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High Annual Risk of Tuberculosis Infection among Nursing Students in South India: A Cohort Study

BACKGROUND: Nurses in developing countries are frequently exposed to infectious tuberculosis (TB) patients, and have a high prevalence of TB infection. To estimate the incidence of new TB infection, we recruited a cohort of young nursing trainees at the Christian Medical College in Southern India. A...

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Autores principales: Christopher, Devasahayam J., James, Prince, Daley, Peter, Armstrong, Lois, Isaac, Barney T. J., Thangakunam, Balamugesh, Premkumar, Beulah, Zwerling, Alice, Pai, Madhukar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3192164/
https://www.ncbi.nlm.nih.gov/pubmed/22022565
http://dx.doi.org/10.1371/journal.pone.0026199
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author Christopher, Devasahayam J.
James, Prince
Daley, Peter
Armstrong, Lois
Isaac, Barney T. J.
Thangakunam, Balamugesh
Premkumar, Beulah
Zwerling, Alice
Pai, Madhukar
author_facet Christopher, Devasahayam J.
James, Prince
Daley, Peter
Armstrong, Lois
Isaac, Barney T. J.
Thangakunam, Balamugesh
Premkumar, Beulah
Zwerling, Alice
Pai, Madhukar
author_sort Christopher, Devasahayam J.
collection PubMed
description BACKGROUND: Nurses in developing countries are frequently exposed to infectious tuberculosis (TB) patients, and have a high prevalence of TB infection. To estimate the incidence of new TB infection, we recruited a cohort of young nursing trainees at the Christian Medical College in Southern India. Annual tuberculin skin testing (TST) was conducted to assess the annual risk of TB infection (ARTI) in this cohort. METHODOLOGY/PRINCIPAL FINDINGS: 436 nursing students completed baseline two-step TST testing in 2007 and 217 were TST-negative and therefore eligible for repeat testing in 2008. 181 subjects completed a detailed questionnaire on exposure to tuberculosis from workplace and social contacts. A physician verified the questionnaire and clinical log book and screened the subjects for symptoms of active TB. The majority of nursing students (96.7%) were females, almost 84% were under 22 years of age, and 80% had BCG scars. Among those students who underwent repeat testing in 2008, 14 had TST conversions using the ATS/CDC/IDSA conversion definition of 10 mm or greater increase over baseline. The ARTI was therefore estimated as 7.8% (95%CI: 4.3–12.8%). This was significantly higher than the national average ARTI of 1.5%. Sputum collection and caring for pulmonary TB patients were both high risk activities that were associated with TST conversions in this young nursing cohort. CONCLUSIONS: Our study showed a high ARTI among young nursing trainees, substantially higher than that seen in the general Indian population. Indian healthcare providers and the Indian Revised National TB Control Programme will need to implement internationally recommended TB infection control interventions to protect its health care workforce.
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spelling pubmed-31921642011-10-21 High Annual Risk of Tuberculosis Infection among Nursing Students in South India: A Cohort Study Christopher, Devasahayam J. James, Prince Daley, Peter Armstrong, Lois Isaac, Barney T. J. Thangakunam, Balamugesh Premkumar, Beulah Zwerling, Alice Pai, Madhukar PLoS One Research Article BACKGROUND: Nurses in developing countries are frequently exposed to infectious tuberculosis (TB) patients, and have a high prevalence of TB infection. To estimate the incidence of new TB infection, we recruited a cohort of young nursing trainees at the Christian Medical College in Southern India. Annual tuberculin skin testing (TST) was conducted to assess the annual risk of TB infection (ARTI) in this cohort. METHODOLOGY/PRINCIPAL FINDINGS: 436 nursing students completed baseline two-step TST testing in 2007 and 217 were TST-negative and therefore eligible for repeat testing in 2008. 181 subjects completed a detailed questionnaire on exposure to tuberculosis from workplace and social contacts. A physician verified the questionnaire and clinical log book and screened the subjects for symptoms of active TB. The majority of nursing students (96.7%) were females, almost 84% were under 22 years of age, and 80% had BCG scars. Among those students who underwent repeat testing in 2008, 14 had TST conversions using the ATS/CDC/IDSA conversion definition of 10 mm or greater increase over baseline. The ARTI was therefore estimated as 7.8% (95%CI: 4.3–12.8%). This was significantly higher than the national average ARTI of 1.5%. Sputum collection and caring for pulmonary TB patients were both high risk activities that were associated with TST conversions in this young nursing cohort. CONCLUSIONS: Our study showed a high ARTI among young nursing trainees, substantially higher than that seen in the general Indian population. Indian healthcare providers and the Indian Revised National TB Control Programme will need to implement internationally recommended TB infection control interventions to protect its health care workforce. Public Library of Science 2011-10-12 /pmc/articles/PMC3192164/ /pubmed/22022565 http://dx.doi.org/10.1371/journal.pone.0026199 Text en Christopher et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Christopher, Devasahayam J.
James, Prince
Daley, Peter
Armstrong, Lois
Isaac, Barney T. J.
Thangakunam, Balamugesh
Premkumar, Beulah
Zwerling, Alice
Pai, Madhukar
High Annual Risk of Tuberculosis Infection among Nursing Students in South India: A Cohort Study
title High Annual Risk of Tuberculosis Infection among Nursing Students in South India: A Cohort Study
title_full High Annual Risk of Tuberculosis Infection among Nursing Students in South India: A Cohort Study
title_fullStr High Annual Risk of Tuberculosis Infection among Nursing Students in South India: A Cohort Study
title_full_unstemmed High Annual Risk of Tuberculosis Infection among Nursing Students in South India: A Cohort Study
title_short High Annual Risk of Tuberculosis Infection among Nursing Students in South India: A Cohort Study
title_sort high annual risk of tuberculosis infection among nursing students in south india: a cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3192164/
https://www.ncbi.nlm.nih.gov/pubmed/22022565
http://dx.doi.org/10.1371/journal.pone.0026199
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