scholarly journals Prevalence of and risk factors associated with latent tuberculosis infection in a Latin American region

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e9429
Author(s):  
Javier Andrés Bustamante-Rengifo ◽  
Luz Ángela González-Salazar ◽  
Nicole Osorio-Certuche ◽  
Yesica Bejarano-Lozano ◽  
José Rafael Tovar Cuevas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Latin American ◽  
Linear Models ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Decisive Role ◽  
Tuberculosis Infection ◽  
Cross Sectional ◽  
Latin American Region

Tuberculosis (TB) represents a health problem in Colombia, and its control is focused on the search for contacts and treatment of TB cases underscoring the role of latent tuberculosis infection (LTBI) as a reservoir of Mycobacterium tuberculosis. The burden of LTBI in Colombia is unknown. We aimed to estimate the prevalence of LTBI and identify the associated risk factors. In this cross-sectional study, we recruited participants from four health care centers in Cali, Colombia. The participants were eligible if they were aged between 14 and 70 years, and all participants answered a survey evaluating their medical history and sociodemographic and lifestyle factors. LTBI status was based on tuberculin skin test (TST) positivity using two thresholds: ≥10 mm (TST-10) and ≥15 mm (TST-15). The magnitude of the associations between independent factors and dependent outcomes (LTBI status and TST induration) were evaluated by logistic regression and generalized linear models, respectively. A total of 589 individuals were included with TST positivity rates of 25.3% (TST-10) and 13.2% (TST-15). Logistic regression showed that being between age 40 and 69 years (OR = 7.28, 95% CI [1.62–32.7]), being male (OR = 1.71, 95% CI [1.04–2.84]), being employed (OR = 1.56, 95% CI [1.02–2.38]), and having a low intake of alcohol (OR = 2.40, 95% CI [1.13–5.11]) were risk factors for TST positivity, while living in the north zone (OR = 0.32, 95% CI [0.18–0.55]), living in the suburb zone (OR = 0.28, 95% CI [0.15–0.52]) and having a secondary education (OR = 0.49 95% CI [0.29–0.83]) lowered the risk of TST positivity. The generalized linear model showed that the previous predictors, as well as a low body mass index, had an effect on TST reaction size. The LTBI prevalence found in the population was moderate, reflecting the continuous transmission of M. tuberculosis. Social factors seem to play a decisive role in the risk of LTBI. Employed males, who are over 40 years of age, are overweight, have a lower level of education and have a low intake of alcohol (50–100 mL, once/week) should be a priority group for prophylactic treatment as a strategy for TB control in this city.

scholarly journals Latent tuberculosis infection among health-care workers using Quantiferon-TB Gold-Plus in a country with a low burden for tuberculosis: prevalence and risk factors

2020 ◽  
Vol 40 (3) ◽  
pp. 191-199
Author(s):  
Abdulellah Almohaya ◽  
Abdulwahab Aldrees ◽  
Layan Akkielah ◽  
Alshaima Talal Hashim ◽  
Fahad Almajid ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Logistic Regression ◽  
Health Care Workers ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Binary Logistic Regression ◽  
Case Control ◽  
Cross Sectional ◽  
Care Workers

