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He G.X.,U.S. Center for Disease Control and Prevention | Wang L.X.,U.S. Center for Disease Control and Prevention | Chai S.J.,Centers for Disease Control and Prevention | Klena J.D.,Centers for Disease Control and Prevention | And 12 more authors.
International Journal of Tuberculosis and Lung Disease | Year: 2012

SETTING: Health care workers (HCWs) are at increased risk for tuberculosis (TB) infection. In China, surveys examining TB infection among HCWs have not studied general health care facilities, compared tuberculin tests conducted using local protocols against an internationally accepted test or characterised risk factors. OBJECTIVE: To measure the prevalence of and risk factors for TB infection among HCWs in Inner Mongolia, China. DESIGN: Between April and August 2010, we administered QuantiFERON®-TB Gold In-Tube (QFT-GIT) tests, skin tests using Chinese tuberculin (TST) and surveys among HCWs at an infectious diseases hospital and a general medical hospital. We assessed whether demographic characteristics, personal exposure and work exposure were associated with QFT-GIT and TST positivity, and assessed agreement between test results. RESULTS: Of 999 HCWs, 683 (68%) were QFT-GIT-positive, which was associated with greater age, longer HCW career, TB disease in a co-worker and greater daily patient exposure using multivariable analysis. TST reactions ≥ 5 mm occurred in 69% of the HCWs; agreement between test results was low (κ 0.22). CONCLUSIONS: The prevalence of TB infection among HCWs in Inner Mongolia is high; infection was associated with occupational exposure. Results from locally conducted TST are difficult to interpret. In China, TB infection control in health care facilities should be strengthened. © 2012 The Union. Source


He G.,U.S. Center for Disease Control and Prevention | Li Y.,Centers for Disease Control and Prevention | Zhao F.,U.S. Center for Disease Control and Prevention | Wang L.,U.S. Center for Disease Control and Prevention | And 27 more authors.
PLoS ONE | Year: 2015

Background: China is a high tuberculosis (TB) burden country. More than half of acute TB cases first seek medical care in village doctors' clinics or community health centers. Despite being responsible for patient referral and management, village doctors are not systematically evaluated for TB infection or disease. We assessed prevalence and incidence of latent TB infection (LTBI) among village doctors in China. Methods and Findings: A longitudinal study was conducted in Inner Mongolia Autonomous Region. We administered a questionnaire on demographics and risk factors for TB exposure and disease; Tuberculin skin testing (TST) and QuantiFERON-TB Gold in-tube assay (QFT-GIT) was conducted at baseline and repeated 12 months later. We used a logistic regression model to calculate adjusted odds ratios (ORs) for risk factors for TST and QFT-GIT prevalence and incidence. At the time of follow up, 19.5% of the 880 participating village doctors had a positive TST and 46.0% had a positive QFT-GIT result. Factors associated with TST prevalence included having a BCG scar (OR = 1.45, 95%CI 1.03-2.04) and smoking (OR = 1.69, 95%CI 1.17-2.44). Risk factors associated with QFT-GIT prevalence included being male (OR = 2.17, 95%CI 1.63-2.89), below college education (OR=1.42, 95%CI 1.01-1.97), and working for ≥25 years as a village doctor (OR = 1.64, 95%CI 1.12-2.39). The annual incidence of LTBI was 11.4% by TST and 19.1% by QFT-GIT. QFT-GIT conversion was associated with spending 15 minutes or more per patient on average (OR = 2.62, 95% CI1.39-4.97) and having BCG scar (OR = 0.53, 95%CI0.28-1.00). Conclusions: Prevalence and incidence of LTBI among Chinese village doctors is high. TB infection control measures should be strengthened among village doctors and at village healthcare settings. © 2015, Public Library of Science. All rights reserved. This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication. Source

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