title: Why healthcare workers are sick of TB.
abstract: Dr Thato Mosidi never expected to be diagnosed with tuberculosis (TB), despite widely prevalent exposure and very limited infection control measures. The life-threatening diagnosis of primary extensively drug-resistant TB (XDR-TB) came as an even greater shock. The inconvenient truth is that, rather than being protected, Dr Mosidi and thousands of her healthcare colleagues are at an increased risk of TB and especially drug-resistant TB. In this viewpoint paper we debunk the widely held false belief that healthcare workers are somehow immune to TB disease (TB-proof) and explore some of the key factors contributing to the pervasive stigmatization and subsequent non-disclosure of occupational TB. Our front-line workers are some of the first to suffer the consequences of a progressively more resistant and fatal TB epidemic, and urgent interventions are needed to ensure the safety and continued availability of these precious healthcare resources. These include the rapid development and scale-up of improved diagnostic and treatment options, strengthened infection control measures, and focused interventions to tackle stigma and discrimination in all its forms. We call our colleagues to action to protect themselves and those they care for.
authors: TB Proof; School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Observatory, 7925, South Africa. Electronic address: vuzumsi@gmail.com.
authors: Arne
authors: A
authors: von Delft
authors: TB Proof; Paediatric Infectious Diseases, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.
authors: Angela
authors: A
authors: Dramowski
authors: TB Proof; Instituto Nacional de Saúde, Ministry of Health, Maputo, Mozambique.
authors: Celso
authors: C
authors: Khosa
authors: TB Proof; Division of Community Health, Stellenbosch University, Cape Town, South Africa.
authors: Koot
authors: K
authors: Kotze
authors: TB Proof; Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
authors: Philip
authors: P
authors: Lederer
authors: TB Proof; Wits Health Consortium, Respiratory and Meningeal Pathogens Unit, Johannesburg, South Africa.
authors: Thato
authors: T
authors: Mosidi
authors: TB Proof.
authors: Jurgens A
authors: JA
authors: Peters
authors: TB Proof; Department of Epidemiology, Emory Rollins School of Public Health, Atlanta, Georgia, USA; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA; Visual Epidemiology, New Haven, Connecticut, USA.
authors: Jonathan
authors: J
authors: Smith
authors: TB Proof; Division of Community Health, Stellenbosch University, Cape Town, South Africa.
authors: Helene-Mari
authors: HM
authors: van der Westhuizen
authors: TB Proof.
authors: Dalene
authors: D
authors: von Delft
authors: TB Proof; Division of Community Health, Stellenbosch University, Cape Town, South Africa.
authors: Bart
authors: B
authors: Willems
authors: UNZA-UCLMS Project, University Teaching Hospital, Lusaka, Zambia.
authors: Matthew
authors: M
authors: Bates
authors: Senior Lecturer, City University London, London, UK.
authors: Gill
authors: G
authors: Craig
authors: Karolinska Institute, Stockholm, Sweden.
authors: Markus
authors: M
authors: Maeurer
authors: The Children's Hospital at Westmead and the Marie Bashir Institute for Infectious Diseases and Biosecurity (MBI), The University of Sydney, Sydney, Australia.
authors: Ben J
authors: BJ
authors: Marais
authors: UNZA-UCLMS Project, University Teaching Hospital, Lusaka, Zambia.
authors: Peter
authors: P
authors: Mwaba
authors: Maputo Central Hospital, Maputo, Mozambique.
authors: Elizabete A
authors: EA
authors: Nunes
authors: European and Developing Countries Clinical Trials Partnership (EDCTP), Cape Town, South Africa.
authors: Thomas
authors: T
authors: Nyirenda
authors: UK All Party Parliamentary Group on Global TB, London, UK.
authors: Matt
authors: M
authors: Oliver
authors: TB Proof; Division of Infection and Immunity, University College London, and NIHR Biomedical Research Centre, at University College London Hospital, London, UK.
authors: Alimuddin
authors: A
authors: Zumla
mesh_terms: D054908:Extensively Drug-Resistant Tuberculosis / Q000635:transmission; D005260:Female; D006282:Health Personnel; D006801:Humans; D017053:Infection Control; D017758:Infectious Disease Transmission, Patient-to-Professional; D015995:Prevalence; D012306:Risk; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission*
keywords: Healthcare worker (occupational); Infection control; Multidrug- & Extensively Drug-Resistant TB (MDR-TB & XDR-TB); Prevention; Stigma; Tuberculosis (TB)