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Tuberculosis in physicians. Compliance with preventive measures.

P J Geiseler, K E Nelson, R G Crispen

    The American Review of Respiratory Disease
    |January 1, 1987
    PubMed
    Summary
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    Physician compliance with tuberculosis control guidelines is poor, with many healthcare workers not adhering to recommended preventive measures. This study highlights gaps in screening, vaccination, and treatment protocols for tuberculosis prevention among medical professionals.

    Area of Science:

    • Public Health
    • Infectious Disease Epidemiology
    • Occupational Health

    Background:

    • Tuberculosis (TB) remains a significant global health concern, particularly in healthcare settings.
    • Compliance with preventive strategies is crucial for protecting healthcare workers (HCWs) from occupational TB exposure.
    • Previous studies indicate potential deficiencies in TB control adherence among medical professionals.

    Purpose of the Study:

    • To evaluate physician adherence to public health recommendations for tuberculosis control.
    • To assess compliance with screening, vaccination, and chemoprophylaxis guidelines.
    • To identify factors influencing adherence to TB prevention policies among physicians.

    Main Methods:

    • A survey was conducted among 4,417 physicians regarding their TB exposure and preventive measures.

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  • Data collected included bacille Calmette-Guérin (BCG) vaccination status, tuberculin positivity, occupational exposure, and adherence to testing and treatment protocols.
  • Analysis focused on compliance rates based on graduation year, vaccination status, and exposure levels.

    • Main Results:

    • Only 31% of physicians reported BCG vaccination, and 47% were tuberculin-positive.
    • Significant proportions of physicians with high occupational TB exposure did not adhere to recommended screening frequencies (tuberculin tests or chest roentgenograms).
    • Isoniazid chemoprophylaxis was underutilized, with only 8% of eligible physicians receiving it, though rates were higher in younger, recently graduated physicians.

    Conclusions:

    • Physician compliance with recommended tuberculosis control policies is suboptimal.
    • Gaps exist in the implementation of preventive measures, including screening and chemoprophylaxis, for healthcare workers.
    • Improved adherence to TB prevention strategies is necessary to mitigate occupational risks for physicians and safeguard public health.