scholarly journals Identifying factors affecting latent tuberculosis treatment acceptance among healthcare workers: a retrospective analysis in a tertiary care centre

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e047444
Author(s):  
Maskit Bar-Meir ◽  
Gali Pariente ◽  
Ayal Romem ◽  
Yonit Wiener-Well
Keyword(s):  
Healthcare Workers ◽  
Tertiary Care ◽  
Latent Tuberculosis ◽  
Acceptance Rate ◽  
Tertiary Care Centre ◽  
Academic Medical Centre ◽  
Ltbi Treatment ◽  
Factors Affecting ◽  
Latent Tb Infection ◽  
Treatment Acceptance

ObjectiveOfficial guidelines recommend tuberculosis (TB) screening programmes for all healthcare workers (HCWs), along with offering treatment when latent TB infection (LTBI) is diagnosed. However, adherence to treatment among HCWs is lower compared with non-HCWs. The aim of the present study was to examine the rate of LTBI treatment acceptance among HCWs and to characterise the factors associated with non-acceptance.Design and settingThis was a retrospective cohort study. All HCWs diagnosed with LTBI, who had tuberculin skin test (TST) conversion during their work, between 2000 and 2015, in a single tertiary academic medical centre, and who consented to answer a questionnaire, were enrolled.ResultsOverall, 147 of 219 (67%) with TST conversion agreed to participate. Acceptance rate for LTBI treatment was only 16%. The overall completion rate among those who accepted treatment was 87%. HCWs’ recall of discussing the importance of LTBI treatment with their caregiver had the strongest association with LTBI treatment acceptance: 23 of 52 HCWs (44%) who recalled this discussion accepted treatment (adjusted OR=10.2, 95% CI: 2.2 to 47.6, p=0.003). Knowing the risk of developing TB was associated with 3.7 increased odds to accept treatment (95% CI: 1.2 to 11.8, p=0.02).ConclusionsLTBI acceptance rate was very low among our HCWs. Focusing on educating HCWs is potentially the key step towards an increased rate of LTBI treatment acceptance.

Compliance with Postexposure Screening and Treatment of Latent Tuberculosis Infection among Healthcare Workers in a Tertiary Care Hospital in Saudi Arabia

2014 ◽  
Vol 35 (2) ◽  
pp. 176-181 ◽  
Author(s):  
Hanan H. Balkhy ◽  
Thaddeus L. Miller ◽  
Saira Ali ◽  
Jennifer B. Nuzzo ◽  
Karine Kentenyants ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Healthcare Workers ◽  
Tertiary Care ◽  
Latent Tuberculosis ◽  
Care Hospital ◽  
Respiratory Therapists ◽  
Occupationally Exposed ◽  
Medical City ◽  
Latent Tb Infection ◽  
Clinical Records

Background.Controlling tuberculosis (TB) infection among occupationally exposed healthcare workers (HCWs) may be challenging.Methods.We retrospectively reviewed clinical records of HCWs who were exposed to patients diagnosed with infectious TB at King Abdulaziz Medical City, Riyadh, Saudi Arabia, between 2008 and 2010. The collected data included baseline tuberculin skin test (TST) status, potential predictors of TST positivity, postexposure diagnosis of latent TB infection (LTBI), and postexposure compliance with LTBI therapy.Results.Thirteen patients were diagnosed with infectious pulmonary TB during the study period. A total of 298 HCWs met our definition for exposure. Exposed HCWs tended to be female (62.9%), non-Saudi (83.9%), nurses (68.6%), or respiratory therapists (24.0%) working in critical care locations (72.8%). Baseline (preemployment) TST documentation existed for 41.3% (123/298). Among those with documented baseline TSTs, 51.2% (63/123) were positive, representing 21.1% (63/298) of all HCWs. Only 48.9% (115/235) of exposed HCWs who had negative or unknown preexposure TST status had their TST tested after exposure. Approximately 46.1% (53/115) of them were diagnosed with postexposure LTBI, and 92.5% (49/53) of them were prescribed LTBI therapy. Among those, 93.9% (46/49) started LTBI therapy; however, 82.6% (38/46) failed to complete the recommended course.Conclusions.We found low rates of baseline TST documentation and postexposure screening among exposed HCWs. Compliance with initiating postexposure isoniazid prophylaxis among HCWs was fair, but only a small fraction of those who started prophylaxis completed the recommended course of therapy. These findings suggest substantial opportunities to implement administrative measures to enhance LTBI management among HCWs.

