Prevalence of Latent Tuberculosis among Health Care Workers in High Burden Countries: A Systematic Review and Meta-Analysis
Tuberculosis is one of the leading causes of death worldwide. Twenty-two high burden countries contributed to the majority of worldwide tuberculosis cases in 2015. Health care workers are at high risk of acquiring tuberculosis through occupational exposure. To estimate the prevalence of latent tuber...
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| description | Tuberculosis is one of the leading causes of death worldwide. Twenty-two high burden countries contributed to the majority of worldwide tuberculosis cases in 2015. Health care workers are at high risk of acquiring tuberculosis through occupational exposure.
To estimate the prevalence of latent tuberculosis infection (LTBI) among health care workers in high burden countries.
Databases including MEDLINE (Ovid), EMBASE (Ovid), CINAHL (Ovid) and ISI Web of Science (Thompson-Reuters), and grey literature were searched for English language records on relevant medical subject headings (MeSH) terms of LTBI and health care providers. Literature was systematically reviewed using EPPI-Reviewer4 software. Prevalence and incidence of LTBI and 95% confidence intervals (CI) were reported. Pooled prevalence of LTBI and 95% CI were calculated using random-effects meta-analysis models and heterogeneity was assessed using I2 statistics. Sub-group analysis was conducted to assess the cause of heterogeneity.
A total of 990 records were identified. Of those, 18 studies from only 7 high burden countries representing 10,078 subjects were included. Tuberculin skin test results were available for 9,545 participants. The pooled prevalence of LTBI was 47% (95% CI 34% to 60%, I2 = 99.6%). In subgroup analyses according to the country of the study, the pooled prevalence of LTBI was lowest in Brazil (37%) and highest in South Africa (64%). The pooled prevalence of LTBI among medical and nursing students was 26% (95% CI 6% to 46%, I2 = 99.3%) while the prevalence among all types of health care workers was 57% (95% CI 44% to 70%, I2 = 99.1%). Incidence of LTBI was available for health care workers in four countries. The cumulative incidence ranged from 2.8% in Brazilian medical students to 38% among all types of health care workers in South Africa.
The findings of this study suggest that there is a high burden of LTBI among health care workers in high burden countries. Adequate infection control measures are warranted to prevent and control transmission in health care settings. |
| doi_str_mv | 10.1371/journal.pone.0164034 |
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To estimate the prevalence of latent tuberculosis infection (LTBI) among health care workers in high burden countries.
Databases including MEDLINE (Ovid), EMBASE (Ovid), CINAHL (Ovid) and ISI Web of Science (Thompson-Reuters), and grey literature were searched for English language records on relevant medical subject headings (MeSH) terms of LTBI and health care providers. Literature was systematically reviewed using EPPI-Reviewer4 software. Prevalence and incidence of LTBI and 95% confidence intervals (CI) were reported. Pooled prevalence of LTBI and 95% CI were calculated using random-effects meta-analysis models and heterogeneity was assessed using I2 statistics. Sub-group analysis was conducted to assess the cause of heterogeneity.
A total of 990 records were identified. Of those, 18 studies from only 7 high burden countries representing 10,078 subjects were included. Tuberculin skin test results were available for 9,545 participants. The pooled prevalence of LTBI was 47% (95% CI 34% to 60%, I2 = 99.6%). In subgroup analyses according to the country of the study, the pooled prevalence of LTBI was lowest in Brazil (37%) and highest in South Africa (64%). The pooled prevalence of LTBI among medical and nursing students was 26% (95% CI 6% to 46%, I2 = 99.3%) while the prevalence among all types of health care workers was 57% (95% CI 44% to 70%, I2 = 99.1%). Incidence of LTBI was available for health care workers in four countries. The cumulative incidence ranged from 2.8% in Brazilian medical students to 38% among all types of health care workers in South Africa.
