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  • Title: Prevalence of tuberculin reactivity among healthcare workers from a Mexican hospital.
    Author: Molina-Gamboa J, Fivera-Morales I, Ponce-de-León-Rosales S.
    Journal: Infect Control Hosp Epidemiol; 1994 May; 15(5):319-20. PubMed ID: 8077644.
    Abstract:
    The prevalence of tuberculosis (TB) infection in healthcare workers (HCWs) is completely unknown in Mexico. To evaluate the frequency of TB infection in our hospital, we performed a prevalence study of tuberculin reactivity among a random sample of asymptomatic HCWs. Our results showed an extremely high prevalence of PPD reactivity (70%) among 175 HCWs, probably related to the high incidence of active TB in the general population and to the absence of preventive programs. Tuberculosis (TB) is again a fast growing health problem in the world. Recent data from the World Health Organization revealed 1.7 billion persons are infected with TB in the world, with at least 8 million new cases of active pulmonary TB and 2.9 million deaths every year. A prevalence study of tuberculin reactivity was performed among a random sample of 200 asymptomatic National Institute of Nutrition (NIN) health care workers (HCWs) in a Mexican hospital in order to evaluate the frequency of TB infection. Trained nurses inoculated purified protein derivative (PPD) using the Mantoux technique. All HCWs tested completed a questionnaire about demographic data, previous TB infection, previous contact with active tuberculous patients, Bacillus Calmette-Guerin (BCG) vaccine scar, previous PPD testing, and immunosuppressive conditions. 175 (87.5%) returned for test reading, including 51 nurses, 49 physicians, 36 office workers, 28 lab workers, and 11 janitors. There were 52 males and 123 females, with a median age of 25 years (range, 18-60). Overall, 123 (70%) of 175 HCWs were PPD reactive. The rate of reactivity was higher among persons with a history of BCG vaccination than those without such history (105/139 [75.5%] versus 18/36 [50%]; P 0.01) and was higher among HCWs at least 30 years old than among those younger than 30 years (45/64 [70%] versus 78/120 [65%]; P 0.05). The rate of PPD positivity was not influenced by sex, area of work, or reported contact with TB patients. Median induration among reactors was 17.5 mm, whereas it was 0 mm among nonreactors. Results showed an extremely high prevalence of PPD reactivity among our HCWs, which probably is explained by the high incidence of active TB in the general population and to the absence of preventive programs. It is useful to establish the PPD reactivity of HCWs for early recognition of active disease among symptomatic reactors and for follow up of nonreactors to detect subsequent conversions among them in order to prevent the nosocomial dissemination of tuberculosis.
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