scholarly journals Determinants of Latent Tuberculosis Treatment Acceptance and Completion in Healthcare Personnel

2019 ◽  
Vol 71 (2) ◽  
pp. 284-290 ◽  
Author(s):  
Melanie D Swift ◽  
Robin G Molella ◽  
Andrew I S Vaughn ◽  
Laura E Breeher ◽  
Richard D Newcomb ◽  
...  
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Latent Tuberculosis ◽  
Retrospective Chart Review ◽  
Clinic Visit ◽  
Healthcare Personnel ◽  
Ltbi Treatment ◽  
Occupational Factors ◽  
Latent Tb Infection ◽  
Treatment Acceptance

Abstract Background US public health strategy for eliminating tuberculosis (TB) prioritizes treatment of latent TB infection (LTBI). Healthcare personnel (HCP) are less willing to accept treatment than other populations. Little is known about factors associated with HCP LTBI therapy acceptance and completion. Methods We conducted a retrospective chart review to identify all employees with LTBI at time of hire at a large academic medical center during a 10-year period. Personal demographics, occupational factors, and clinic visit variables were correlated with LTBI treatment acceptance and completion rates using multivariate logistic regression. Results Of 470 HCP with LTBI for whom treatment was recommended, 193 (41.1%) accepted treatment, while 137 (29.1%) completed treatment. Treatment adherence was better with 4 months of rifampin than 9 months of isoniazid (95% vs 68%, P < .005). Increased age of the healthcare worker was independently associated with lower rates of treatment acceptance (odds ratio [95% confidence interval]: 0.97 [0.94–0.99] per year), as was having an occupation of clinician (0.47 [0.26–0.85]) or researcher (0.34 [0.19–0.64]). Male gender was associated with higher treatment acceptance (1.90 [1.21–2.99]). Treatment completion was associated with being from a low- (9.49 [2.06–43.73]) or medium- (8.51 [3.93–18.44]) TB-burden country. Conclusions Geographic and occupational factors affect acceptance and completion of LTBI therapy. Short-course regimens may improve adherence. Physicians, researchers, and HCP from high-TB-burden countries have lower treatment rates than other HCP. Improving LTBI treatment in HCP will require attending to cultural and occupational differences.

scholarly journals A cross sectional study on demographic factors affecting low birth weight

2019 ◽  
Vol 6 (11) ◽  
pp. 4896
Author(s):  
Renu Sulakhe Vasant ◽  
Lavanya K. M. Rao ◽  
Nageswara Rao V.
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Tertiary Care ◽  
Income Group ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Factors Affecting

Background: Low birth weight (LBW) is one of the commonest cause for infant and childhood morbidity and mortality. The majority of low birth weight in developing countries is due to intrauterine growth retardation, while most low birth weight in industrialized countries is due to preterm birth. LBW is the single most important factor determining the survival chances of the child. The objectives of the study were to assess the proportion of low birth weight among babies delivered by mothers at a tertiary care hospital and to analyse the relationship between low birth weight and certain socio-demographic factors.Methods: A cross-sectional study conducted in a tertiary care centre for a period of six months.Results: The prevalence of LBW was 23.5%. The proportion of mothers having low birth weight was maximum in women aged less than 18 years (35%) and more than 30 years (26.5%). Muslim women had a higher proportion of LBW (28.8%). LBW was more in women belonging to joint family (30.0%), low per capita income group and illiterates.Conclusions: The prevalence of LBW still continues to be high, almost one fourth of the babies are LBW. Different socio-demographic characteristics of the population are still the important factors determining the occurrence of LBW.

scholarly journals 754. Prevalence of Latent Tuberculosis Infection Among Healthcare Workers at a Tertiary Care University Hospital

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S271-S271
Author(s):  
Eun Ju Choo ◽  
Se Yoon Park
Keyword(s):  
Risk Factors ◽  
Healthcare Workers ◽  
Latent Tuberculosis Infection ◽  
Tertiary Care ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
University Hospital ◽  
Increased Risk ◽  
High Prevalence ◽  
Univariate Analyses

