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Free Content Tuberculin skin testing to assess the occupational risk of Mycobacterium tuberculosis infection among health care workers in Abidjan, Côte d'Ivoire

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SETTING: Tuberculin skin test (TST) survey of health care workers (HCWs) in selected clinical services in Abidjan, Côte d'Ivoire.

OBJECTIVE: To assess whether HCWs in Abidjan are at increased risk for occupationally acquired Mycobacterium tuberculosis infection.

DESIGN: From October 1996 to January 1997, consenting HCWs from four services where tuberculosis (TB) prevalence among patients was high and two services where it was low were evaluated with a questionnaire, TST (including evaluation of anergy) and chest radiograph.

RESULTS: Of the 512 participants, 405 (79%) had a TST reaction of ≥10 mm, eight (2%) were anergic, five (1%) had a radiograph compatible with TB, and two had confirmed TB. Using a cut-off of 10 mm, we found a higher prevalence of TST positivity in services with high TB prevalence than in those with low TB prevalence (92% vs 72%; odds ratio [OR] 4.3; 95% confidence interval [CI] 2.3–8.0]) and among HCWs with direct (87%; OR 2.9; 95%CI 1.6–5.1) and indirect patient contact (80%, OR 1.7; 95%CI 1.0–2.3) than among those with minimal patient contact (69%).

CONCLUSION: These findings indicate that TST positivity among HCWs is related to level of exposure to TB patients, and suggest that HCWs in Abidjan are at risk for the nosocomial transmission of TB.

Keywords: Cote d'Ivoire; health care workers; nosocomial transmission; tuberculin skin testing; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Projet RETRO-CI, Abidjan, Côte d'Ivoire 2: Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA 3: Projet RETRO-CI, Abidjan, Côte d'Ivoire; and Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA 4: Programme National de Lutte Contre le SIDA, les Maladies Sexuellement Transmissibles et la Tuberculose, Ministère de la Santé Publique, Abidjan, Côte d'Ivoire 5: Centres Antituberculeux, Ministère de la Santé Publique, Abidjan, Côte d'Ivoire 6: Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire

Publication date: April 1, 2000

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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