SETTING: Chiang Rai, the northernmost province of
Thailand.
OBJECTIVE: To evaluate the occupational risk for tuberculous
infection of health care workers (HCWs) and the
utility of tuberculin skin test (TST) in a developing
country setting.
DESIGN: A cross-sectional TST survey, including a
risk assessment questionnaire, of Chiang Rai Hospital
HCWs.
RESULTS: Of 911 HCWs tested, 623 (68%) had indurations
of 10 mm and 322 (35%) indurations of 15
mm. Factors most predictive for TST positivity, using
either cut-off, were employment 1 year, frequent direct
patient contact, and male sex. Moreover, having a bacillus
Calmette-Guérin (BCG) scar was predictive of a 10
mm, but not a 15 mm, reaction.
CONCLUSIONS: Chiang Rai Hospital HCWs had an
increased risk for Mycobacterium tuberculosis infection,
which was significantly associated with occupational
exposure. Where BCG coverage is high, a TST
cut-off of 15 mm may correlate better with M. tuberculosis
infection than does a cut-off of 10 mm. Effective,
affordable infection control measures are needed
for health care facilities in developing countries such as
Thailand, where HCWs may be at increased risk for M.
tuberculosis infection from occupational exposures.
KEY WORDS: health care workers; tuberculin skin testing;
Thailand
AFTER
SETTING: Chiang Rai, the northernmost province of
Thailand.
OBJECTIVE: To evaluate the occupational risk for tuberculous
infection of health care workers (HCWs) and the
utility of tuberculin skin test (TST) in a developing
country setting.
DESIGN: A cross-sectional TST survey, including a
risk assessment questionnaire, of Chiang Rai Hospital
HCWs.
RESULTS: Of 911 HCWs tested, 623 (68%) had indurations
of 10 mm and 322 (35%) indurations of 15
mm. Factors most predictive for TST positivity, using
either cut-off, were employment 1 year, frequent direct
patient contact, and male sex. Moreover, having a bacillus
Calmette-Guérin (BCG) scar was predictive of a 10
mm, but not a 15 mm, reaction.
CONCLUSIONS: Chiang Rai Hospital HCWs had an
increased risk for Mycobacterium tuberculosis infection,
which was significantly associated with occupational
exposure. Where BCG coverage is high, a TST
cut-off of 15 mm may correlate better with M. tuberculosis
infection than does a cut-off of 10 mm. Effective,
affordable infection control measures are needed
for health care facilities in developing countries such as
Thailand, where HCWs may be at increased risk for M.
tuberculosis infection from occupational exposures.
KEY WORDS: health care workers; tuberculin skin testing;
Thailand
AFTER
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