Three-year Evaluation of Pre-employment Screening for Tuberculosis (TB) and Post-exposure Compliance with Therapy for Latent TB Infection Among Healthcare Workers Working in A Tertiary Care Hospital in Saudi Arabia Open Access

Abstract

Background: Controlling tuberculosis (TB) among occupationally exposed
healthcare workers (HCWs) is challenged by limited documentation of pre-
employment tuberculin skin test (TST) screening and the lack of clinical
evaluation and completion of therapy for latent TB infection (LTBI) after
occupational TB exposure. Methods: We retrospectively reviewed occupational
TB exposures between 2008 and 2010 in King Abdulaziz Medical City, Riyadh,
Saudi Arabia. We abstracted records and collected predictor data for
documenting pre-employment TST status and subsequent TST screening and
treatment for LTBI among occupationally exposed HCWs. Results: We found 13
occupational TB exposure events involving 298 HCWs. Exposed HCWs tend to
be female (70.6%), non-Saudi (76.9%), nurse (55.7%) or respiratory therapist
(19.5%), working in critical care locations (72.8%). Pre-employment TST
documentation existed for only 123 out of 298 (41.3%) exposed HCWs. Among
those with documented baseline TST, 63 (51.2%) were TST positive (21.1% of all
298 HCWs). After exposure, 53 (17.8%) of 298 exposed HCWs were newly
diagnosed with LTBI and 49 (92.5%) of them were prescribed therapy for LTBI.
Among those prescribed, 46 (93.9%) started therapy for LBTI with the majority
(82.6%) did not finish the recommended course of therapy. Conclusions: We
found low rates of pre-employment TST documentation among exposed HCWs in
a large tertiary care hospital in Saudi Arabia and low treatment compliance rate.

Table of Contents

Introduction..........pg 1

Literature review....pg 6

Methods...............pg 11

Results.................pg 13

Discussion.............pg 15

Recommendations...pg 19

References............pg 21

Tables and Figures..pg 23

About this Master's Thesis

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• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Keyword	LTBI HCW TB
Committee Chair / Thesis Advisor	McNabb, Scott JN, Emory University
Partnering Agencies	Hospital or other health care provider

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