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
{"title":"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","authors":"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","doi":"10.1016/j.jhin.2025.01.004","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Aim</h3><div>To evaluate the effectiveness of the WHO-recommended measures regarding the risk of developing TB among the HCWs.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Findings</h3><div>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 (<em>P</em> = 0.035) and the incidence rates rose from 39 to 157 per 100,000 patients (<em>P</em> = 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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"157 ","pages":"Pages 75-82"},"PeriodicalIF":3.9000,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"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\",\"authors\":\"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\",\"doi\":\"10.1016/j.jhin.2025.01.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>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.</div></div><div><h3>Aim</h3><div>To evaluate the effectiveness of the WHO-recommended measures regarding the risk of developing TB among the HCWs.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Findings</h3><div>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 (<em>P</em> = 0.035) and the incidence rates rose from 39 to 157 per 100,000 patients (<em>P</em> = 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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>\",\"PeriodicalId\":54806,\"journal\":{\"name\":\"Journal of Hospital Infection\",\"volume\":\"157 \",\"pages\":\"Pages 75-82\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2025-01-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Hospital Infection\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0195670125000076\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hospital Infection","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0195670125000076","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
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
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.
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.
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