The findings of this study suggest that there is a high burden of LTBI among health care workers in high burden countries. Adequate infection control measures are warranted to prevent and control transmission in health care settings.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0164034</identifier><identifier>PMID: 27711155</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Analysis ; Bibliographic data bases ; Biology and Life Sciences ; Confidence intervals ; Cost of Illness ; Dentistry ; Disease control ; Disease transmission ; English language ; Epidemiology ; Finite element method ; Handbooks ; Health aspects ; Health care ; Health care industry ; Health Personnel - statistics & numerical data ; Heterogeneity ; Hospitals ; Humans ; Incidence ; Infections ; Interferon ; Latent Tuberculosis - economics ; Latent Tuberculosis - epidemiology ; Medical personnel ; Medical research ; Medical students ; Medicine ; Medicine and Health Sciences ; Meta-analysis ; Mycobacterium tuberculosis ; Nursing ; Occupational exposure ; Occupational health ; Physical Sciences ; Population ; Research and Analysis Methods ; Skin ; Skin tests ; Statistical analysis ; Students ; Studies ; Surveillance ; Systematic review ; Tuberculin ; Tuberculosis ; Workers</subject><ispartof>PloS one, 2016-10, Vol.11 (10), p.e0164034-e0164034</ispartof><rights>COPYRIGHT 2016 Public Library of Science</rights><rights>2016 Nasreen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2016 Nasreen et al 2016 Nasreen et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-272b11f4f0360e03bfa73785fd4f4c7f38028a6cf3da098cc764023527917a8d3</citedby><cites>FETCH-LOGICAL-c692t-272b11f4f0360e03bfa73785fd4f4c7f38028a6cf3da098cc764023527917a8d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5053544/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5053544/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27711155$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Wilkinson, Katalin Andrea</contributor><creatorcontrib>Nasreen, Sharifa</creatorcontrib><creatorcontrib>Shokoohi, Mostafa</creatorcontrib><creatorcontrib>Malvankar-Mehta, Monali S</creatorcontrib><title>Prevalence of Latent Tuberculosis among Health Care Workers in High Burden Countries: A Systematic Review and Meta-Analysis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Tuberculosis is one of the leading causes of death worldwide. Twenty-two high burden countries contributed to the majority of worldwide tuberculosis cases in 2015. Health care workers are at high risk of acquiring tuberculosis through occupational exposure.
To estimate the prevalence of latent tuberculosis infection (LTBI) among health care workers in high burden countries.
Databases including MEDLINE (Ovid), EMBASE (Ovid), CINAHL (Ovid) and ISI Web of Science (Thompson-Reuters), and grey literature were searched for English language records on relevant medical subject headings (MeSH) terms of LTBI and health care providers. Literature was systematically reviewed using EPPI-Reviewer4 software. Prevalence and incidence of LTBI and 95% confidence intervals (CI) were reported. Pooled prevalence of LTBI and 95% CI were calculated using random-effects meta-analysis models and heterogeneity was assessed using I2 statistics. Sub-group analysis was conducted to assess the cause of heterogeneity.
A total of 990 records were identified. Of those, 18 studies from only 7 high burden countries representing 10,078 subjects were included. Tuberculin skin test results were available for 9,545 participants. The pooled prevalence of LTBI was 47% (95% CI 34% to 60%, I2 = 99.6%). In subgroup analyses according to the country of the study, the pooled prevalence of LTBI was lowest in Brazil (37%) and highest in South Africa (64%). The pooled prevalence of LTBI among medical and nursing students was 26% (95% CI 6% to 46%, I2 = 99.3%) while the prevalence among all types of health care workers was 57% (95% CI 44% to 70%, I2 = 99.1%). Incidence of LTBI was available for health care workers in four countries. The cumulative incidence ranged from 2.8% in Brazilian medical students to 38% among all types of health care workers in South Africa.
