Health care workers and risk of hospital-related tuberculosis

To determine the incidence and risk of hospital-related TB amongst the health care workers and trainee students of this institution.

Retrospective study.

Chart review of PTB and EPTB diagnosed by AAFB in sputum, suggestive chest X-ray features of TB and aspiration cytology or tissue histology.

Thirty-two (1.5%) of the 2,173 total staff strength developed occupation-related TB in a 15 year period, 15 (47.0%) of which presented as HIV/TB co-infection. Junior HCWs were mostly affected and the male:female ratio was about 1:2. PTB occurred in 25 staffs (78.1%), EPTB occurred in 5 (15.6%) and 2 (6.3%) had disseminated TB. HCWs directly caring for patients; 24 (75.0%) were mostly affected. They were HCWs from nursing, 15 (47.0%) and clinical services, 9 (28.0%). Duration of employment of the affected HCWs varied from half a year to 11.5 years and the rate of diagnosis of cases varied from nil to 3 per year. Identified risks for acquiring and developing active TB in the hospital were; HIV infection 47.%, diabetes mellitus 9.4%, "alcoholic" liver cirrhosis; 6.3% and chronic obstructive pulmonary disease 3.1%.

Incidence of hospital-related TB is low amongst the staffs of UITH; however, all the HCWs of the hospital were at risk of exposure. Staffs at the clinical sections had the highest frequency of developing occupation-related TB, and HIV infection was the commonest risk factor.