埃塞俄比亚阿姆哈拉地区医疗机构中医护人员和支持人员中活动性结核病的患病率。
Prevalence of active tuberculosis disease among healthcare workers and support staff in healthcare settings of the Amhara region, Ethiopia.
机构信息
Research and Technology Transfer Directorate, Amhara Public Health Institute, Bahir Dar, Ethiopia.
Department of Clinical Chemistry, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
出版信息
PLoS One. 2021 Jun 11;16(6):e0253177. doi: 10.1371/journal.pone.0253177. eCollection 2021.
BACKGROUND
Health care workers (HCWs) are at an increased risk of acquiring tuberculosis (TB) compared to the general population, because of the frequent face to face contact or potential exposure to TB through shared air or space with infectious patient(s), regardless of economic setting and local TB incidence. Information on the burden of active TB disease among HCWs will help guide control measures, can be utilized to evaluate the effectiveness of TB infection prevention programs in the health care setting, and guide necessary actions. However, data on TB among HCW in Ethiopia is limited. Therefore, this study aimed to determine the prevalence of active TB disease among healthcare workers and support staff in healthcare settings in the Amhara region of Ethiopia.
METHODS
A cross-sectional study design was used to recruit a total of 580 randomly selected study participants in the Amhara region. Data were collected over four months in selected hospitals and health centers. Implementation of TB prevention and control measures was evaluated using a standardized checklist. The main outcome indicator was active TB as measured by a laboratory diagnosis using GeneXpert technology.
RESULTS
A total of 580 study participants were enrolled. The mean age was 31.3 (±7.8 standard deviation) years, with about two-thirds (65.3%) aged between 18-24 years. A total of 9 (1.6%) MTB cases were detected, 4 (1.4%) in HCWs and 5 (1.7%) in support staff, which did not significantly differ (P = 0.50). About 90% of the participants had not received TB infection prevention and control training ever. More than half (54%) of the study participants worked in poorly ventilated rooms. Triage of coughing patients was not practiced in 32% of the studied facilities (health centers and hospitals).
CONCLUSIONS
The magnitude of TB among healthcare workers and support staff in healthcare settings was higher than in the general population (140 per 100000 population). The status of implementation of tuberculosis prevention and control measures indicated missed opportunities. Hence, strict implementation of developed infection control plans of TB in healthcare settings needs to be improved.
背景
与一般人群相比，医护人员（HCWs）由于经常面对面接触或与传染性患者共用空气或空间而潜在暴露于结核（TB），因此感染结核病的风险增加，无论经济环境和当地结核病发病率如何。医护人员中活动性结核病负担的信息将有助于指导控制措施，可以用于评估卫生保健环境中结核病感染预防计划的有效性，并指导必要的行动。然而，关于埃塞俄比亚 HCW 中结核病的数据有限。因此，本研究旨在确定埃塞俄比亚阿姆哈拉地区医疗保健环境中医护人员和支持人员中活动性结核病的患病率。
方法
采用横断面研究设计，共招募了阿姆哈拉地区的 580 名随机选择的研究参与者。在选定的医院和保健中心收集了四个月的数据。使用标准化检查表评估结核病预防和控制措施的实施情况。主要结局指标是使用 GeneXpert 技术进行实验室诊断的活动性结核病。
结果
共纳入 580 名研究参与者。平均年龄为 31.3（±7.8 标准差）岁，约三分之二（65.3%）年龄在 18-24 岁之间。共检测到 9（1.6%）例 MTB 病例，其中 4（1.4%）例在 HCWs 中，5（1.7%）例在支持人员中，差异无统计学意义（P=0.50）。约 90%的参与者从未接受过结核病感染预防和控制培训。超过一半（54%）的研究参与者在通风不良的房间工作。在 32%的研究设施（保健中心和医院）中，没有对咳嗽患者进行分诊。
结论
医疗保健环境中医护人员和支持人员中的结核病患病率高于一般人群（每 100000 人中有 140 人）。结核病预防和控制措施的实施情况表明存在错失的机会。因此，需要改进医疗保健环境中结核病感染控制计划的严格实施。
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