The findings of this study suggest that there is a high burden of LTBI among health care workers in high burden countries. Adequate infection control measures are warranted to prevent and control transmission in health care settings.</description><subject>Analysis</subject><subject>Bibliographic data bases</subject><subject>Biology and Life Sciences</subject><subject>Confidence intervals</subject><subject>Cost of Illness</subject><subject>Dentistry</subject><subject>Disease control</subject><subject>Disease transmission</subject><subject>English language</subject><subject>Epidemiology</subject><subject>Finite element method</subject><subject>Handbooks</subject><subject>Health aspects</subject><subject>Health care</subject><subject>Health care industry</subject><subject>Health Personnel - statistics & numerical data</subject><subject>Heterogeneity</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infections</subject><subject>Interferon</subject><subject>Latent Tuberculosis - economics</subject><subject>Latent Tuberculosis - epidemiology</subject><subject>Medical personnel</subject><subject>Medical research</subject><subject>Medical students</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Meta-analysis</subject><subject>Mycobacterium tuberculosis</subject><subject>Nursing</subject><subject>Occupational exposure</subject><subject>Occupational health</subject><subject>Physical Sciences</subject><subject>Population</subject><subject>Research and Analysis Methods</subject><subject>Skin</subject><subject>Skin tests</subject><subject>Statistical analysis</subject><subject>Students</subject><subject>Studies</subject><subject>Surveillance</subject><subject>Systematic 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one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nasreen, Sharifa</au><au>Shokoohi, Mostafa</au><au>Malvankar-Mehta, Monali S</au><au>Wilkinson, Katalin Andrea</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence of Latent Tuberculosis among Health Care Workers in High Burden Countries: A Systematic Review and Meta-Analysis</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2016-10-06</date><risdate>2016</risdate><volume>11</volume><issue>10</issue><spage>e0164034</spage><epage>e0164034</epage><pages>e0164034-e0164034</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Tuberculosis is one of the leading causes of death worldwide. Twenty-two high burden countries contributed to the majority of worldwide tuberculosis cases in 2015. Health care workers are at high risk of acquiring tuberculosis through occupational exposure.
To estimate the prevalence of latent tuberculosis infection (LTBI) among health care workers in high burden countries.
Databases including MEDLINE (Ovid), EMBASE (Ovid), CINAHL (Ovid) and ISI Web of Science (Thompson-Reuters), and grey literature were searched for English language records on relevant medical subject headings (MeSH) terms of LTBI and health care providers. Literature was systematically reviewed using EPPI-Reviewer4 software. Prevalence and incidence of LTBI and 95% confidence intervals (CI) were reported. Pooled prevalence of LTBI and 95% CI were calculated using random-effects meta-analysis models and heterogeneity was assessed using I2 statistics. Sub-group analysis was conducted to assess the cause of heterogeneity.
A total of 990 records were identified. Of those, 18 studies from only 7 high burden countries representing 10,078 subjects were included. Tuberculin skin test results were available for 9,545 participants. The pooled prevalence of LTBI was 47% (95% CI 34% to 60%, I2 = 99.6%). In subgroup analyses according to the country of the study, the pooled prevalence of LTBI was lowest in Brazil (37%) and highest in South Africa (64%). The pooled prevalence of LTBI among medical and nursing students was 26% (95% CI 6% to 46%, I2 = 99.3%) while the prevalence among all types of health care workers was 57% (95% CI 44% to 70%, I2 = 99.1%). Incidence of LTBI was available for health care workers in four countries. The cumulative incidence ranged from 2.8% in Brazilian medical students to 38% among all types of health care workers in South Africa.
The findings of this study suggest that there is a high burden of LTBI among health care workers in high burden countries. Adequate infection control measures are warranted to prevent and control transmission in health care settings.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>27711155</pmid><doi>10.1371/journal.pone.0164034</doi><tpages>e0164034</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2016-10, Vol.11 (10), p.e0164034-e0164034 |
| issn | 1932-6203 1932-6203 |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Analysis Bibliographic data bases Biology and Life Sciences Confidence intervals Cost of Illness Dentistry Disease control Disease transmission English language Epidemiology Finite element method Handbooks Health aspects Health care Health care industry Health Personnel - statistics & numerical data Heterogeneity Hospitals Humans Incidence Infections Interferon Latent Tuberculosis - economics Latent Tuberculosis - epidemiology Medical personnel Medical research Medical students Medicine Medicine and Health Sciences Meta-analysis Mycobacterium tuberculosis Nursing Occupational exposure Occupational health Physical Sciences Population Research and Analysis Methods Skin Skin tests Statistical analysis Students Studies Surveillance Systematic review Tuberculin Tuberculosis Workers |
| title | Prevalence of Latent Tuberculosis among Health Care Workers in High Burden Countries: A Systematic Review and Meta-Analysis |
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