Portuguese healthcare workers

<p>Abstract</p> <p>Introduction</p> <p>Results of systematic screening of healthcare workers (HCWs) for tuberculosis (TB) with the tuberculin skin test (TST) and interferon-γ release assays (IGRA) in a Portuguese hospital from 2007 to 2010 are reported.</p> <p&...

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Bibliographic Details
Main Authors: Ringshausen Felix C, Silva Rui, Torres Costa José, Nienhaus Albert
Format: Article
Language:English
Published: BMC 2011-06-01
Series:Journal of Occupational Medicine and Toxicology
Online Access:http://www.occup-med.com/content/6/1/19
Description
Summary:<p>Abstract</p> <p>Introduction</p> <p>Results of systematic screening of healthcare workers (HCWs) for tuberculosis (TB) with the tuberculin skin test (TST) and interferon-γ release assays (IGRA) in a Portuguese hospital from 2007 to 2010 are reported.</p> <p>Methods</p> <p>All HCWs are offered screening for TB. Screening is repeated depending on risk assessment. TST and QuantiFERON Gold In-Tube (QFT) are used simultaneously. X-ray is performed when TST is > 10 mm, IGRA is positive or typical symptoms exist.</p> <p>Results</p> <p>The cohort comprises 2,889 HCWs. TST and IGRA were positive in 29.5%, TST-positive but IGRA-negative results were apparent in 43.4%. Active TB was diagnosed in twelve HCWs - eight cases were detected during screening and four cases were predicted by IGRA as well as by TST. However, the progression rate in IGRA-positive was higher than in TST-positive HCWs (0.4% vs. 0.2%, p-value 0.06).</p> <p>Conclusions</p> <p>The TB burden in this cohort was high (129.8 per 100,000 HCWs). However, the progression to active TB after a positive TST or positive IGRA was considerably lower than that reported in literature for close contacts in low-incidence countries. This may indicate that old LTBI prevails in these HCWs.</p>
ISSN:1745-6673