The epidemiology of tuberculosis in health care workers in South Africa: a systematic review
The epidemiology of tuberculosis in health care workers in South Africa: a systematic review
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DOI：
10.1186/s12913-016-1601-5
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发表时间：
2016-08-20
影响因子：
2.8
通讯作者：
Osman, Muhammad
中科院分区：
文献类型：
--
作者：
Grobler, Liesl;Mehtar, Shaheen;Osman, Muhammad
背景：在南非，工作场所获得性结核病（TB）是卫生保健工作者的一个重要职业问题。为了有效地管理这一问题，了解卫生保健工作者的结核病负担是很重要的。本系统综述描述了南非卫生保健工作者中结核病的流行病学。全面检索电子数据库[MEDLINE、EMBASE、Web of Science（社会科学引文索引/科学引文索引），科克伦图书馆（包括对照试验中心注册），CINAHL和WHO国际临床试验注册平台（ICTRP）]对南非卫生保健工作者结核病流行病学任何方面的报告进行了研究，研究时间截止到2015年4月。在纳入审查的16项研究中，10项研究报告了卫生保健工作者中活动性结核病的发病率，2项报告了活动性结核病的患病率，2项报告了潜伏性结核病感染的发病率，三项研究报告了潜伏性结核病感染的流行情况，四项研究报告了南非各种卫生保健机构卫生保健工作者的结核病病例数。五项研究提供了关于卫生保健工作者结核病风险因素的信息。所有纳入的研究均在公共资助的医疗机构进行;主要位于夸祖鲁-纳塔尔省和西开普省。大多数的研究反映了较高的发病率和患病率的活动性结核病的卫生保健工作者，包括耐药结核病，相比周围的社区或一般population.Conclusions：有相对较少的研究结核病的流行病学在南非的卫生保健工作者，尽管这个问题的重要性。为了确定卫生保健工作者结核病流行的真实程度，应在所有卫生保健设施的所有卫生保健工作者中进行结核病的定期筛查，但未来的研究需要调查南非卫生保健工作者结核病筛查的最佳方法。证据基础表明，南非卫生保健工作者的活动性和潜伏性结核病负担很高，迫切需要改善南非卫生保健机构现有的结核病感染、预防和控制措施。
Background: In South Africa, workplace acquired tuberculosis (TB) is a significant occupational problem among health care workers. In order to manage the problem effectively it is important to know the burden of TB in health care workers. This systematic review describes the epidemiology of TB in South African health care workers.Methods: A comprehensive search of electronic databases [MEDLINE, EMBASE, Web of Science (Social Sciences Citation Index/Science Citation Index), Cochrane Library (including CENTRAL register of Controlled Trials), CINAHL and WHO International Clinical Trials Registry Platform (ICTRP)] was conducted up to April 2015 for studies reporting on any aspect of TB epidemiology in health care workers in South Africa.Results: Of the 16 studies included in the review, ten studies reported on incidence of active TB disease in health care workers, two report on the prevalence of active TB disease, two report on the incidence of latent TB infection, three report on the prevalence of latent TB infection and four studies report on the number of TB cases in health care workers in various health care facilities in South Africa. Five studies provide information on risk factors for TB in health care workers. All of the included studies were conducted in publicly funded health care facilities; predominately located in KwaZulu-Natal and Western Cape provinces. The majority of the studies reflect a higher incidence and prevalence of active TB disease in health care workers, including drug-resistant TB, compared to the surrounding community or general population.Conclusions: There is relatively little research on the epidemiology of TB in health care workers in South Africa, despite the importance of the issue. To determine the true extent of the TB epidemic in health care workers, regular screening for TB disease should be conducted on all health care workers in all health care facilities, but future research is required to investigate the optimal approach to TB screening in health care workers in South Africa. The evidence base shows a high burden of both active and latent TB in health care workers in South Africa necessitating an urgent need to improve existing TB infection, prevention and control measures in South African health care facilities.