Infection control and the burden of tuberculosis infection and disease in health care workers in china: a cross-sectional study.
Infection control and the burden of tuberculosis infection and disease in health care workers in china: a cross-sectional study.
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DOI：
10.1186/1471-2334-10-313
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发表时间：
2010-10-28
影响因子：
3.7
通讯作者：
Borgdorff MW
中科院分区：
文献类型：
--
作者：
He GX;van denHof S;van der Werf MJ;Wang GJ;Ma SW;Zhao DY;Hu YL;Yu SC;Borgdorff MW
感染控制不力的医院是结核病(TB)出现和传播的危险环境。[方法]对河南省中国地区结核病防治中心医务人员的结核病控制现状、隐性结核感染情况、结核病患病情况及危险因素进行评价。2005年进行了一项横断面调查。为了评估结核病中心的结核病感染控制实践，使用了核对表。医务人员接受结核菌素皮肤试验(TST)以测量下呼吸道感染的患病率，并要求其进行痰涂片和胸部X光检查以发现结核病，并进行问卷调查以评估危险因素。分类变量组间差异采用二元Logistic回归分析。采用多水平Logistic模型考虑了研究的集群化设计。对感染控制做法的评估表明，只有少数中心将患者会诊区和X光区与候诊区和行政区分开。在任何一个结核病中心都没有机械通风。没有为HCW提供N95呼吸器，也没有为结核病患者和疑似患者提供外科口罩。合并卡痕和不合并卡痕的轻度烧伤发生率分别为55.6%和49.0%(P=0.003)。年龄越大、工作年限越长、工作年限越长、接触结核病患者越多的科室工作人员，LTBI的患病率越高。在地级结核病中心工作或在住院病房工作的卫生工作者也有较高的LTBI患病率。3746名工人中检出肺结核20例。医务人员结核病患病率为6.7/1000，行政/后勤人员为2.5/1000。河南省结核病控制中心结核病感染控制不到位，医务人员轻伤和结核病患病率较高。中国应加强结核病中心的结核病感染控制措施，包括行政措施、建筑物改造、使用口罩和口罩。需要考虑定期对HCW进行结核病和LTBI筛查，为TST转换者提供预防性治疗。
Hospitals with inadequate infection control are risky environments for the emergence and transmission of tuberculosis (TB). We evaluated TB infection control practices, and the prevalence of latent TB infection (LTBI) and TB disease and risk factors in health care workers (HCW) in TB centers in Henan province in China. A cross-sectional survey was conducted in 2005. To assess TB infection control practices in TB centers, checklists were used. HCW were tuberculin skin tested (TST) to measure LTBI prevalence, and were asked for sputum smears and chest X-rays to detect TB disease, and questionnaires to assess risk factors. Differences between groups for categorical variables were analyzed by binary logistic regression. The clustered design of the study was taken into account by using a multilevel logistic model. The assessment of infection control practices showed that only in a minority of the centers the patient consultation areas and X-ray areas were separated from the waiting areas and administrative areas. Mechanical ventilation was not available in any of the TB centers. N95 respirators were not available for HCW and surgical masks were not available for TB patients and suspects. The LTBI prevalence of HCW with and without BCG scar was 55.6% (432/777) and 49.0% (674/1376), respectively (P = 0.003). Older HCW, HCW with longer duration of employment, and HCW who worked in departments with increased contact with TB patients had a higher prevalence of LTBI. HCW who work in TB centers at the prefecture level, or with an inpatient ward also had a higher prevalence of LTBI. Twenty cases of pulmonary TB were detected among 3746 HCW. The TB prevalence was 6.7/1000 among medical staff and 2.5/1000 among administrative/logistic staff. TB infection control in TB centers in Henan, China, appears to be inadequate and the prevalence of LTBI and TB disease among HCW was high. TB infection control practices in TB centers should be strengthened in China, including administrative measures, renovation of buildings, and use of respirators and masks. Regular screening of HCW for TB disease and LTBI needs to be considered, offering preventive therapy to those with TST conversions.
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影响因子：
39.2
作者：
BLUMBERG, HM;WATKINS, DL;MCGOWAN, JE
通讯作者：
MCGOWAN, JE
影响因子：
15.8
作者：
Joshi R;Reingold AL;Menzies D;Pai M
通讯作者：
Pai M
影响因子：
10
作者：
Kolappan, C;Gopi, PG
通讯作者：
Gopi, PG
影响因子：
4.5
作者：
Cook, S;Maw, KL;Frieden, TR
通讯作者：
Frieden, TR
影响因子：
39.2
作者：
PEARSON, ML;JEREB, JA;JARVIS, WR
通讯作者：
JARVIS, WR