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Free Content Serial testing of Malaysian health care workers with QuantiFERON®-TB Gold In-Tube

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BACKGROUND: Serial testing for tuberculosis (TB) exposure has been advocated among health care workers (HCWs) at risk of nosocomial infection.

OBJECTIVE: To determine the incidence and factors associated with TB infection among selected HCWs in Malaysia and to determine interferon-gamma response in serial testing.

DESIGN: A cohort of 769 HCWs were retested after 1 year using QuantiFERON®-TB Gold In-Tube. Incidence of TB infection was determined among HCWs who previously tested negative. Conversion and reversion rates using several definitions were explored.

RESULTS: Incidence of TB infection was 9.9 per 100 workers per year (95%CI 7.9–12.3). Working in the Emergency Department (ED; RR 2.18, 95%CI 1.07–4.43) was significantly associated with risk of TB infection. Reversion and conversion occurred frequently, with 46.7% reversion among HCWs with baseline interferon-gamma (IFN-γ) levels of 0.35–0.70 international units (IU)/ml, and 23.8% conversion among HCWs with baseline IFN-γ levels of 0.20–0.34 IU/ml.

CONCLUSIONS: TB infection control measures need to be strengthened, particularly in the ED, as the incidence of TB was high. Conversion and reversion rates in serial testing were high, and further studies are needed to facilitate its interpretation.
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Keywords: LTBI; conversion; epidemiology; occupational; reversion

Document Type: Research Article

Affiliations: 1: Institute for Medical Research, Jalan Pahang, Kuala Lumpur, Malaysia 2: Perdana University Graduate School of Medicine, Serdang, Malaysia

Publication date: 2012-02-01

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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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