40 Overdiagnosis and overtreatment of latent tuberculosis in low risk north american health care workers: stop this unproven, expensive, and potentially dangerous testing mandate

Author(s):  
Carolyn Sachs
Dermatitis ◽  
2008 ◽  
Vol 19 (5) ◽  
pp. 261-274 ◽  
Author(s):  
Erin M. Warshaw ◽  
Sarah E. Schram ◽  
Howard I. Maibach ◽  
Donald V. Belsito ◽  
James G. Marks ◽  
...  

Author(s):  
Nitin Shetty ◽  
Nivedita Chakrabarty ◽  
Amit Joshi ◽  
Amar Patil ◽  
Suyash Kulkarni ◽  
...  

Background: Theoretically, health care workers (HCW) are at increased risk of getting infected with COVID-19 compared to the general population. Limited data exists regarding the actual incidence of COVID-19 infection amongst the high risk and low risk HCW of the same hospital. We present an audit from our tertiary cancer care centre comparing the COVID-19 infection rate between the high risk and low risk HCW, all of whom had been provided with adequate protective measures and health education.Methods: This is a retrospective observational study from 01 April 2020 to 30 September 2020, in which all the 970 HCW of Advanced Centre for Treatment, Research and Education in Cancer were divided into high risk and low risk groups. High risk HCW included all the medical and non-medical staff directly involved with the care of COVID-19 patients, and rest were low risk HCW. Adequate protective measures and classes for infection prevention were provided to all the HCW. We calculated the incidence of COVID-19 infection in both these groups based on the positive real time-polymerase chain reaction (RT-PCR) result and also looked for any significant difference in incidence between these two groups.Results: The incidence of COVID-19 infection amongst the high risk HCW was 13% and that of low risk HCW was 14%.Conclusions: We found no significant difference in COVID-19 infection between the high risk and low risk HCW. Thus, along with protective measures, behavior modifications induced by working in high risk areas, prevented the high risk HCW from getting increased COVID-19 infection compared to the low risk HCW.


2020 ◽  
Vol 5 (3) ◽  
pp. 116
Author(s):  
Moe Hnin Phyu ◽  
Hutcha Sriplung ◽  
Myo Su Kyi ◽  
Cho Cho San ◽  
Virasakdi Chongsuvivatwong

Health care workers (HCWs) in high tuberculosis (TB) prevalence countries have to care for many cases, thus increasing their risk of infection. The objective of the study was to compare the prevalence of latent TB infection (LTBI) between general HCWs and TB HCWs, and also to explore the associated factors. A cross-sectional study was conducted in Nay Pyi Taw, Myanmar from September 2019 to January 2020. Staff working at two general hospitals were recruited. Those allocated for TB care were classified as TB HCWs, while the remaining were classified as general HCWs. Participants were interviewed using a structured questionnaire, and screened for LTBI using a tuberculin skin test (TST). Individuals who had an induration of 10 mm or more with normal chest radiograph were regarded as having LTBI. The prevalence of LTBI among general HCWs was 2.04 times higher than that of TB HCWs (31.2% vs. 15.3%, p < 0.001). The associated factors for LTBI included low education level, duration of work experience ≥ 10 years, a low knowledge of regular TB screening, and teaching cough etiquette to TB patients. The higher prevalence of LTBI in the general HCWs in this study was due to confounding by education and experience. After adjustment for these, we have no evidence to support that either group of HCWs had higher LTBI risk.


2019 ◽  
Vol 147 ◽  
Author(s):  
Yunfeng Deng ◽  
Yun Liu ◽  
Yan Li ◽  
Hui Jing ◽  
Yan Wang ◽  
...  

AbstractThis study aimed to reveal the associated risk factors for latent tuberculosis infection (LTBI) detected by T-SPOT.TB assay among health care workers (HCWs) at different working locations or job categories in China. This cross-sectional study included 934 HCWs who underwent the T-SPOT.TB assay. Demographic and social characteristics of the participants, including age, sex, job categories, department/ward and duration of healthcare service, were recorded. Among 934 HCWs, 267 (28.5867%) were diagnosed as having LTBI with positive T-SPOT.TB assay. HCWs working in inpatient tuberculosis (TB) (odds ratio (OR) 2.917; 95% confidence interval (CI) 1.852–4.596; P < 0.001) and respiratory wards (OR 1.840; 95% CI 1.124–3.011; P = 0.015), and with longer duration of healthcare service (OR 1.048; 95% CI 1.016–1.080; P = 0.003) were risk factors for positive T-SPOT.TB result. Furthermore, longer working duration increased the positive rate of T-SPOT.TB results for physicians and nurses, and physicians had higher risks than nurses for the same working duration. Inpatient TB and respiratory wards were high-risk working locations for HCWs with LTBI, and longer duration of healthcare service also increased the risk of LTBI among HCWs. A complete strategy for TB infection control and protection awareness among HCWs should be enhanced.


2017 ◽  
Vol 67 (8) ◽  
pp. 641-643 ◽  
Author(s):  
M Henderson ◽  
S J Howard

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