Details
Category: Volume 07 Issue 07 July 2019
Hits: 1053

Title: Active Case Finding For TB / DR- TB in Health Care Workers

Authors: Dr SM Khan, Dr. B.O Tayde, Dr Sonal Arsude, Dr Chetan Khedkar

 DOI: https://dx.doi.org/10.18535/jmscr/v7i7.150

Abstract

The present study was conducted in NKP SIMS, RC and Lata Mangeshkar Hospital, Nagpur on Health Care Workers with the aim to diagnose and treat Tuberculosis and Drug Resistant Tuberculosis through Active Case Finding Approach. The Active Case Finding sessions were organised by the Department of Respiratory Medicine in co-ordination with TB Department staff and health workers assigned for project work. 425 Health Care Workers actually visited the ACF session and were symptoms screened and subjected to sputum examination for Acid fast bacilli, Chest X-ray, and if needed higher investigations as per the RNTCP and PMDT diagnostic algorithm. 15 Health Care Workers were found to have active tuberculosis. The more health care workers with TB were noticed to be in 25 to 34 yrs age group and the females outnumbered the males (female 8, male 7) and have been diagnosed as the case of active TB disease in less than 2 yrs of employment (13 out of 15 HCWs). This study reflects that the hospital based active case finding is likely to have additional benefits such as contribution to early case finding and detection of patients of tuberculosis from vulnerable group possibly with an extended benefit for reducing secondary  cases in the community. The results of the study can constitute and evidence base for future policy formulations on Active Case Finding in Health Care Workers as the evidence shows a high burden of active TB in health care workers, necessity an urgent need to improve existing TB Infection, Prevention and Control measures in Health Care Facilities.

Keywords: Active Case Finding in Health Care Workers, Tuberculosis and Multi Drug Resistant Tuberculosis, Revised National Tuberculosis Control Programme and Programmatic Management of Drug Resistant TB Guidelines.      

