title: Prevalence and risk factors for tuberculosis infection among hospital workers in Hanoi, Viet Nam.
abstract: 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.
authors.affiliation: Hanoi Tuberculosis and Lung Disease Hospital, Hanoi, Viet Nam.
authors.forename: Luu Thi
authors.initials: LT
authors.lastname: Lien
authors.forename: Nguyen Thi Le
authors.initials: NT
authors.lastname: Hang
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Hideki
authors.initials: H
authors.lastname: Yanai
authors.forename: Emiko
authors.initials: E
authors.lastname: Toyota
authors.forename: Shinsaku
authors.initials: S
authors.lastname: Sakurada
authors.forename: Pham Huu
authors.initials: PH
authors.lastname: Thuong
authors.forename: Vu Cao
authors.initials: VC
authors.lastname: Cuong
authors.forename: Akiko
authors.initials: A
authors.lastname: Nanri
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mizoue
authors.forename: Ikumi
authors.initials: I
authors.lastname: Matsushita
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Harada
authors.forename: Kazue
authors.initials: K
authors.lastname: Higuchi
authors.forename: Le Anh
authors.initials: LA
authors.lastname: Tuan
authors.forename: Naoto
authors.initials: N
authors.lastname: Keicho
mesh_terms: 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