Prevalence of and risk factors for tuberculosis among health care workers in Yogyakarta, Indonesia

Abstract

Background Healthcare workers (HCWs) are at risk of contracting TB, particularly when in high tuberculosis (TB) burden settings. Routine surveillance data and evidence are limited on the burden of TB amongst HCWs in Indonesia. Objective To measure the prevalence of TB infection (TBI) and disease among HCWs in four healthcare facilities in Yogyakarta and explore risk factors for TBI. Methods A cross-sectional TB screening study targeted all HCWs from four pre-selected facilities (1 hospital, 3 primary care) in Yogyakarta, Indonesia. Voluntary screening included symptom assessment, Chest X-ray (CXR), Xpert MTB/RIF (if indicated) and tuberculin skin test (TST). Analyses were descriptive and included multivariable logistic regression. Results Of 792 HCWs, 681 consented (86%) to the screening; 59% (n=401) were female, 62% were medical staff (n=421), 77% worked in the one participating hospital (n=524), and the median time working in the health sector was 13 years (IQR: 6-25 years). Nearly half had provided services for people with TB (46%, n=316) and 9% reported ever having TB (n=60). Among participants with presumptive TB (15%, n=99/662), none were diagnosed microbiologically or clinically with active TB disease. TBI was detected in 25% (95% CI: 22-30; n=112/441) of eligible HCWs with a TST result. A significant association was found between TB infection and being male (adjusted Odds Ratio (aOR) 2.02 (95%CI: 1.29-3.17)), currently working in the participating hospital compared to primary care (aOR 3.15 (95%CI: 1.75-5.66)), and older age (1.05 OR increase per year of life between 19-73 years (95%CI: 1.02-1.06)). Conclusion This study supports prioritisation of HCWs as a high-risk group for TB infection and disease, and the need for comprehensive prevention and control programs in Indonesia. Further, it identifies characteristics of HCWs in Yogyakarta at higher risk of TBI, who could be prioritised in screening programs if universal coverage of prevention and control measures cannot be achieved.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

The costs of this study were funded by TB Reach, Stop TB Partnership with additional financial support from the PRIME-TB project funded by the Australian Government's Indo-Pacific Centre for Health Security.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Not Applicable

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical approval was obtained from the Institutional Ethical Review Board at the University of Gadjah Mada (0138/2020), Indonesia and the Alfred Hospital Human Research Ethics Committee (639/20), Australia.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Not Applicable

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Not Applicable

I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.

Not Applicable

Data Availability

Data cannot be shared publicly because of project partnership stipulations/agreements. Data are available from the University of Gadjah Mada and Burnet Institute for researchers who meet the criteria for access to confidential data.

留言 (0)

沒有登入
gif