Prevalence and risk factors for tuberculosis infection among hospital workers in Hanoi, Viet Nam.
BACKGROUND
Transmission of tuberculosis (TB) to health care workers (HCWs) is a global issue. Although effective infection control measures are expected to reduce nosocomial TB, HCWs' infection has not been assessed enough in TB high burden countries. We conducted a cross-sectional study to determine the prevalence of TB infection and its risk factors among HCWs in Hanoi, Viet Nam.


RESULTS
A total of 300 HCWs including all staff members in a municipal TB referral hospital received an interferon-gamma release assay (IGRA), QuantiFERON-TB Gold In-Tube(TM), followed by one- and two-step tuberculin skin test (TST) and a questionnaire-based interview. Agreement between the tests was evaluated by kappa statistics. Risk factors for TB infection were analyzed using a logistic regression model. Among the participants aged from 20 to 58 years (median = 40), prevalence of TB infection estimated by IGRA, one- and two-step TST was 47.3%, 61.1% and 66.3% respectively. Although the levels of overall agreement between IGRA and TST were moderate, the degree of agreement was low in the group with BCG history (kappa = 0.29). Working in TB hospital was associated with twofold increase in odds of TB infection estimated by IGRA. Increased age, low educational level and the high body mass index also demonstrated high odds ratios of IGRA positivity.


CONCLUSIONS
Prevalence of TB infection estimated by either IGRA or TST is high among HCWs in the hospital environment for TB care in Viet Nam and an infection control program should be reinforced. In communities with heterogeneous history of BCG vaccination, IGRA seems to estimate TB infection more accurately than any other criteria using TST.
Lien
Luu Thi
LT
Hanoi Tuberculosis and Lung Disease Hospital, Hanoi, Viet Nam.
Hang
Nguyen Thi Le
NT
Kobayashi
Nobuyuki
N
Yanai
Hideki
H
Toyota
Emiko
E
Sakurada
Shinsaku
S
Thuong
Pham Huu
PH
Cuong
Vu Cao
VC
Nanri
Akiko
A
Mizoue
Tetsuya
T
Matsushita
Ikumi
I
Harada
Nobuyuki
N
Higuchi
Kazue
K
Tuan
Le Anh
LA
Keicho
Naoto
N
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010564:Personnel, Hospital; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014374:Tuberculin Test; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology*; D014744:Vietnam / Q000453:epidemiology