ABSTRACT BACKGROUND: Health-care workers (HCW) are susceptible to latent tuberculosis infection (LTBI). The prevalence of LTBI in HCW in Saudi Arabia has not been reported using the fourth-generation interferon gamma release assay QuantiFERON-TB Gold Plus (QFT-Plus). OBJECTIVE: Determine the prevalence of LTBI in a large heterogeneous HCW population and assess risk factors for LTBI. DESIGN: Cross-sectional and case-control study. SETTING: Tertiary academic hospital, Riyadh, Saudi Arabia. PATIENTS AND METHODS: Medical records of HCWs who had QFT-Plus performed between January to December 2018 were reviewed and included in the cross-sectional study. In a subset analysis, randomly selected positive QFT-Plus cases were compared with controls selected from the same areas of work. Univariate and binary logistic regression analyses were performed to assess the significance of other factors to QFT-PLus positivity. MAIN OUTCOME MEASURES: Prevalence of LTBI in HCWs and potential risk factors for LTBI. SAMPLE SIZE: 3024 HCWs in the cross-sectional analysis; 294 cases and 294 controls in the case-control analysis. RESULTS: Twenty-four percent (n=733) of the HCWs had a positive QFT-Plus. The median (interquartile range) age was 34.0 (31.0-37.1) years, 71% were female, and only 24.8% were of Saudi nationals. Nursing represented 57.7% of HCWs, and 24.7% were working in a non-clinical area. Only 20.3% worked in TB-related departments. A higher risk of LTBI was present in HCWs who were older than 50 years (OR=1.95), from either Philippines (OR=4.7) or the Indian subcontinent (OR=4.1), working as a nurse (OR=2.7), allied health profession (OR=2.1), radiology technician (OR=3.1), or in the emergency room (OR=2.4) or intensive care unit (OR=2.1). In the binary logistic regression, independent predictors for positive QFT-Plus were age group older than 50 years (aOR=2.96), known TB exposure (aOR=1.97), and not receiving BCG at birth (aOR=3.08). LIMITATION: Single-center, retrospective, possible recall bias for BCG vaccination. CONCLUSION: The high prevalence of LTBI among HCW emphasizes the need to continue pre-employment screening, especially for employed personnel from high endemic areas, with targeted annual screening for the same group and other identified high-risk groups. These findings can aid in the development of national screening guidelines for LTBI in HCW. CONFLICT OF INTEREST: None.

scholarly journals 1649. Characterizing Factors Associated with Pediatric Latent Tuberculosis Infection in an Urban Health System to Improve Screening Practices

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S812-S812
Author(s):  
Nadia E Hoekstra ◽  
Mark Anderson ◽  
James Gaensbauer
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Logistic Regression ◽  
Health System ◽  
Urban Health ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Spanish Language ◽  
Tuberculosis Infection ◽  
Primary Care Clinics

Abstract Background The epidemiology and risk factors informing current American Academy of Pediatrics (AAP) guidelines on screening for pediatric latent tuberculosis infection (LTBI) have evolved over the past decade. To improve pediatric LTBI screening efficiency, we sought to reevaluate characteristics associated with positive QuantiFERON-TB Gold Plus (QFT-Plus) at Denver Health (DH), an urban health system that includes a network of primary care clinics, a refugee clinic and a tuberculosis clinic. Methods We retrospectively analyzed all QFT-Plus tests performed on children aged 2-18 years from 1/2019 to 9/2019. To obtain additional variables we conducted chart review on all positive and indeterminate results, and a random 10% sample of negatives. Characteristics (age range, sex, region of birth, clinic setting, primary language) of patients with positive and negative QFT-Plus were compared using Chi2 or Fisher’s exact tests (Table 1). Using the 10% negative controls, we calculated odds ratios for each variable and included important or significant variables in a multivariable logistic regression model. Results Of 1063 QFT-Plus tests performed, 29 (2.7%) were positive. 76% of all positive tests and 83% of positive tests in primary care clinics occurred in patients age ≥10. 51.7% of all positive patients were born in the US. Among factors analyzed by logistic regression including birth region, reason for screening, sex, age, ordering location, insurance status, and language, only Spanish language (OR 5.0, CI 1.6-15.8) and non-English, non-Spanish language (OR 6.4, CI 1.4-28.5) were significant risk factors for positive testing. Characteristics of Denver Health Patients with Positive and Negative QFT-Plus, January-September 2019. Conclusion Language was the only predictor of LTBI in this study, and may be a proxy for high risk travel and family exposure. Region of birth was not predictive, as half of positive tests occurred in US-born children. The majority of positive tests occurred in older children, suggesting they should be prioritized in screening programs, though occasional detection among younger children reinforces the importance of LTBI detection in ages where risk of progression to active TB is higher. Further studies are needed to better elucidate the details behind positive testing, including more detailed characterization of travel and potential family exposures. Disclosures All Authors: No reported disclosures

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