Comparison of the standardized incidence ratio of tuberculosis among workers at medical and educational institutions: a nationwide LTBI observational cohort study

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES Journal of Infection and Public Health Pub Date : 2024-10-19 DOI:10.1016/j.jiph.2024.102569

Yun-Hee Lee , Ju Sang Kim , Young-Joon Park , Gahee Kim , Yujin Kim , Gyuri Park , Hyung Woo Kim , Jun-Pyo Myong

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Abstract

Background

The objective of this study was to determine the incidence of tuberculosis (TB) among workers at medical institutions based on interferon-gamma release assay (IGRA) and compare it with that of workers at educational institutions and the general population.

Methods

From March 2017 to December 2020, we used a cohort of workers from medical and educational institutions in Korea, who underwent IGRA as part of a national screening program for latent tuberculosis infection (LTBI). After connecting to the National Health Insurance Service (NHIS) database to detect for any actual cases of active TB, we estimated standardized incidence ratio (SIR) and the expected number of cases to compare the incidence of TB with that of the general population.

Results

Significant disparities in TB incidence were revealed among workers in medical and educational institutions, based on IGRA results, age, and occupation. Individuals positive for IGRA in medical institutions displayed substantially higher SIR for TB, 7.19 (6.15–8.41), compared to counterparts in educational institutions, 3.69 (3.02–4.51). Comparing by age group, we see that the SIRs are higher in younger age groups compared to older ones, with 37.30 (28.11–49.50) and 11.89 (7.28–19.41) for IGRA-positive medical and education workers under 30 years of age, respectively. In the results by occupation within the medical institutions, nurses had the highest SIR at 14.17 (11.14–18.04).

Conclusions

Healthcare workers in medical institutions are more likely to develop actual TB after a positive result of LTBI screening in Korea. Intensive management and surveillance programs should be reinforced.

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医疗机构和教育机构工作人员结核病标准化发病率的比较：一项全国性的 LTBI 观察性队列研究。

研究背景本研究的目的是根据干扰素-γ释放测定（IGRA）确定医疗机构工作人员的结核病（TB）发病率，并将其与教育机构工作人员和普通人群的发病率进行比较：从 2017 年 3 月到 2020 年 12 月，我们使用了韩国医疗机构和教育机构工作人员的队列，他们接受了 IGRA 作为潜伏肺结核感染（LTBI）国家筛查计划的一部分。在与国民健康保险服务（NHIS）数据库连接以检测任何实际活动性肺结核病例后，我们估算了标准化发病率（SIR）和预期病例数，以便将肺结核发病率与普通人群的发病率进行比较：根据 IGRA 结果、年龄和职业，医疗机构和教育机构工作人员的结核病发病率存在显著差异。医疗机构 IGRA 阳性者的结核病 SIR 值为 7.19（6.15-8.41），而教育机构工作人员的 SIR 值为 3.69（3.02-4.51），两者相差甚远。按年龄组比较，我们发现年轻组的 SIR 值高于年长组，30 岁以下 IGRA 阳性的医务人员和教育工作者的 SIR 值分别为 37.30（28.11-49.50）和 11.89（7.28-19.41）。在医疗机构内按职业划分的结果中，护士的 SIR 最高，为 14.17（11.14-18.04）：结论：在韩国，医疗机构的医护人员在LTBI筛查结果呈阳性后更有可能患上实际的肺结核。应加强管理和监测计划。

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.