Table 4 Risk factors associated with active TB disease or latent TB infection (LTBI) in health care workers
From: The epidemiology of tuberculosis in health care workers in South Africa: a systematic review
Study ID | Age | Employment duration | Occupation | HIV status | Diabetes | TB IPC training |
|---|---|---|---|---|---|---|
Incidence of active TB disease | ||||||
Ayuk et al. [20] | Not significantly associated with odds of acquiring TB disease; age 40–49 years most affected by TB disease | Not significantly associated with odds of acquiring TB disease | Not assessed | HIV+ HCWs have significantly increased odds of acquiring TB disease (OR: 67.08 95%CI: 7.5–596.6) | Not significantly associated with odds of acquiring TB disease (OR: 1.7 95%CI: 0.8–3.8) | No previous training in TB prevention (OR: 2.97 95%CI: 1.2–7.7); no knowledge of TB risk profile of work place (OR: 8.7 95%CI: 1.1–67.96) significantly associated with increased odds of acquiring TB disease |
Tudor et al. [18] | Not significantly associated with incidence of TB disease | Years worked in hospital not significantly associated with incidence of TB disease | No significant association between occupational category and incidence of TB disease; history of working in TB ward significantly associated with increased incidence of TB disease (IRR: 2.87 95 % CI: 1.67–4.93) | HIV-positivity significantly associated with increase incidence of TB disease (adjIRR: 3.2 95%CI: 1.54–6.66) | Not reported on | Not reported on |
Incidence of latent TB infection | ||||||
Adams et al. [14] | Age 31–40 years significantly associated with increased odds of LTBI (OR: 2.08 95%CI: 1.04, 4.17) | Employment in primary level health care facility > 20 years significantly associated with increased odds of LTBI (OR: 3.47, 95%CI 1.01–11.97) | Not assessed | 3/5 HCWs with TB disease were HIV + HIV+ significantly associated with decreased odds of TSTpos (OR: 0.41 95%CI: 0.17–0.95) | Not significantly associated with odds of LTBI | In secondary level staff “some training on self-protection from TB infection” significantly associated with decreased odds of LTBI (OR: 0.38 95%CI: 0.16–0.91) |
McCarthy et al. [22] | IGRA: ≥ 31 years significantly associated with increased risk of latent TB infection (crude IRR: 2.3 95%CI: 0.9, 5.8) TST: No significant association | Not reported on | IGRA: HCWs had a significantly greater risk of acquiring latent TB infection (crude IRR: 4.32, 95%CI: 1.7–12.2) TST: No significant association | No significant association between HIV status and risk of latent TB infection with both IGRA and TST | Not reported on | IGRA: Higher TB knowledge score (crude IRR: 0.4, 95%CI: 0.1, 1.3) and TB infection control training (crude IRR: 0.4, 95%CI: 0.1, 1.2) significantly reduced risk of latent TB infection TST; TB infection control practiced by participants significantly reduced risk of latent TB infection (crude IRR: 0.4, 95%CI: 0.1, 1.3) |
Prevalence of latent TB infection | ||||||
Van Rie [23] | Prevalence of LTBI No significant association with LTBI in medical students or health care workers | Not reported on | Not assessed in medical students No significant association with LTBI in health care workers | Medical students all HIV-negative HIV-negative health care workers significantly reduced odds of TST positive (OR: 0.28 95%CI: 0.1–0.74) | Not reported on | Medical students: TB knowledge score > 7 (median score) significantly decreased odds of LTBI (adjOR: 0.29 95 % CI: 0.09–0.98) Health care workers: no significant association |