Latent tuberculosis infection: risks to health care students at a hospital 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.
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: 2006-10-01
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