Latent tuberculosis infection among undergraduate medical students in Rio de Janeiro State, Brazil.
METHODS
Five medical schools in three cities with different tuberculosis (TB) incidence rates in Rio de Janeiro State, Brazil.


OBJECTIVE
To estimate prevalence of and associated factors for latent tuberculosis infection (LTBI) among medical students.


METHODS
A cross-sectional survey was conducted among undergraduate students in pre-clinical, early and late clinical years from schools in cities with low (28/100,000), intermediate (63/100,000) and high (114/100,000) TB incidence rates. Information on socio-demographic profile, previous BCG vaccination, potential TB exposure, co-morbidity and use of respiratory protective masks was obtained. A tuberculin skin test (TST) was performed using the Mantoux technique by an experienced professional. A positive TST, defined as induration > or = 10 mm, was considered LTBI.


RESULTS
LTBI prevalence was 6.9% (95%CI 5.4-8.6). In multivariate analysis, male sex (adjusted odds ratio [aOR] 1.8; 95% CI 1.1-3.0), late clinical years (aOR 1.9; 95% CI 1.01-3.5), intermediate TB incidence (aOR 4.3; 95% CI 1.3-14.6) and high TB incidence in the city of medical school (aOR 5.1; 95% CI 1.6-16.8) were significantly associated with LTBI.


CONCLUSIONS
The higher prevalence of LTBI in late clinical years suggests that medical students are at increased risk for nosocomial Mycobacterium tuberculosis infection. The implementation of a TB control program may be necessary in medical schools, particularly in cities with higher TB incidence.
Teixeira
E G
EG
Department of Internal Medicine, Gama Filho University, Rio de Janeiro, Brazil. elenygt@centroin.com.br
Menzies
D
D
Comstock
G W
GW
Cunha
A J L A
AJ
Kritski
A L
AL
Soares
L C
LC
Bethlem
E
E
Zanetti
G
G
Ruffino-Netto
A
A
Belo
M T C T
MT
Selig
L
L
Branco
M M Castello
MM
Cherri
D
D
Maia
S
S
Marandino
R
R
Luiz
R R
RR
Chaisson
R E
RE
Trajman
A
A
D000328:Adult; D001938:Brazil; D003428:Cross Infection; D003430:Cross-Sectional Studies; D004504:Education, Medical, Undergraduate; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D017053:Infection Control; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D013337:Students, Medical; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology* / Q000635:transmission*