Tuberculosis in healthcare workers and infection control measures at primary healthcare facilities in South Africa.
Tuberculosis in healthcare workers and infection control measures at primary healthcare facilities in South Africa.
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DOI：
10.1371/journal.pone.0076272
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Borgdorff MW
中科院分区：
文献类型：
--
作者：
Claassens MM;van Schalkwyk C;du Toit E;Roest E;Lombard CJ;Enarson DA;Beyers N;Borgdorff MW
南非在结核病感染控制和医院医护人员结核病方面存在挑战。然而，很少有研究报告非医院医护人员（例如初级或社区医护人员）的结核病。我们的目的是调查初级卫生保健机构结核感染控制措施的实施情况、初级卫生保健人员的涂片阳性结核病发病率以及卫生保健人员结核感染控制措施与所有类型结核病之间的关联。 2009 年，我们走访了南非五个省份的 133 个初级卫生保健机构。在每个机构，都完成了结核病感染控制审计和机构调查问卷。获取了过去三年内患有结核病的医护人员人数。初级卫生保健人员涂阳结核病的标准化发病率表明，其发病率是一般人群的两倍多。在单变量逻辑回归中，感染控制审核评分与医护人员报告的结核病病例显着相关（OR=1.04，95%CI 1.01-1.08，p=0.02），工作人员数量也显着相关（OR=3.78，95%CI 1.77-8.08）。在多变量分析中，工作人员数量仍然与医护人员结核病显着相关（OR=3.33，95%CI 1.37-8.08）。医护人员中结核病的高发病率表明存在重大的院内传播风险，但所使用的感染控制审核工具未能充分衡量这种风险。应通过当地开发和测试的经过验证的工具来监测感染控制措施。可以使用常规监测系统等不同策略来评估医护人员的结核病负担，以便计算结核病发病率、监测趋势并实施干预措施以减少职业性结核病。
Challenges exist regarding TB infection control and TB in hospital-based healthcare workers in South Africa. However, few studies report on TB in non-hospital based healthcare workers such as primary or community healthcare workers. Our objectives were to investigate the implementation of TB infection control measures at primary healthcare facilities, the smear positive TB incidence rate amongst primary healthcare workers and the association between TB infection control measures and all types of TB in healthcare workers. One hundred and thirty three primary healthcare facilities were visited in five provinces of South Africa in 2009. At each facility, a TB infection control audit and facility questionnaire were completed. The number of healthcare workers who had had TB during the past three years was obtained. The standardised incidence ratio of smear positive TB in primary healthcare workers indicated an incidence rate of more than double that of the general population. In a univariable logistic regression, the infection control audit score was significantly associated with reported cases of TB in healthcare workers (OR=1.04, 95%CI 1.01-1.08, p=0.02) as was the number of staff (OR=3.78, 95%CI 1.77-8.08). In the multivariable analysis, the number of staff remained significantly associated with TB in healthcare workers (OR=3.33, 95%CI 1.37-8.08). The high rate of TB in healthcare workers suggests a substantial nosocomial transmission risk, but the infection control audit tool which was used did not perform adequately as a measure of this risk. Infection control measures should be monitored by validated tools developed and tested locally. Different strategies, such as routine surveillance systems, could be used to evaluate the burden of TB in healthcare workers in order to calculate TB incidence, monitor trends and implement interventions to decrease occupational TB.
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影响因子：
3.7
作者：
He GX;van denHof S;van der Werf MJ;Wang GJ;Ma SW;Zhao DY;Hu YL;Yu SC;Borgdorff MW
通讯作者：
Borgdorff MW
DOI：
10.5588/ijtld.12.0041
发表时间：
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DOI：
10.7196/samj.3903
发表时间：
2010-04-01
期刊：
SAMJ: South African Medical Journal
影响因子：
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作者：
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