Referrals for positive tuberculin tests in new health care workers and students: a retrospective cohort study

Yining Xu; Schwartzman, Kevin
January 2010
BMC Public Health;2010, Vol. 10 Issue 1, p1
Academic Journal
Background: Documentation of test results for latent tuberculosis (TB) infection is important for health care workers and students before they begin work. A negative result provides a baseline for comparison with future tests. A positive result affords a potential opportunity for treatment of latent infection when appropriate. We sought to evaluate the yield of the referral process for positive baseline tuberculin tests, among persons beginning health care work or studies. Methods: Retrospective cohort study. We reviewed the charts of all new health care students and workers referred to the Montreal Chest Institute in 2006 for positive baseline tuberculin skin tests (=10 mm). Health care workers and students evaluated for reasons other than positive baseline test results were excluded. Results: 630 health care students and workers were evaluated. 546 (87%) were foreign-born, and 443 (70%) reported previous Bacille Calmette-Guérin (BCG) vaccination. 420 (67%) were discharged after their first evaluation without further treatment. 210 (33%) were recommended treatment for latent TB infection, of whom 165 (79%) began it; of these, 115 (70%) completed adequate treatment with isoniazid or rifampin. Treatment discontinuation or interruption occurred in a third of treated subjects, and most often reflected loss to follow-up, or abdominal discomfort. No worker or student had active TB. Conclusions: Only a small proportion of health care workers and students with positive baseline tuberculin tests were eligible for, and completed treatment for latent TB infection. We discuss recommendations for improving the referral process, so as to better target workers and students who require specialist evaluation and treatment for latent TB infection. Treatment adherence also needs improvement.


Related Articles

  • Health Care Workers and the Initiation of Treatment for Latent Tuberculosis Infection. Gershon, Andrea S.; McGeer, Allison; Bayoumi, Ahmed M.; Raboud, Janet; Jae Yang // Clinical Infectious Diseases;9/1/2004, Vol. 39 Issue 5, p667 

    Background. Despite strong evidence and recommendations supporting the treatment of latent tuberculosis infection, many affected health care workers at risk of acquiring tuberculosis from and potentially transmitting tuberculosis to their patients do not receive treatment. The objective of this...

  • mantoux test. Peters, Michael // BMA A-Z Family Medical Encyclopedia;2004, p488 

    A definition of the term "mantoux test," which refers to a skin test that is performed to detect tuberculosis, is presented.

  • Tuberculosis Knowledge among New York City Injection Drug Users. Wolfe, Hannah; Marmor, Michael; Maslansky, Robert; Nichols, Stuart; Simberkoff, Michael; Des Jarlais, Don; Moss, Andrew // American Journal of Public Health;Jul1995, Vol. 85 Issue 7, p985 

    Structured interviews measuring tuberculosis knowledge were administered to 494 New York City injection drug users, 31% of whom reported a history of having a reactive tuberculin skin test. Medical records review of a subsample confirmed the validity of self-reported data. Most respondents...

  • Nurses reject introduction of 115-year-old test.  // Nurse Prescribing;Feb2006, Vol. 4 Issue 1, p6 

    The article reports that seventy percent of tuberculosis nurses had rejected the introduction of the 115-year-old Mantoux tuberculin (TB) skin test in Great Britain. According to the report, over half of nurses who use the skin test often do not carry it out because they believe the results will...

  • Influence of Bacille Calmette-Guérin Vaccination on Size of Tuberculin Skin Test Reaction: To What Size? Tissot, F.; Zanetti, G.; Francioli, P.; Zellweger, J.-P.; Zysset, F. // Clinical Infectious Diseases;1/15/2005, Vol. 40 Issue 2, p211 

    Background. Previous bacillus Calmette-Guérin (BCG) vaccination can confound the results of a tuberculin skin test (TST). We sought to determine a cutoff diameter of TST induration beyond which the influence of BCG vaccination was negligible in evaluating potential Myco bacterium tuberculosis...

  • A Comparative Study of the Old Tuberculin Tine Test and the PPD-Tine Test. Steiner, Phillip; Rao, Madu; Victoria, Minerva; James, Pushpom // Clinical Pediatrics;Jun1980, Vol. 19 Issue 6, p389 

    Forty-one children suspected of having tuberculosis were simultaneously given an intermediate strength Mantoux test, an old tuberculin tine test (OT), and a purified protein derivative (PPD) tine test. Each test was read at 48 hours, and the largest diameter of induration was recorded....

  • Tuberculosis Risk for Hospital Employees: Analysis of Five-Year Tuberculin Skin Testing Program. Berman, Joseph; Levin, Michael L.; Orr, Suezanne Tangerose; Desi, Laurence // American Journal of Public Health;Nov81, Vol. 71 Issue 11, p1217 

    This study of hospital employee tuberculin conversion tales was undertaken in a 516-bed urban general hospital to determine if employment in such a hospital placed employees at risk of infection with tuberculosis. Data collected on the tuberculin status of employees from 1971 through 1976...

  • Increasing the efficiency of detecting active tuberculosis cases in intermediate and high-burden tuberculosis countries: A way forward. Muhammad Atif; Syed Azhar Syed Sulaiman // Journal of Basic & Clinical Pharmacy;Sep-Nov2012, Vol. 3 Issue 4, p330 

    The author reflects on the need to improve the efficiency in the detection of active turberculosis cases in countries experiencing intermediate and high-burden tuberculosis. He stresses that such disease is considered global health issue with an annual incidence rate of 9 million cases...

  • Rates of Tuberculosis Transmission to Children and Adolescents in a Community with a High Prevalence of HIV Infection among Adults. Middelkoop, Keren; Bekker, Linda-Gail; Myer, Landon; Dawson, Rodney; Wood, Robin // Clinical Infectious Diseases;8/1/2008, Vol. 47 Issue 3, p349 

    Background. Tuberculin skin test surveys are routinely used to test for tuberculosis (TB) infection in communities, but there are few data from tuberculin skin test surveys from countries in which both TB and human immunodeficiency virus (HIV) infection are prevalent. Methods. We conducted a...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics