Tuberculosis among health-care workers in low- and middle-income countries: a systematic review.
<h4>Background</h4>The risk of transmission of Mycobacterium tuberculosis from patients to health-care workers (HCWs) is a neglected problem in many low- and middle-income countries (LMICs). Most health-care facilities in these countries lack resources to prevent nosocomial transmission...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2006-12-01
|
| Series: | PLoS Medicine |
| Online Access: | https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.0030494&type=printable |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849685333305720832 |
|---|---|
| author | Rajnish Joshi Arthur L Reingold Dick Menzies Madhukar Pai |
| author_facet | Rajnish Joshi Arthur L Reingold Dick Menzies Madhukar Pai |
| author_sort | Rajnish Joshi |
| collection | DOAJ |
| description | <h4>Background</h4>The risk of transmission of Mycobacterium tuberculosis from patients to health-care workers (HCWs) is a neglected problem in many low- and middle-income countries (LMICs). Most health-care facilities in these countries lack resources to prevent nosocomial transmission of tuberculosis (TB).<h4>Methods and findings</h4>We conducted a systematic review to summarize the evidence on the incidence and prevalence of latent TB infection (LTBI) and disease among HCWs in LMICs, and to evaluate the impact of various preventive strategies that have been attempted. To identify relevant studies, we searched electronic databases and journals, and contacted experts in the field. We identified 42 articles, consisting of 51 studies, and extracted data on incidence, prevalence, and risk factors for LTBI and disease among HCWs. The prevalence of LTBI among HCWs was, on average, 54% (range 33% to 79%). Estimates of the annual risk of LTBI ranged from 0.5% to 14.3%, and the annual incidence of TB disease in HCWs ranged from 69 to 5,780 per 100,000. The attributable risk for TB disease in HCWs, compared to the risk in the general population, ranged from 25 to 5,361 per 100,000 per year. A higher risk of acquiring TB disease was associated with certain work locations (inpatient TB facility, laboratory, internal medicine, and emergency facilities) and occupational categories (radiology technicians, patient attendants, nurses, ward attendants, paramedics, and clinical officers).<h4>Conclusions</h4>In summary, our review demonstrates that TB is a significant occupational problem among HCWs in LMICs. Available evidence reinforces the need to design and implement simple, effective, and affordable TB infection-control programs in health-care facilities in these countries. |
| format | Article |
| id | doaj-art-bda625b4334b4be2b3c9c3e958f89b8f |
| institution | DOAJ |
| issn | 1549-1277 1549-1676 |
| language | English |
| publishDate | 2006-12-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Medicine |
| spelling | doaj-art-bda625b4334b4be2b3c9c3e958f89b8f2025-08-20T03:23:11ZengPublic Library of Science (PLoS)PLoS Medicine1549-12771549-16762006-12-01312e49410.1371/journal.pmed.0030494Tuberculosis among health-care workers in low- and middle-income countries: a systematic review.Rajnish JoshiArthur L ReingoldDick MenziesMadhukar Pai<h4>Background</h4>The risk of transmission of Mycobacterium tuberculosis from patients to health-care workers (HCWs) is a neglected problem in many low- and middle-income countries (LMICs). Most health-care facilities in these countries lack resources to prevent nosocomial transmission of tuberculosis (TB).<h4>Methods and findings</h4>We conducted a systematic review to summarize the evidence on the incidence and prevalence of latent TB infection (LTBI) and disease among HCWs in LMICs, and to evaluate the impact of various preventive strategies that have been attempted. To identify relevant studies, we searched electronic databases and journals, and contacted experts in the field. We identified 42 articles, consisting of 51 studies, and extracted data on incidence, prevalence, and risk factors for LTBI and disease among HCWs. The prevalence of LTBI among HCWs was, on average, 54% (range 33% to 79%). Estimates of the annual risk of LTBI ranged from 0.5% to 14.3%, and the annual incidence of TB disease in HCWs ranged from 69 to 5,780 per 100,000. The attributable risk for TB disease in HCWs, compared to the risk in the general population, ranged from 25 to 5,361 per 100,000 per year. A higher risk of acquiring TB disease was associated with certain work locations (inpatient TB facility, laboratory, internal medicine, and emergency facilities) and occupational categories (radiology technicians, patient attendants, nurses, ward attendants, paramedics, and clinical officers).<h4>Conclusions</h4>In summary, our review demonstrates that TB is a significant occupational problem among HCWs in LMICs. Available evidence reinforces the need to design and implement simple, effective, and affordable TB infection-control programs in health-care facilities in these countries.https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.0030494&type=printable |
| spellingShingle | Rajnish Joshi Arthur L Reingold Dick Menzies Madhukar Pai Tuberculosis among health-care workers in low- and middle-income countries: a systematic review. PLoS Medicine |
| title | Tuberculosis among health-care workers in low- and middle-income countries: a systematic review. |
| title_full | Tuberculosis among health-care workers in low- and middle-income countries: a systematic review. |
| title_fullStr | Tuberculosis among health-care workers in low- and middle-income countries: a systematic review. |
| title_full_unstemmed | Tuberculosis among health-care workers in low- and middle-income countries: a systematic review. |
| title_short | Tuberculosis among health-care workers in low- and middle-income countries: a systematic review. |
| title_sort | tuberculosis among health care workers in low and middle income countries a systematic review |
| url | https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.0030494&type=printable |
| work_keys_str_mv | AT rajnishjoshi tuberculosisamonghealthcareworkersinlowandmiddleincomecountriesasystematicreview AT arthurlreingold tuberculosisamonghealthcareworkersinlowandmiddleincomecountriesasystematicreview AT dickmenzies tuberculosisamonghealthcareworkersinlowandmiddleincomecountriesasystematicreview AT madhukarpai tuberculosisamonghealthcareworkersinlowandmiddleincomecountriesasystematicreview |