ArticleBMC public health2013
Screening for latent tuberculosis in Norwegian health care workers: high frequency of discordant tuberculin skin test positive and interferon-gamma release assay negative results.
Article in BMC public health, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- Risk of Occupational Latent Tuberculosis Infection among Health Personnel Measured by Interferon-Gamma Release Assays in Low Incidence Countries-A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2020Pooled it
- European policies on tuberculosis prevention in healthcare workers: Which role for BCG? A systematic review.Human vaccines & immunotherapeutics · 2016Pooled it
- Early detection of tuberculosis: a systematic review.Pneumonia (Nathan Qld.) · 2024Review
- The Challenges of Tuberculosis Management beyond Professional Competence: Insights from Tuberculosis Outbreaks among Ethiopian Immigrants in Israel.Tropical medicine and infectious disease · 2024Article
- Tuberculosis infection status and risk factors among health workers: an updated systematic review.Annals of occupational and environmental medicine · 2021Review
- Tuberculosis Infection Screening in 5468 Italian Healthcare Students: Investigation of a Borderline Zone Value for the QFT-Test.International journal of environmental research and public health · 2020Article
- Conversion and Reversion Rates of Tuberculosis Screening Assays in Patients With Rheumatic Diseases and Negative Baseline Screening Under Long-Term Biologic Treatment.Pathogens & immunity · 2020Article
- Screening for Tuberculosis in Health Care Workers: Experience in an Italian Teaching Hospital.BioMed research international · 2017Article
- Predictors of low prevalence of latent tuberculosis infection among Egyptian health care workers at intensive care and bronchoscopy units.GMS hygiene and infection control · 2016Article
- Vitamin D status and incidence of tuberculosis infection conversion in contacts of pulmonary tuberculosis patients: a prospective cohort study.Epidemiology and infection · 2015Article
- The Usefulness of the Tuberculosis Skin Test and the Interferon-gamma Release Assay in the Diagnosis of Latent Tuberculosis Infection in South Korea.Osong public health and research perspectives · 2014Article
- Occupational screening for tuberculosis and the use of a borderline zone for interpretation of the IGRA in German healthcare workers.PloS one · 2014Article
- Diagnosis and treatment of latent tuberculosis infection: an update.Current respiratory care reports · 2013Article
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTuberculosis (TB) presents globally a significant health problem and health care workers (HCW) are at increased risk of contracting TB infection. There is no diagnostic gold standard for latent TB infection (LTBI), but both blood based interferon-gamma release assays (IGRA) and the tuberculin skin test (TST) are used. According to the national guidelines, HCW who have been exposed for TB should be screened and offered preventive anti-TB chemotherapy, but the role of IGRA in HCW screening is still unclear.
methodsA total of 387 HCW working in clinical and laboratory departments in three major hospitals in the Western region of Norway with possible exposure to TB were included in a cross-sectional study. The HCW were asked for risk factors for TB and tested with TST and the QuantiFERON®TB Gold In-Tube test (QFT). A logistic regression model analyzed the associations between risk factors for TB and positive QFT or TST.
resultsA total of 13 (3.4%) demonstrated a persistent positive QFT, whereas 214 (55.3%) had a positive TST (≥ 6 mm) and 53 (13.7%) a TST ≥ 15 mm. Only ten (4.7%) of the HCW with a positive TST were QFT positive. Origin from a TB-endemic country was the only risk factor associated with a positive QFT (OR 14.13, 95% CI 1.37 - 145.38, p=0.026), whereas there was no significant association between risk factors for TB and TST ≥ 15 mm. The five HCW with an initial positive QFT that retested negative all had low interferon-gamma (IFN-γ) responses below 0.70 IU/ml when first tested.
conclusionsWe demonstrate a low prevalence of LTBI in HCW working in hospitals with TB patients in our region. The "IGRA-only" seems like a desirable screening strategy despite its limitations in serial testing, due to the high numbers of discordant TST positive/IGRA negative results in HCW, probably caused by BCG vaccination or boosting due to repetitive TST testing. Thus, guidelines for TB screening in HCW should be updated in order to secure accurate diagnosis of LTBI and offer proper treatment and follow-up.
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