Abstract Background We investigated the prevalence of latent tuberculosis infection (LTBI) among healthcare workers (HCWs) and analyzed its risk factors in a tertiary care university hospital in South Korea in a population with intermediate tuberculosis (TB) burden. Methods A standard questionnaire regarding the baseline demographics and risk factors for LTBI was given to each participant. QuantiFERON-TB GOLD In-Tube (QFT-GIT) assay and chest radiography were performed to investigate the rate of LTBI. Results A total of 1,429 participants, 213 (14.9%) doctors and 988 (69.1%) nurses and 228 (16.0%) others were enrolled. The mean age of the subjects was 33.0 years old, and 1,175 (82.2%) were female. Of the participants, 94.5% had received BCG vaccine. QFT-GIT assays were positive for 156 subjects (10.9%). Of the 213 doctors, 28 (13.1%) were positive by QFT-GIT, and among the 988 nurses, 94 (9.5%) had positive QFT-GIT results. Experience of working in hospital was significantly associated with positive LTBI test results by QFT-GIT assay. Gender and duration of employment as an HCW were significantly associated with having a positive QFT-GIT result in univariate analyses. In multivariate analyses, duration of employment as an HCW (>15 years) (odds ratio, 1.98; 95% confidence interval, 1.14–3.43) was independently associated with increased risk of a positive QFT-GIT result. Conclusion A high prevalence of LTBI was found among our HCWs. Considering the association between the experience of working in hospital and high risk of LTBI. The risk for tuberculosis infection among HCWs was higher than general population, which suggests that stricter preventive strategies against nosocomial tuberculosis infection should be implemented. Disclosures All authors: No reported disclosures.

scholarly journals Factors affecting on Adherence to the Prescribed Drugs in Diabetic Patients Visiting a Tertiary Care Centre

2013 ◽  
Vol 2 (2) ◽  
pp. 11-17
Author(s):  
Bijay Thapa ◽  
Paras Kumar Pokharel ◽  
Ishwori Sharma Poudel ◽  
Sanjib Kumar Sharma ◽  
Pramod Mohan Shyangwa ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Diabetic Patients ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Factors Affecting ◽  
Medical College

Journal of Nobel Medical College Vol. 2, No.2 Issue 4 May-October 2013 Page 11-17 DOI: http://dx.doi.org/10.3126/jonmc.v2i2.8799

scholarly journals Tuberculosis Screening and Active Tuberculosis among HIV-Infected Persons in a Canadian Tertiary Care Centre

2009 ◽  
Vol 20 (2) ◽  
pp. 51-57 ◽  
Author(s):  
Paul Brassard ◽  
Travis Salway Hottes ◽  
Richard G Lalonde ◽  
Marina B Klein
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Tertiary Care ◽  
Latent Tuberculosis ◽  
Clinic Visit ◽  
Skin Tests ◽  
Country Of Birth ◽  
Hiv Diagnosis ◽  
Tertiary Care Centre ◽  
Tuberculosis Screening

RATIONALE: HIV infection increases the risk of reactivation of latent tuberculosis (TB). The present study evaluates how latent TB is detected and treated to determine the effectiveness of screening in HIV-infected patients with diverse risk profiles.METHOD: A retrospective medical record database review (1988 to 2007) was conducted at a tertiary care HIV clinic. The proportion of patients receiving tuberculin skin tests (TSTs) and the rate of active TB at each stage of screening and prevention were estimated. Predictors of receiving a TST at baseline, testing positive by TST and developing active TB were evaluated.RESULTS: In the present study, 2123 patients were observed for a total of 9412 person-years. Four hundred seventy-six (22.4%) patients were tested by TST within 90 days of first clinic visit. Having a first clinic visit during the highly active antiretroviral therapy era (OR 3.64; 95% CI 2.66 to 4.99), country of birth (ORs: Africa 3.11, Asia 2.79, Haiti 3.14, and Latin America and the Caribbean 2.38), time between HIV diagnosis and first visit (OR per one-year change 0.97; 95% CI 0.94 to 0.99) and previous antiretroviral exposure (OR 0.61; 95% CI 0.45 to 0.81) were independent predictors of receiving a TST at baseline. Of the 17 patients who developed active TB during follow-up, nine (53%) had no documented TSTs at baseline or during follow-up. Forty-one per cent of all TB patients and 56% of TB patients who were not screened were born in Canada.CONCLUSION: The administration of TSTs to newly diagnosed HIV patients was inconsistent and differential according to country of birth, among other factors, resulting in missed opportunities for TB prevention.

