Tuberculosis infection risk, preventive therapy care cascade and incidence of tuberculosis disease in healthcare workers at Maputo Central Hospital

• Published in: BMC infectious diseases 2019-04, Vol.19 (1), p.346-10, Article 346
• Main Authors: Graves, Susannah K, Augusto, Orvalho, Viegas, Sofia Omar, Lederer, Philip, David, Catarina, Lee, Kristen, Hassane, Anila, Cossa, Anilsa, Amade, Salma, Peleve, Susete, Zindoga, Pereira, Massawo, Leguesse, Torriani, Francesca J, Nunes, Elizabete A
• Format: Article
• Language: English
• Subjects: Antitubercular agents; Antitubercular Agents - therapeutic use; Assaying; Bacillus Calmette-Guerin vaccine; BCG; Biological response modifiers; Cross-Sectional Studies; Design factors; Disease prevention; Education; Health aspects; Health care; Health facilities; Health Personnel - statistics & numerical data; Health risks; Healthcare workers; HIV; HIV tests; Hospitals; Human immunodeficiency virus; Humans; Incidence; Infections; Infectious diseases; Interferon; Interferon gamma; Interferon-gamma release assay; Isoniazid; Isoniazid preventive therapy; Laboratories; Latent tuberculosis infection; Medical personnel; Medical research; Medical tests; Microscopy; Mozambicans; Mozambique - epidemiology; Prevention; Preventive medicine; Risk analysis; Risk Factors; Sexually transmitted diseases; Side effects; Skin; Skin tests; STD; Surgery; Systematic review; Teachers; Therapy; Tuberculin; Tuberculosis; Tuberculosis - diagnosis; Tuberculosis - drug therapy; Tuberculosis - epidemiology; Tuberculosis - prevention & control; Vaccination; Workers; γ-Interferon
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-019-3966-7

Mozambican healthcare workers have high rates of latent and active tuberculosis, but occupational screening for tuberculosis is not routine in this setting. Furthermore, the specificity of tuberculin skin testing in this population compared with interferon gamma release assay testing has not been established. This study was conducted among healthcare workers at Maputo Central Hospital, a public teaching quaternary care hospital in Mozambique. With a cross sectional study design, risk factors for tuberculosis were assessed using multivariable logistic regression. The care cascade is reported for participants who were prescribed six months of isoniazid preventive therapy for HIV or highly reactive testing for latent tuberculosis infection. The agreement of interferon-gamma release assay results with positive tuberculin skin testing was calculated. Of 690 screened healthcare workers, three (0.4%) had active tuberculosis and 426 (61.7%) had latent tuberculosis infection. Less education, age 35-49, longer hospital service, and work in the surgery department were associated with increased likelihood of being tuberculosis infected at baseline (p