title: Increased risk of tuberculosis among health care workers in Samara Oblast, Russia: analysis of notification data.
abstract: METHODS
  Samara Oblast, Russia.
  
  
  OBJECTIVE
  To compare the rates of tuberculosis (TB) in health care workers (HCWs) working in TB services, general health services (GHS) and the general population in a region of the Russian Federation.
  
  
  METHODS
  Analysis of notification rates of TB among HCWs, GHS workers and the general population during the 9-year period from 1994 to 2002.
  
  
  RESULTS
  During 1994-2002, TB incidence among staff employed at the TB services in Samara Oblast was ten times higher than among the general population, reaching 741.6/100 000 person years at risk. Staff working at in-patient TB facilities were found to be at highest risk, with an incidence rate ratio of 17.7 (95% CI 11.6-27.0) compared to HCWs at the GHS.
  
  
  CONCLUSIONS
  HCWs at TB services in the Russian Federation are at substantially increased risk for TB, suggesting significant risks from nosocomial transmission. Control of institutional spread of TB in the Russian Federation is an area that requires urgent attention, especially given the epidemic of human immunodeficiency virus that Russia is currently witnessing.
authors.affiliation: Department of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: B
authors.initials: B
authors.lastname: Dimitrova
authors.forename: A
authors.initials: A
authors.lastname: Hutchings
authors.forename: R
authors.initials: R
authors.lastname: Atun
authors.forename: F
authors.initials: F
authors.lastname: Drobniewski
authors.forename: G
authors.initials: G
authors.lastname: Marchenko
authors.forename: S
authors.initials: S
authors.lastname: Zakharova
authors.forename: I
authors.initials: I
authors.lastname: Fedorin
authors.forename: R J
authors.initials: RJ
authors.lastname: Coker
mesh_terms: D000328:Adult; D018563:Disease Notification; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D019538:Health Care Surveys; D006282:Health Personnel; D006801:Humans; D015994:Incidence; D017758:Infectious Disease Transmission, Patient-to-Professional; D008297:Male; D012307:Risk Factors; D012426:Russia / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology* / Q000209:etiology*