title: Tuberculin skin testing to assess the occupational risk of Mycobacterium tuberculosis infection among health care workers in Abidjan, Côte d'Ivoire.
abstract: METHODS
  Tuberculin skin test (TST) survey of health care workers (HCWs) in selected clinical services in Abidjan, Côte d'Ivoire.
  
  
  OBJECTIVE
  To assess whether HCWs in Abidjan are at increased risk for occupationally acquired Mycobacterium tuberculosis infection.
  
  
  METHODS
  From October 1996 to January 1997, consenting HCWs from four services where tuberculosis (TB) prevalence among patients was high and two services where it was low were evaluated with a questionnaire, TST (including evaluation of anergy) and chest radiograph.
  
  
  RESULTS
  Of the 512 participants, 405 (79%) had a TST reaction of > or =10 mm, eight (2%) were anergic, five (1%) had a radiograph compatible with TB, and two had confirmed TB. Using a cut-off of 10 mm, we found a higher prevalence of TST positivity in services with high TB prevalence than in those with low TB prevalence (92% vs 72%; odds ratio [OR] 4.3; 95% confidence interval [CI] 2.3-8.0]) and among HCWs with direct (87%; OR 2.9; 95%CI 1.6-5.1) and indirect patient contact (80%, OR 1.7; 95%CI 1.0-2.3) than among those with minimal patient contact (69%).
  
  
  CONCLUSIONS
  These findings indicate that TST positivity among HCWs is related to level of exposure to TB patients, and suggest that HCWs in Abidjan are at risk for the nosocomial transmission of TB.
authors.affiliation: Project RETRO-CI, Abidjan, Côte d'Ivoire.
authors.forename: S
authors.initials: S
authors.lastname: Kassim
authors.forename: P
authors.initials: P
authors.lastname: Zuber
authors.forename: S Z
authors.initials: SZ
authors.lastname: Wiktor
authors.forename: F V
authors.initials: FV
authors.lastname: Diomande
authors.forename: I M
authors.initials: IM
authors.lastname: Coulibaly
authors.forename: D
authors.initials: D
authors.lastname: Coulibaly
authors.forename: A
authors.initials: A
authors.lastname: Kadio
authors.forename: A
authors.initials: A
authors.lastname: Yapi
authors.forename: K C
authors.initials: KC
authors.lastname: Touré
authors.forename: P B
authors.initials: PB
authors.lastname: Blekou
authors.forename: B
authors.initials: B
authors.lastname: Irié
authors.forename: A E
authors.initials: AE
authors.lastname: Greenberg
authors.forename: N J
authors.initials: NJ
authors.lastname: Binkin
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D007560:Cote d'Ivoire / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000706:statistics & numerical data*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology*; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014374:Tuberculin Test; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D014504:Urban Health / Q000706:statistics & numerical data