A public health approach to increase treatment of latent TB among household contacts in Brazil

2020 ◽  
Vol 24 (10) ◽  
pp. 1000-1008
Author(s):  
M. L. Bastos ◽  
O. Oxlade ◽  
A. Benedetti ◽  
F. Fregonese ◽  
C. Valiquette ◽  
...  
Keyword(s):  
Public Health ◽  
Healthcare Workers ◽  
Public Health Approach ◽  
Ltbi Treatment ◽  
Household Contacts ◽  
Evaluation Phase ◽  
Service Training ◽  
Latent Tb ◽  
Latent Tb Infection ◽  
To Receive

SETTING: Two consecutive trials were conducted to evaluate the effectiveness of a public health approach to identify and correct problems in the care cascade for household contacts (HHCs) of TB patients in three Brazilian high TB incidence cities.METHODS: In the first trial, 12 clinics underwent standardised evaluation using questionnaires administered to TB patients, HHCs and healthcare workers, and analysis of the cascade of latent TB care among HHCs. Six clinics were then randomised to receive interventions to strengthen management of latent TB infection (LTBI), including in-service training provided by nurses, work process organisation and additional clinic-specific solutions. In the second trial, a similar but streamlined evaluation was conducted in two clinics, who then received initial and subsequent intensive in-service training provided by a physician.RESULTS: In the evaluation phase of both trials, many HHCs were identified, but few started LTBI treatment. After the intervention, the number of HHCs initiating treatment per 100 active TB patients increased by 10 (95%CI ‾11 to 30) in the first trial, and by 44 (95%CI 26 to 61) in the second trial.DISCUSSION: A public health approach with standardised evaluation, local decisions for improvements, followed by intensive initial and in-service training appears promising for improved LTBI management.

scholarly journals Clinico-epidemiological profile of COVID-19 among health care workers from a tertiary care hospital

2021 ◽  
Author(s):  
Anuradha Tolpadi ◽  
Abhijeet Mane ◽  
Jitendra Oswal ◽  
Sujata Rege ◽  
Meera Modak ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Tertiary Care ◽  
Management Strategies ◽  
Care Hospital ◽  
Antigen Test ◽  
Rt Pcr ◽  
Tertiary Care Centre ◽  
Care Workers ◽  
Global Health Issue ◽  
Epidemiological Profile

Background: Coronavirus disease 2019 (COVID-19) is a global health issue. Healthcare workers (HCWs) are especially vulnerable to infection by SARS-CoV-2. The present study was conducted to determine the proportion of HCWs infected with COVID 19 in a tertiary care centre with emphasis on the epidemiological and clinical aspectMethods: HCWs (symptomatic and asymptomatic contacts) who tested positive for COVID-19 by SARS-CoV-RTPCR or COVID-19 rapid antigen test were included in the study. Demographic and clinical data of the infected HCWs was obtained through a detailed telephonic interview with structured questionnaire.Results: Out of total 921 HCWs tested for COVID-19 (SARS-CoV-2 RT-PCR and Rapid antigen test), 323 (35%) HCWs were positive. Proportion of COVID-19 positive HCWs among all HCWs was 13.67% (323/2362). Most COVID-19 positive HCWs (88%) were symptomatic. Majority of infected HCWs (62.23%) were between the age group of 21-30 years. Nurses were the most predominantly affected among various categories of HCWs (42.41%). Fever was the most common presenting symptom, seen in 160 (49.50%) HCWs. Comorbidities were found in 28 (8.66%) of infected HCWs. Majority of HCWs (86%) suffered from mild infection.Conclusions: HCWs, especially nurses, face a high risk of COVID-19 infection while providing care for suspected or confirmed COVID-19 patients. It is important to characterize the epidemiological and clinical profile of HCWs regarding COVID-19 for formulation of prevention and management strategies.

Sign in / Sign up

Export Citation Format

Share Document