Latent tuberculosis infection and associated risk factors among undergraduate healthcare students in Italy: a cross-sectional study

BMC Infectious Diseases

Giancarlo Icardi¹  Filippo Ansaldi²  Alessandro Poli⁵  Francesco Copello⁵  Claudio Viscoli⁸  Giovanni Mazzarello⁷  Mauro Piccinini⁶  Fabio Spigno⁴  Giovanni Sotgiu³  Paolo Durando² 

[1] Department of Health Sciences, Full Professor of Hygiene, Preventive Medicine and Public Health, Chief of the Hygiene Unit, IRCCS AOU San Martino-IST teaching Hospital, University of Genoa, Via Antonio Pastore 1, 16132, Genoa, Italy;Department of Health Sciences, Associate Professor of Hygiene, Preventive Medicine and Public Health, Hygiene Unit, IRCCS AOU San Martino-IST teaching Hospital, University of Genoa, Via Antonio Pastore 1, 16132, Genoa, Italy;Department of Biomedical Sciences, Associate Professor of Medical Statistics, Research, Medical Education and Professional Development Unit, AOU Sassari, University of Sassari, Via Padre Manzella 4, 07100, Sassari, Italy;Department of Health Sciences, Associate Professor of Occupational Health, Chief of the Occupational Health Unit, IRCCS AOU San Martino-IST teaching Hospital, University of Genoa, Largo Rosanna Benzi 10, 16132, Genoa, Italy;Occupational and Preventive Medicine Unit, IRCCS AOU San Martino-IST teaching Hospital, Largo Rosanna Benzi 10, 16132, Genoa, Italy;Prevention and Protection Service of the University of Genoa, Via Balbi 5, 16126, Genoa, Italy;Department of Health Sciences, Infectious Diseases Unit, IRCCS AOU San Martino-IST teaching Hospital, University of Genoa, Largo Rosanna Benzi 10, 16132, Genoa, Italy;Department of Health Sciences, Full Professor of Infectious Diseases, Chief of the Infectious Diseases Unit, IRCCS AOU San Martino-IST teaching Hospital, University of Genoa, Largo Rosanna Benzi 10, 16132, Genoa, Italy

关键词: Risk-factors;    Healthcare students;    Interferon-gamma release assay;    Tuberculin skin test;    Latent tuberculosis infection;    Tuberculosis;   

Others  :  1145730
DOI  :  10.1186/1471-2334-13-443

 received in 2013-04-15, accepted in 2013-09-18,  发布年份 2013

【 摘 要 】

Background

The screening of both healthcare workers and students attending teaching hospitals for latent tuberculosis infection (LTBI) is recommended in hospitals of many countries with a low-incidence of TB, including Italy, as a fundamental tool of tuberculosis (TB) control programs. The aim of the study was to estimate the prevalence of LTBI and evaluate the main risk-factors associated with this condition in a cohort of healthcare Italian students.

Methods

In a cross-sectional study, performed between January and May 2012, 881 undergraduate students attending the Medical, Nursing, Pediatric Nursing and Midwifery Schools of the University of Genoa, trained at the IRCCS San Martino-IST Teaching Hospital of Genoa, were actively called to undergo the Tuberculin Skin Test (TST). All the TST positive cases were also tested with an Interferon-Gamma Release Assay (IGRA) to confirm the diagnosis of LTBI. A standardized questionnaire was collected for risk-assessment analysis.

Results

Seven hundred and thirty-three (83.2%) subjects underwent TST testing. The prevalence of TST positives was 1.4%, and in 4 (0.5%) out of 10 TST positive cases LTBI diagnosis was confirmed by IGRA. No difference in the prevalence of subjects who tested positive to TST emerged between pre-clinical (n = 138) and clinical (n = 595) students. No statistically significant association between TST positivity and age, gender, and BCG vaccination was observed. The main independent variable associated with TST positivity was to be born in a country with a high TB incidence (i.e., ≥20 cases per 100,000 population) (adjusted OR 102.80, 95% CI 18.09-584.04, p < 0.001).

Conclusions

The prevalence of LTBI among healthcare students resulted very low. The only significant association between TST positivity and potential risk factors was to be born in high TB incidence areas. In countries with a low incidence of TB, the screening programs of healthcare students before clinical training can be useful for the early identification and treatment of the sporadic cases of LTBI.

【 授权许可】

   
2013 Durando et al.; licensee BioMed Central Ltd.

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