Latent Tuberculosis Infection and Associated Factors among Health Care Workers in Kigali, Rwanda.
BACKGROUND
Data are limited regarding tuberculosis (TB) and latent TB infection prevalence in Rwandan health facilities.


METHODS
We conducted a cross-sectional survey among healthcare workers (HCWs) in Kigali during 2010. We purposively selected the public referral hospital, both district hospitals, and randomly selected 7 of 17 health centers. School workers (SWs) from the nearest willing public schools served as a local reference group. We tested for latent TB infection (LTBI) using tuberculin skin testing (TST) and asked about past TB disease. We assessed risk of LTBI and past history of TB disease associated with hospital employment. Among HCWs, we assessed risk associated with facility type (district hospital, referral hospital, health center), work setting (inpatient, outpatient), and occupation.


RESULTS
Age, gender, and HIV status was similar between the enrolled 1,131 HCWs and 381 SWs. LTBI was more prevalent among HCWs (62%) than SWs (39%). Adjusted odds of a positive TST result were 2.71 (95% CI 2.01-3.67) times greater among HCWs than SWs. Among HCWs, there was no detectable difference between prevalence of LTBI according to facility type, work setting, or occupation.


CONCLUSIONS
HCWs are at greater risk of LTBI, regardless of facility type, work setting, or occupation. The current status of TB infection control practices should be evaluated in the entire workforce in all Rwandan healthcare facilities.
Division of Tuberculosis and Other Respiratory Communicable Diseases Rwanda Biomedical Centre, Kigali, Rwanda.
Claude
C
Rutanga
Division of Global HIV/AIDS, Centers for Disease Control and Prevention, Kigali, Rwanda.
David W
DW
Lowrance
Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, United States of America.
John E
JE
Oeltmann
Division of Tuberculosis and Other Respiratory Communicable Diseases Rwanda Biomedical Centre, Kigali, Rwanda.
Grace
G
Mutembayire
Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, United States of America.
Matt
M
Willis
Division of Global HIV/AIDS, Centers for Disease Control and Prevention, Kigali, Rwanda.
Claude Bernard
CB
Uwizeye
Division of HIV-AIDS, Sexually Transmitted Infections, and Other Blood Borne Diseases, Rwanda Biomedical Centre, Kigali, Rwanda.
Ruton
R
Hinda
Division of Global HIV/AIDS, Centers for Disease Control and Prevention, Kigali, Rwanda.
Chitou
C
Bassirou
Division of Global HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, United States of America.
Steve
S
Gutreuter
Division of Tuberculosis and Other Respiratory Communicable Diseases Rwanda Biomedical Centre, Kigali, Rwanda.
Michel
M
Gasana
D000328:Adult; D000368:Aged; D002391:Catchment Area, Health; D005260:Female; D006268:Health Facilities; D006282:Health Personnel / Q000706:statistics & numerical data*; D006801:Humans; D055985:Latent Tuberculosis / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012432:Rwanda / Q000453:epidemiology; D012574:Schools; D014374:Tuberculin Test; D055815:Young Adult