Abstract

OSTROSKY-ZEICHNER, Luis et al.  Tuberculosis in healthcare workers: importance of surveillance and control programs. Salud pública Méx [online]. 2000, vol.42, n.1, pp. 48-52. ISSN 0036-3634.  http://dx.doi.org/10.1590/S0036-36342000000100009.

OBJECTIVE: To describe tuberculosis surveillance results among healthcare workers of a tertiary care center. MATERIAL AND METHODS: All medical records of workers from 1992-1998 were reviewed. Demographics, labor, medical history, previous testing, PPD, booster shots and follow-up were analyzed. Statistical analysis was performed with odds ratios, p-values, and 95% confidence intervals. Subgroup analysis were done with c². Kaplan-Meier estimates were used to analyze times to conversion. RESULTS: Surveillance was done in 1617 workers (68% female and 32% male). Mean age was 26.9±7.6(15-68) years. Job positions were 30.5% nurses, 14.6% residents and 14.1% interns. Place of origin was Mexico City in 65.8%. BCG vaccination was present in 71.6% and 15.1% had previous PPD. Admission PPD was positive in 39.6%, negative in 48.3% and 12.1% were lost to follow-up. On negatives, 483 booster shots were applied, and 49 additional positives were found. Follow-up was done in 231 workers, of which 100 (43.3%) converted. The mean time for conversion was 22.8±12.4 months. The conversion rate at twelve months was 20%. Fifty workers received/accepted isoniazid prophylaxis. CONCLUSIONS: A high percentage of workers were PPD-positive; booster shots allowed the detection of an additional 10%. A high conversion rate underscores the need to organize tuberculosis control programs in Mexico.

Keywords : tuberculosis [epidemiologic surveillance]; tuberculin; health services; workers; Mexico.