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 Público

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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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
Palavra-chave	LTBI HCW TB
Committee Chair / Thesis Advisor	McNabb, Scott JN, Emory University
Partnering Agencies	Hospital or other health care provider

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