[Tuberculosis in health personnel: importance of surveillance and control programs].
OBJECTIVE
To describe tuberculosis surveillance results among healthcare workers of a tertiary care center.


METHODS
All medical records of workers from 1992-1998 were reviewed. Demographics, labor, medical history, previous testing, PPD, booster shots and follow-up were analyzed. Statistical analysis was performed with odds ratios, p-values, and 95% confidence intervals. Subgroup analysis were done with chi 2. Kaplan-Meier estimates were used to analyze times to conversion.


RESULTS
Surveillance was done in 1617 workers (68% female and 32% male). Mean age was 26.9 +/- 7.6 (15-68) years. Job positions were 30.5% nurses, 14.6% residents and 14.1% interns. Place of origin was Mexico City in 65.8%. BCG vaccination was present in 71.6% and 15.1% had previous PPD. Admission PPD was positive in 39.6%, negative in 48.3% and 12.1% were lost to follow-up. On negatives, 483 booster shots were applied, and 49 additional positives were found. Follow-up was done in 231 workers, of which 100 (43.3%) converted. The mean time for conversion was 22.8 +/- 12.4 months. The conversion rate at twelve months was 20%. Fifty workers received/accepted isoniazid prophylaxis.


CONCLUSIONS
A high percentage of workers were PPD-positive; booster shots allowed the detection of an additional 10%. A high conversion rate underscores the need to organize tuberculosis control programs in Mexico.
Ostrosky-Zeichner
L
L
División de Epidemiología Hospitalaria y Control de Calidad de la Atención Médica, Instituto Nacional de la Nutrición Salvador Zubirán, México.
Rangel-Frausto
M S
MS
García-Romero
E
E
Vázquez
A
A
Ibarra
M J
MJ
Ponce de León-Rosales
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data*; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000706:statistics & numerical data*; D016017:Odds Ratio; D018571:Sentinel Surveillance; D012959:Socioeconomic Factors; D014374:Tuberculin Test / Q000706:statistics & numerical data; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology* / Q000517:prevention & control