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The Incidence of Active Tuberculosis Among Health Workers with Latent Tuberculosis Infection in Tertiary Hospital Settings
Registry ID: PHRR130325-000057
Secondary Identification Number: None


Scientific Title

The Incidence of Active Tuberculosis Among Health Workers with Latent Tuberculosis Infection in Tertiary Hospital Settings

Project Description

Background Tuberculosis (TB) poses a significant occupational risk among healthcare workers (HCWs) in a TB high burden country. No data exist documenting the prevalence of latent TB infection (LTBI) and incidence of active TB among HCWs in the Philippines. Methodology We conducted a cohort study involving HCWs assigned in the medical wards and medical intensive care units of ten tertiary hospitals. LTBI was documented using tuberculin skin test utilizing a 2 TU-dose of PPD RT23 and a cut-off of at least 10mm in induration. HCWs were followed up over an approximate two year period and were monitored for active TB. Possible risk factors associated with these conditions were likewise identified. Results Out of 337 HCWs monitored, a total of 286 HCWs had PPD reactions of at least 10mm during the study period. The prevalence of LTBI in this cohort was computed to be 84.87% (95% CI, 80.59%-88.52%). The incidence of PPD conversion among those who were non-reactive at baseline was 22.73% (95% CI, 13.31%-34.70%) after one year. Odds ratios (OR) were likewise calculated to possibly look at the risk of LTBI per number of years of employment in their current work status and age. For tenure, the OR was equivalent to 1.12 (95% CI, 1.02-1.24) and for age, the computed OR was 1.03 (95% CI, 0.99-1.08). Nurses and nursing attendants were found to be at greater risk for acquiring LTBI compared to medical residents. The incidence of active TB was 1.4% (95% CI, 0.4%-3.5%). There were no variables significantly associated with the development of active disease. Conclusions HCWs were found to have a high prevalence of LTBI and relatively low incidence of active TB. These findings might have implications in screening and employment policies among HCWs and infection control strategies that should be employed in these tertiary settings.

NUHRA Details
NUHRA Regime NUHRA Classification NUHRA Priority
2010 - 2016 Socio-environmental Health Concerns Health Social Sciences
Project Duration
Start Date Duration in Months Target Completion Date Actual Completion Date
2008-09-01 31 2011-04-01 2011-04-30
Project Status

Completed

Implementing Agency (Primary Sponsor)

Name of Institution Classification Region LTO #
Philippine General Hospital, Section for Pulmonary Medicine Government NCR

Cooperating Agency (Secondary Sponsor)

Name of Institution Classification Region LTO #
Philippine Tuberculosis Society, Inc. Private Non-profit NCR
Philippine College of Chest Physicians Private Non-profit NCR
Philippine College of Chest Physicians TB Council Private Non-profit NCR

Funding Agency (Sources of Monetary or Material Support)

1. Philippine Tuberculosis Society, Inc.
2. Philippine College of Chest Physicians
3. Philippine College of Physicians
4. Philippine Council for Health Research and Development, Department of Science and Technology

Contact for Public Queries

Name: Email Address: Phone Number: Postal Address:
Dr. Jubert P. Benedicto jubertpb@yahoo.com 781-3756 Philippine Tuberculosis Society, Inc. Q.I. Compound, E. Rodriguez Sr. Ave., Quezon City Philippines

Contact for Scientific Queries

Name: Email Address: Phone Number: Postal Address:
Dr. Jubert P. Benedicto jubertpb@yahoo.com 781-3756 Philippine Tuberculosis Society, Inc. Q.I. Compound, E. Rodriguez Sr. Ave., Quezon City Philippines

Investigating Team

Name Expertise Affiliation
Maria Teresa U. Benedicto, MD Radiologist Philippine Tuberculosis Society, Inc.
Rontgene M. Solante, MD Infectious Diseases Philippine Tuberculosis Society, Inc.

Health Condition(s) or Problem(s) Studied

Latent TB infection (LTBI) and incidence of active TB among HCWs in the Philippines.

Primary Outcomes

Out of 337 HCWs monitored, a total of 286 HCWs had PPD reactions of at least 10mm during the study period. The prevalence of LTBI in this cohort was computed to be 84.87% (95% CI, 80.59%-88.52%). The incidence of PPD conversion among those who were non-reactive at baseline was 22.73% (95% CI, 13.31%-34.70%) after one year. Odds ratios (OR) were likewise calculated to possibly look at the risk of LTBI per number of years of employment in their current work status and age. For tenure, the OR was equivalent to 1.12 (95% CI, 1.02-1.24) and for age, the computed OR was 1.03 (95% CI, 0.99-1.08). Nurses and nursing attendants were found to be at greater risk for acquiring LTBI compared to medical residents. The incidence of active TB was 1.4% (95% CI, 0.4%-3.5%). There were no variables significantly associated with the development of active disease.

Key Secondary Outcomes

HCWs were found to have a high prevalence of LTBI and relatively low incidence of active TB. These findings might have implications in screening and employment policies among HCWs and infection control strategies that should be employed in these tertiary settings.

Date of First Enrollment

2008-09-01

Recruitment Status

Unspecified

Countries of Recruitment

Philippines

Research Classification

Non-clinical Studies

Project Location & Institutional Ethics Review Board Which Approved the Study

Unspecified

FDA Document Tracking Number

Unspecified

FDA / ERC Approval Date

Unspecified

Amendment Approval Dates/Reasons

None

Key Inclusion and Exclusion Criteria (CT)

None

Study Type

Unspecified

Method of Allocation

Unspecified

Masking / Blinding

Unspecified

Masking Details

None

Assignment

Unspecified

Purpose

Unspecified

Phase

Unspecified

Target Sample Size (Philippines)

0

Actual Sample Size (Philippines)

0

Date of first enrollment

2008-09-01

Have you applied for Intellectual Property Protection for your product?

No

Research Utilization

Type of Research Utilization Utilization Information
Publication Jan-Apr 2012 issue of the Philippine Journal of Chest Diseases Vol 15 No 1.
Oral Presentation Plenary session in the annual PCCP convention March 15 2013.