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Free Content Latent tuberculosis infection: risks to health care students at a hospital in Lima, Peru

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Abstract:

SETTING: University hospital and university campus in Lima, Peru.

OBJECTIVE: To demonstrate the risk of latent tuberculosis infection (LTBI) in the hospital relative to the community.

DESIGN: Prospective cohort study of university students measuring prevalence, boosting, and conversion of tuberculin skin tests (TSTs) among health care students (HCS) and non-health care students (NHCS).

RESULTS: Among the HCS relative to NHCS, prevalence of initial positive TST was 20.9% vs. 12.2% (P < 0.001), and conversion rate was 1.1% vs. 0% (P = 0.423) at the 10 mm cut-off and 11.8% vs. 0% at the 6 mm cut-off (P = 0.00005). Multivariate analysis showed that the HCS group had a higher risk of baseline positive TST compared with the NHCS group after controlling for confounding factors (OR 1.7, 95%CI 1.1–2.6).

CONCLUSION: HCS are at greater risk than NHCS for having positive baseline TSTs and for TST conversion at the 6 mm cut-off. We conclude that the hospital we studied in Lima, Peru, poses a greater risk than the surrounding community for tuberculosis infection, and greater attention to hospital infection control measures is warranted. A higher rate of skin test boosting among the HCS cohort suggests the possibility of transient, non-progressive LTBI, which merits further study.

Keywords: Peru; nosocomial; transmission; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Harvard Medical School, Boston, Massachusetts, USA; and Harvard Vanguard Medical Associates, Boston, Massachusetts, USA 2: Socios En Salud, Lima, Peru 3: Harvard Medical School, Boston, Massachusetts, USA; and Massachusetts General Hospital Health Care Center, Revere, Massachusetts, USA 4: Partners In Health and the Program in Infectious Disease and Social Change, Harvard Medical School, Boston, Massachusetts, USA

Publication date: October 1, 2006

More about this publication?
  • 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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