Tuberculosis disease among health care workers

  • Roberto Accinelli Tanaka Universidad Peruana Cayetano Heredia
  • Julio Noda Milla Universidad Peruana Cayetano Heredia
  • Erika Bravo Padilla Universidad Peruana Cayetano Heredia
  • Maribel Galloso Benites Universidad Peruana Cayetano Heredia
  • Lidia López Oropeza Universidad Peruana Cayetano Heredia
  • João Da Silva Caballero Universidad Peruana Cayetano Heredia
  • Yeny Bravo Pajuelo Universidad Peruana Cayetano Heredia
  • Juan Agapito Panta Hospital Nacional Cayetano Heredia
  • Amador Carcelén Bustamante Hospital Nacional Cayetano Heredia
  • Augusto Yi Chu Hospital Nacional Cayetano Heredia
  • Javier Díaz Urteaga Hospital Nacional Cayetano Heredia
  • Rosa Mayhua Pérez Hospital Nacional Cayetano Heredia
  • William Chávez Frías Hospital Nacional Cayetano Heredia
  • Danilo Salazar Oré Hospital Nacional Cayetano Heredia
  • Henry Martínez Garibay Hospital Nacional Cayetano Heredia
Keywords: Tuberculosis, Healthcare, Workers

Abstract

Introduction: Tuberculosis (TB) transmission is a well-recognized risk in healthcare facilities. This risk is variable considering to the nature of such facilities (primary, secondary, or tertiary care), the prevalence of TB in the community, occupational groups of healthcare workers (HCW), the particular area in which they work, and the effectiveness of control programs.
Objectives: To describe the features of TB and results of therapy for this disease in HCW seen in the TB Control Program in Cayetano Heredia National Hospital in Lima, Peru.
Material and methods: A descriptive observational study was performed, including cases (HCWs) and controls (patients) admitted in the TB Control Program in Cayetano Heredia National Hospital in Lima, Peru, between 1994 and 2007.
Results: 957 TB cases were seen in the TB Control Program in Cayetano Heredia Hospital from January 1994 to December 2007. One hundred and fifty nine (16,6%) were HCW, their average age was 31,05 ±8,79 years, 84 (52,8%) were female, and 122 (76,7%) developed pulmonary disease. Of these latter cases, 36,5% were healthcare professionals and 34,6% were medicine, nursing, or health technology students. Amongst healthcare professionals that developed TB, 41 (71%) were physicians, and most of them (63%) were residents in-training. Amongst students, medicine students accounted for most TB cases (87%), and 75% of them were senior medical students (interns and 6th year). Twenty isolated of M. tuberculosis had susceptibility tests performed, 11 (55%) were resistant to at least one antituberculous drug, 5 (25%) were multidrug resistant M. tuberculosis isolates, 8 (40%) were isoniazid-resistant, 6 (30%), were rifampin-resistant, 6 (30%) were streptomycin-resistant, and 4 (20%) were ethambutol-resistant. Seventy four (60,7%) of 122 HCWs with pulmonary TB entered the Program with sputum smears negative for acid-fast bacilli (AFB), and only 41 (33%) controls had negative sputum smears (p<0.001). HCWs received the same antituberculous therapy and for the same time compared to controls (7,2 ±3,1 months and 6,8 ±3,6 months, p= 0,3), but they received a higher number of doses during the first phase of antituberculous therapy (73,2 ±65,6 vs. 59,01 ±44,5 doses, p= 0.001). Five per cent of HCWs and 13,21% controls had a contact diagnosed with TB during the control period (p<0.001).
Conclusions: Most healthcare workers with TB were professionals or students, with a high frequency of MDR strains, there were no deaths in the population studied, and smear-negative forms were most frequent amongst pulmonary TB cases. Compared with controls, TB cases in HCWs had better curation rates with the same time of therapy, but using more daily doses.

Downloads

Download data is not yet available.
Published
2009-03-31
How to Cite
1.
Accinelli Tanaka R, Noda Milla J, Bravo Padilla E, Galloso Benites M, López Oropeza L, Da Silva Caballero J, Bravo Pajuelo Y, Agapito Panta J, Carcelén Bustamante A, Yi Chu A, Díaz Urteaga J, Mayhua Pérez R, Chávez Frías W, Salazar Oré D, Martínez Garibay H. Tuberculosis disease among health care workers. Acta Med Peru [Internet]. 2009Mar.31 [cited 2024Mar.28];26(1):35 -47. Available from: https://amp.cmp.org.pe/index.php/AMP/article/view/1492
Section
ORIGINAL ARTICLES

Most read articles by the same author(s)