Impact of WHO-recommended tuberculosis control measures on occupational tuberculosis risk among healthcare workers in a high-burden tertiary hospital in Brazil: a 24-year retrospective analysis

IF 3.9 3区医学 Q1 INFECTIOUS DISEASES Journal of Hospital Infection Pub Date : 2025-01-17 DOI:10.1016/j.jhin.2025.01.004

P. Bortolozzi-Mendes , M. Rennó de Campos , H. de Oliveira Couto , M.C. Vieira de Almeida , J.G.C. Gonçalves de Oliveira , F. Bellissimo-Rodrigues , C.H. Miranda , A. Pazin-Filho

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Abstract

Background

Tuberculosis (TB) remains a significant public health concern, particularly in low-to-middle-income countries. Healthcare workers (HCWs) are at a higher risk due to prolonged exposure. The World Health Organization (WHO) has proposed guidelines focusing on administrative interventions, structural interventions, and personal protective equipment (PPE) usage to mitigate this risk.

Aim

To evaluate the effectiveness of the WHO-recommended measures regarding the risk of developing TB among the HCWs.

Methods

This was a retrospective analysis of TB incidence among patients admitted to a tertiary public emergency department (ED) compared with HCWs from 2000 to 2023. TB notifications were extracted among HCWs and the general population of Ribeirão Preto from a public database.

Findings

From 2000 to 2023, the ED handled an average of 148,496 patients per quadrennium, with 202 TB patients per quadrennium. The prevalence ratio of TB per 100,000 patients increased from 80 to 170 (P = 0.035) and the incidence rates rose from 39 to 157 per 100,000 patients (P = 0.046). The incidence rate of TB among HCWs started at 412.0 (85.0; 1201.0) and decreased to 179.0 (20.0; 619.0). In total, 11 HCWs were diagnosed with TB. The relative risk of having TB between HCWs and the general population was significantly higher before the programme implementation and became equivalent after it.

Conclusion

Implementing WHO-recommended TB control measures was demonstrated to be effective in reducing the incidence rate ratios between HCWs and the general population in a high-burden tertiary hospital in Brazil.

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世卫组织推荐的结核病控制措施对巴西一家高负担三级医院医护人员职业结核病风险的影响：一项24年回顾性分析

背景：结核病（TB）仍然是一个重大的公共卫生问题，特别是在低收入和中等收入国家。由于长期接触，卫生保健工作者（HCWs）面临更高的风险。世界卫生组织（世卫组织）提出了指导方针，重点是行政干预、结构性干预和个人防护装备的使用，以减轻这一风险。尽管有这些建议，但在巴西缺乏关于这些建议在降低职业结核病风险方面的效率的数据。目的：评价世卫组织建议的卫生保健工作者中结核病发生风险措施的有效性。方法：我们对2000年至2023年在三级公共急诊科（ED）和HCWs住院的患者的结核病发病率进行了回顾性分析。我们从公共数据库中提取了卫生保健员和里贝赫普雷图普通人群的结核病报告。我们比较分析了患者和卫生保健人员之间的发病率，以评估世卫组织推荐措施的有效性。结果：从2000年到2023年，ED每四年平均处理148,496名患者，每四年处理202名结核病患者。结核病患病率从每10万例患者80例增加到170例（p=0.035），发病率从每10万例患者39例增加到157例（p=0.046）。我院卫生保健工作者结核病发病率从412.0（85.0;1201.0）降至179.0（20.0;619.0）。共有11名卫生保健员被诊断患有结核病。卫生保健工作者与一般人群患结核病的相对风险在项目实施前显著高于普通人群，在项目实施后两者相当。结论：在巴西一家高负担三级医院，实施世卫组织推荐的结核病控制措施可有效降低卫生保健人员与普通人群之间的发病率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hospital Infection 医学-传染病学

CiteScore

12.70

自引率

5.80%

发文量

271

审稿时长

19 days

期刊介绍： The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience. The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that: provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings; provide new insight into cleaning, disinfection and decontamination; provide new insight into the design of healthcare premises; describe novel aspects of outbreaks of infection; throw light on techniques for effective antimicrobial stewardship; describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control; improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change; improve understanding of the use of IT systems in infection surveillance and prevention and control.