title: Tuberculosis infection among young nursing trainees in South India.
abstract: BACKGROUND
  Among healthcare workers in developing countries, nurses spend a large amount of time in direct contact with tuberculosis (TB) patients, and are at high risk for acquisition of TB infection and disease. To better understand the epidemiology of nosocomial TB among nurses, we recruited a cohort of young nursing trainees at Christian Medical College, a large, tertiary medical school hospital in Southern India.
  
  
  RESULTS
  Among 535 nursing students enrolled in 2007, 468 gave consent to participate, and 436 underwent two-step tuberculin skin testing (TST). A majority (95%) were females, and almost 80% were under 22 years of age. Detailed TB exposure information was obtained using interviews and clinical log books. Prevalence of latent TB infection (LTBI) was estimated using Bayesian latent class analyses (LCA). Logistic regression analyses were done to determine the association between LTBI prevalence and TB exposure and risk factors. 219 of 436 students (50.2%, 95% CI: 45.4-55.0) were TST positive using the 10 mm or greater cut-off. Based on the LCA, the prevalence of LTBI was 47.8% (95% credible interval 17.8% to 65.6%). In the multivariate analysis, TST positivity was strongly associated with time spent in health care, after adjusting for age at entry into healthcare.
  
  
  CONCLUSIONS
  Our study showed a high prevalence of LTBI even in young nursing trainees. With the recent TB infection control (TBIC) policy guidance from the World Health Organization as the reference, Indian healthcare providers and the Indian Revised National TB Control Programme will need to implement TBIC interventions, and enhance capacity for TBIC at the country level. Young trainees and nurses, in particular, will need to be targeted for TBIC interventions.
authors.affiliation: Department of Pulmonary Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Devasahayam J
authors.initials: DJ
authors.lastname: Christopher
authors.forename: Peter
authors.initials: P
authors.lastname: Daley
authors.forename: Lois
authors.initials: L
authors.lastname: Armstrong
authors.forename: Prince
authors.initials: P
authors.lastname: James
authors.forename: Richa
authors.initials: R
authors.lastname: Gupta
authors.forename: Beulah
authors.initials: B
authors.lastname: Premkumar
authors.forename: Joy Sarojini
authors.initials: JS
authors.lastname: Michael
authors.forename: Vedha
authors.initials: V
authors.lastname: Radha
authors.forename: Alice
authors.initials: A
authors.lastname: Zwerling
authors.forename: Ian
authors.initials: I
authors.lastname: Schiller
authors.forename: Nandini
authors.initials: N
authors.lastname: Dendukuri
authors.forename: Madhukar
authors.initials: M
authors.lastname: Pai
mesh_terms: D003906:Developing Countries; D004506:Education, Nursing; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007194:India; D017053:Infection Control; D017758:Infectious Disease Transmission, Patient-to-Professional; D008297:Male; D009726:Nurses; D016273:Occupational Exposure; D017410:Practice Guidelines as Topic; D015995:Prevalence; D014376:Tuberculosis / Q000453:epidemiology* / Q000517:prevention & control; D014944:World Health Organization; D055815:Young Adult
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