References

  1. O’Donnell MR, Jarand J, Loveday M, Padayatchi N, Zelnick J, Werner L, Naidoo K, Master I, Osburn G, Kvasnovsky C, et al. High incidence of hospital admissions with multidrug-resistant and extensively drug-resistant tuberculosis among South African health care workers.Ann Intern Med. 2010;153(8):516–522. doi: 10.7326/0003-4819-153-8-201010190-00008. [PMC free article] [PubMed] [CrossRef]
  2. Joshi R, Reingold AL, Menzies D, Pai M. Tuberculosis among Health-Care Workers in Low- and Middle-Income Countries: A Systematic Review.PLoS Med. 2006;3(12):e494. doi: 10.1371/journal.pmed.0030494. [PMC free article] [PubMed] [CrossRef]
  3. Naidoo A et al. Tuberculosis in medical doctors- a study of personal experiences and attitudes. S Afr  Med J . 2013 Jan 18 ;103 ( 3 ) : 176-80
  4. Golub Je ,Mohan CI ,Comstok GW , Chasson R E . Active case finding of Tuberculosis: historical perspective and future prospects . Int J  Tuberc  Lung Dis 2005 ; 9 : 1183-203
  5. Dye C , Scheele S , Dolin P , Pathania V, Raviglione M. C. Consesus statement. Global burden of tuberculosis :estimated incidence , prevalence , and moraility by country. WHO Global Surveillance and Monitoring Project. JAMA 1999 ;282 : 677-686
  6. World Health Organization. Report on the meeting of second ad hoc Committee on the Tuberculosis Epidemic. Montreux , Switzerland , 18-19 September , 2003 . WHO /HTM /STB/2004.28. Geneva , Switzerland : WHO 2004
  7. Carbett EL , Watt C J , Walker N , et al. The growing burden of tuberculosis : global trends and interactions with the HIV epidemic . Arch Intern Med 2003; 163 :1009-1021
  8. De Cock K M , Chaisson R E. Will DOTS do it ? A reappraisal of tuberculosis control in countries with high rates of HIV infection . Int J Tuberc Lung Dis 199; 3:457-465
  9. Murray C J, Salomon J A, Modeling the impact of global tuberculosis control strategies .Proc Natl Acad Sci USA 1998 ;95 :13881 13886.
  10. Currie C S , Williams B G , Cheng R C , Dye C. Tuberculosis epidemics driven by HIV : is preven better than cure ? AIDS 2003 ; 17 : 2501-2508
  11. Rieder H . What is the role of case detection by periodic mass radiographic examination in TB control In Frieden T  ( E d) Toman's Tuberculosis . Geneva , WHO , 2004.
  12. Guidelines for intensified tuberculosis case- finding and isoniazid preventive therapy for people living with HIV in resource constrained settings. Geneva : World Health Organization , 2010.
  13. Bothamley GH, Ditiu L Migliori GB, Lange C ; TBNET contributors. Active case finding in Europe : a Tuberculosis Network European Trials Group (TBNET) survey. Eur Respir J . 2008 Oct ; 32 (4)1023-30. Ep.ub 2008 Jun 11
  14. Adams S, Ehrlich R, Baatjies R, van Zyl-Smit RN, Said-Hartley Q, Dawson R, Dheda K. Incidence of occupational latent tuberculosis infection in South African healthcare workers. Eur Respir J. 2015;45:1364–1373. [PubMed]
  15. World Health Organisation. WHO Global TB Database. In. Geneva: World Health Organisation; http://www.who.int/tb/country/en/
  16. Ayuk J. A cross-sectional study of tuberculosis among workers in Tygerberg Academic Hospital, Western Cape province, South Africa. Stellenbosch University; 2012.http://hdl.handle.net/10019.1/85836. Accessed 3 Aug 2016
  17. Naidoo S, Jinabhai CC. TB in health care workers in KwaZulu-Natal, South Africa.Int J Tuberc Lung Dis. 2006;10(6):676–682. [PubMed17
  18. Balt E, Durrheim DN, Weyer K. Nosocomial transmission of tuberculosis to health care workers in Mpumalanga.S Afr Med J. 1998;88(11):1363–1366. [PubMed]
  19. Tudor C, Van der Walt M, Margot B, Dorman SE, Pan WK, Yenokyan G, Farley JE. Tuberculosis among health care workers in KwaZulu-Natal, South Africa: a retrospective cohort analysis.BMC Public Health. 2014;14:891. doi: 10.1186/1471-2458-14-891. [PMC free article] [PubMed] [CrossRef]
  20. McCarthy KM, Scott LE, Gous N, Tellie M, Venter WD, Stevens WS, Van Rie A. High incidence of latent tuberculous infection among South African health workers: an urgent call for action.Int J Tuberc Lung Dis. 2015;19(6):647–653. doi: 10.5588/ijtld.14.0759. [PubMed] [CrossRef]
  21. Kranzer K, Bekker LG, van Schaik N, Thebus L, Dawson M, Caldwell J, Hausler H, Grant R, Wood R. Community health care workers in South Africa are at increased risk for tuberculosis.S Afr Med J.2010;100(4):224–226. doi:
  22. Connelly D, Veriava Y, Roberts S, Tsotetsi J, Jordan A, DeSilva E. Prevalence of HIV infection and median CD4 counts among healh care workers in South Africa.S Afr Med J. 2007;97(2):115–120.[PubMed]
  23. Wilkinson D, Gilks CF. Increasing frequency of tuberculosis among staff in a South African district hospital: impact of the HIV epidemic on the supply side of health care.Trans R Soc Trop Med Hyg.1998;92(5):500–502. doi: 10.1016/S0035-9203(98)90889-6. [PubMed] [CrossRef]
  24. Jiamjarasrangsi W, Hirunsuthikul N, Kamolratanakul P. Tuberculosis among health care workers at King Chulalongkorn Memorial Hospital, 1988–2002. Int J Tuberc Lung Dis 2005;9: 1253–1258.
  25. Kilinc O, Ucan E S, Cakan A, et al. Risk of tuberculosis among health care workers: can tuberculosis be considered as an occupational disease? Res Med 2002; 96: 506–510.
  26. Babus V. Tuberculosis morbidity risk in medical nurses in specialized institutions for the treatment of lung diseases in Zagreb. Int J Tuberc Lung Dis 1997; 1: 254–258.

Corresponding Author

Dr SM Khan

Department of Respiratory Medicine, NKP Salve Institute of Medical Sciences, RC and Lata Mangeshkar Hospital, Nagpur, Maharashtra, India