{"title":"拉丁美洲和加勒比地区医护人员潜伏肺结核感染（LTBI）流行率：系统回顾和荟萃分析。","authors":"Edinson Dante Meregildo-Rodriguez, Mariano Ortiz-Pizarro, Martha Genara Asmat-Rubio, Mayra Janett Rojas-Benites, Gustavo Adolfo Vásquez-Tirado","doi":"10.53854/liim-3203-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis remains a significant global health concern, and healthcare workers (HCWs) face a high risk of acquiring latent tuberculosis infection (LTBI) through occupational exposure. In the Latin American and Caribbean (LAC) region, where the burden of tuberculosis is substantial, understanding the prevalence of LTBI among HCWs is crucial for effective infection control measures. Therefore, we conducted a systematic review and meta-analysis to estimate the prevalence of LTBI among HCWs in LAC countries.</p><p><strong>Methods: </strong>Our search included MEDLINE, Scopus, EMBASE, Web of Science, and Google Scholar databases, focusing on relevant English-language records. We looked for observational studies from inception until December 2023.</p><p><strong>Results: </strong>Our analysis included 38 studies representing 15,236 HCWs and 6,728 LTBI cases. These studies spanned the period from 1994 to 2023 and were conducted in Brazil, Peru, Cuba, Colombia, Trinidad and Tobago, Mexico, and Chile. The mean prevalence of LTBI among HCWs was 35.32% (range 17.86-56.00%) for interferon-gamma release assay (IGRA) and 43.67% (range 6.68-70.29%) for tuberculin skin test (TST). The pooled prevalence of LTBI among HCWs was 34.5% (95% CI 25.4-44.1%) for IGRA and 43.0% (95% CI 35.5-50.7%) for TST. When considering both IGRA and TST tests, the overall prevalence of LTBI among HCWs was 40.98% (95% CI 34.77-47.33%). LTBI was associated with longer lengths of employment and exposure to patients, family members, or any person with TB. Additionally, older HCWs faced a higher risk of LTBI. Specific professional roles (such as nurses, nurse technicians, or physicians), smoking, and deficient TB infection control measures increased the likelihood of LTBI. However, information regarding gender and BCG vaccination status showed discordance among studies.</p><p><strong>Conclusion: </strong>Our findings underscore a substantial burden of LTBI among HCWs in LAC countries. Implementing adequate infection control measures is essential to prevent and control transmission within healthcare settings.</p>","PeriodicalId":502111,"journal":{"name":"Le infezioni in medicina","volume":"32 3","pages":"292-311"},"PeriodicalIF":0.0000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11392545/pdf/","citationCount":"0","resultStr":"{\"title\":\"Prevalence of latent tuberculosis infection (LTBI) in healthcare workers in Latin America and the Caribbean: systematic review and meta-analysis.\",\"authors\":\"Edinson Dante Meregildo-Rodriguez, Mariano Ortiz-Pizarro, Martha Genara Asmat-Rubio, Mayra Janett Rojas-Benites, Gustavo Adolfo Vásquez-Tirado\",\"doi\":\"10.53854/liim-3203-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Tuberculosis remains a significant global health concern, and healthcare workers (HCWs) face a high risk of acquiring latent tuberculosis infection (LTBI) through occupational exposure. In the Latin American and Caribbean (LAC) region, where the burden of tuberculosis is substantial, understanding the prevalence of LTBI among HCWs is crucial for effective infection control measures. Therefore, we conducted a systematic review and meta-analysis to estimate the prevalence of LTBI among HCWs in LAC countries.</p><p><strong>Methods: </strong>Our search included MEDLINE, Scopus, EMBASE, Web of Science, and Google Scholar databases, focusing on relevant English-language records. We looked for observational studies from inception until December 2023.</p><p><strong>Results: </strong>Our analysis included 38 studies representing 15,236 HCWs and 6,728 LTBI cases. These studies spanned the period from 1994 to 2023 and were conducted in Brazil, Peru, Cuba, Colombia, Trinidad and Tobago, Mexico, and Chile. The mean prevalence of LTBI among HCWs was 35.32% (range 17.86-56.00%) for interferon-gamma release assay (IGRA) and 43.67% (range 6.68-70.29%) for tuberculin skin test (TST). The pooled prevalence of LTBI among HCWs was 34.5% (95% CI 25.4-44.1%) for IGRA and 43.0% (95% CI 35.5-50.7%) for TST. When considering both IGRA and TST tests, the overall prevalence of LTBI among HCWs was 40.98% (95% CI 34.77-47.33%). LTBI was associated with longer lengths of employment and exposure to patients, family members, or any person with TB. Additionally, older HCWs faced a higher risk of LTBI. Specific professional roles (such as nurses, nurse technicians, or physicians), smoking, and deficient TB infection control measures increased the likelihood of LTBI. However, information regarding gender and BCG vaccination status showed discordance among studies.</p><p><strong>Conclusion: </strong>Our findings underscore a substantial burden of LTBI among HCWs in LAC countries. 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引用次数: 0
摘要
背景：结核病仍然是全球关注的重大健康问题，医护人员（HCWs）面临着通过职业暴露感染潜伏结核病（LTBI）的高风险。在结核病负担沉重的拉丁美洲和加勒比地区（LAC），了解医护人员中潜伏肺结核感染的发病率对于采取有效的感染控制措施至关重要。因此，我们进行了一项系统性回顾和荟萃分析，以估算拉美和加勒比国家高危作业人员中的 LTBI 患病率：我们的检索包括 MEDLINE、Scopus、EMBASE、Web of Science 和 Google Scholar 数据库，重点是相关的英文记录。我们寻找了从开始到 2023 年 12 月的观察性研究：我们的分析包括 38 项研究，涉及 15,236 名高危职业工作者和 6,728 例 LTBI 病例。这些研究的时间跨度为 1994 年至 2023 年，分别在巴西、秘鲁、古巴、哥伦比亚、特立尼达和多巴哥、墨西哥和智利进行。采用干扰素-γ释放测定（IGRA）和结核菌素皮试（TST）的结果分别为 35.32%（范围为 17.86-56.00%）和 43.67%（范围为 6.68-70.29%）。IGRA 和 TST 的合计感染率分别为 34.5% (95% CI 25.4-44.1%)和 43.0% (95% CI 35.5-50.7%)。如果同时考虑 IGRA 和 TST 测试，则人机工程工人中的 LTBI 总流行率为 40.98% (95% CI 34.77-47.33%)。LTBI与工作时间较长以及接触病人、家庭成员或任何结核病患者有关。此外，年龄较大的家政服务人员面临更高的LTBI风险。特定的职业角色（如护士、护士技师或医生）、吸烟和不完善的结核病感染控制措施都会增加发生 LTBI 的可能性。然而，有关性别和卡介苗接种情况的信息在各研究中并不一致：我们的研究结果表明，在拉丁美洲和加勒比国家，高危职业工人中存在大量的 LTBI 患者。实施适当的感染控制措施对于预防和控制医疗机构内的传播至关重要。
Prevalence of latent tuberculosis infection (LTBI) in healthcare workers in Latin America and the Caribbean: systematic review and meta-analysis.
Background: Tuberculosis remains a significant global health concern, and healthcare workers (HCWs) face a high risk of acquiring latent tuberculosis infection (LTBI) through occupational exposure. In the Latin American and Caribbean (LAC) region, where the burden of tuberculosis is substantial, understanding the prevalence of LTBI among HCWs is crucial for effective infection control measures. Therefore, we conducted a systematic review and meta-analysis to estimate the prevalence of LTBI among HCWs in LAC countries.
Methods: Our search included MEDLINE, Scopus, EMBASE, Web of Science, and Google Scholar databases, focusing on relevant English-language records. We looked for observational studies from inception until December 2023.
Results: Our analysis included 38 studies representing 15,236 HCWs and 6,728 LTBI cases. These studies spanned the period from 1994 to 2023 and were conducted in Brazil, Peru, Cuba, Colombia, Trinidad and Tobago, Mexico, and Chile. The mean prevalence of LTBI among HCWs was 35.32% (range 17.86-56.00%) for interferon-gamma release assay (IGRA) and 43.67% (range 6.68-70.29%) for tuberculin skin test (TST). The pooled prevalence of LTBI among HCWs was 34.5% (95% CI 25.4-44.1%) for IGRA and 43.0% (95% CI 35.5-50.7%) for TST. When considering both IGRA and TST tests, the overall prevalence of LTBI among HCWs was 40.98% (95% CI 34.77-47.33%). LTBI was associated with longer lengths of employment and exposure to patients, family members, or any person with TB. Additionally, older HCWs faced a higher risk of LTBI. Specific professional roles (such as nurses, nurse technicians, or physicians), smoking, and deficient TB infection control measures increased the likelihood of LTBI. However, information regarding gender and BCG vaccination status showed discordance among studies.
Conclusion: Our findings underscore a substantial burden of LTBI among HCWs in LAC countries. Implementing adequate infection control measures is essential to prevent and control transmission within healthcare settings.
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