Compliance with postexposure screening and treatment of latent tuberculosis infection among healthcare workers in a tertiary care hospital in Saudi Arabia

Hanan H. Balkhy, Thaddeus L. Miller, Saira Ali, Jennifer Nuzzo, Karine Kentenyants, Aiman El-Saed, Scott J.N. McNabb

Research output: Contribution to journalArticle

Abstract

BACKGROUND. Controlling tuberculosis (TB) infection among occupationally exposed healthcare workers (HCWs) may be challenging. methods. We retrospectively reviewed clinical records of HCWs who were exposed to patients diagnosed with infectious TB at King Abdulaziz Medical City, Riyadh, Saudi Arabia, between 2008 and 2010. The collected data included baseline tuberculin skin test (TST) status, potential predictors of TST positivity, postexposure diagnosis of latent TB infection (LTBI), and postexposure compliance with LTBI therapy. RESULTS. Thirteen patients were diagnosed with infectious pulmonary TB during the study period. A total of 298 HCWs met our definition for exposure. Exposed HCWs tended to be female (62.9%), non-Saudi (83.9%), nurses (68.6%), or respiratory therapists (24.0%) working in critical care locations (72.8%). Baseline (preemployment) TST documentation existed for 41.3% (123/298). Among those with documented baseline TSTs, 51.2% (63/123) were positive, representing 21.1% (63/298) of all HCWs. Only 48.9% (115/235) of exposed HCWs who had negative or unknown preexposure TST status had their TST tested after exposure. Approximately 46.1% (53/115) of them were diagnosed with postexposure LTBI, and 92.5% (49/53) of them were prescribed LTBI therapy. Among those, 93.9% (46/49) started LTBI therapy; however, 82.6% (38/46) failed to complete the recommended course. CONCLUSIONS. We found low rates of baseline TST documentation and postexposure screening among exposed HCWs. Compliance with initiating postexposure isoniazid prophylaxis among HCWs was fair, but only a small fraction of those who started prophylaxis completed the recommended course of therapy. These findings suggest substantial opportunities to implement administrative measures to enhance LTBI management among HCWs.

Original languageEnglish (US)
Pages (from-to)176-181
Number of pages6
JournalInfection control and hospital epidemiology
Volume35
Issue number2
DOIs
StatePublished - Feb 1 2014
Externally publishedYes

Fingerprint

Latent Tuberculosis
Saudi Arabia
Tertiary Healthcare
Tertiary Care Centers
Tuberculin Test
Skin Tests
Delivery of Health Care
Infection
Therapeutics
Documentation
Tuberculosis
Isoniazid
Critical Care
Pulmonary Tuberculosis
Nurses

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Compliance with postexposure screening and treatment of latent tuberculosis infection among healthcare workers in a tertiary care hospital in Saudi Arabia. / Balkhy, Hanan H.; Miller, Thaddeus L.; Ali, Saira; Nuzzo, Jennifer; Kentenyants, Karine; El-Saed, Aiman; McNabb, Scott J.N.

In: Infection control and hospital epidemiology, Vol. 35, No. 2, 01.02.2014, p. 176-181.

Research output: Contribution to journalArticle

Balkhy, Hanan H. ; Miller, Thaddeus L. ; Ali, Saira ; Nuzzo, Jennifer ; Kentenyants, Karine ; El-Saed, Aiman ; McNabb, Scott J.N. / Compliance with postexposure screening and treatment of latent tuberculosis infection among healthcare workers in a tertiary care hospital in Saudi Arabia. In: Infection control and hospital epidemiology. 2014 ; Vol. 35, No. 2. pp. 176-181.
@article{078b6ca08b774ff28cc9f4617092abc8,
title = "Compliance with postexposure screening and treatment of latent tuberculosis infection among healthcare workers in a tertiary care hospital in Saudi Arabia",
abstract = "BACKGROUND. Controlling tuberculosis (TB) infection among occupationally exposed healthcare workers (HCWs) may be challenging. methods. We retrospectively reviewed clinical records of HCWs who were exposed to patients diagnosed with infectious TB at King Abdulaziz Medical City, Riyadh, Saudi Arabia, between 2008 and 2010. The collected data included baseline tuberculin skin test (TST) status, potential predictors of TST positivity, postexposure diagnosis of latent TB infection (LTBI), and postexposure compliance with LTBI therapy. RESULTS. Thirteen patients were diagnosed with infectious pulmonary TB during the study period. A total of 298 HCWs met our definition for exposure. Exposed HCWs tended to be female (62.9{\%}), non-Saudi (83.9{\%}), nurses (68.6{\%}), or respiratory therapists (24.0{\%}) working in critical care locations (72.8{\%}). Baseline (preemployment) TST documentation existed for 41.3{\%} (123/298). Among those with documented baseline TSTs, 51.2{\%} (63/123) were positive, representing 21.1{\%} (63/298) of all HCWs. Only 48.9{\%} (115/235) of exposed HCWs who had negative or unknown preexposure TST status had their TST tested after exposure. Approximately 46.1{\%} (53/115) of them were diagnosed with postexposure LTBI, and 92.5{\%} (49/53) of them were prescribed LTBI therapy. Among those, 93.9{\%} (46/49) started LTBI therapy; however, 82.6{\%} (38/46) failed to complete the recommended course. CONCLUSIONS. We found low rates of baseline TST documentation and postexposure screening among exposed HCWs. Compliance with initiating postexposure isoniazid prophylaxis among HCWs was fair, but only a small fraction of those who started prophylaxis completed the recommended course of therapy. These findings suggest substantial opportunities to implement administrative measures to enhance LTBI management among HCWs.",
author = "Balkhy, {Hanan H.} and Miller, {Thaddeus L.} and Saira Ali and Jennifer Nuzzo and Karine Kentenyants and Aiman El-Saed and McNabb, {Scott J.N.}",
year = "2014",
month = "2",
day = "1",
doi = "10.1086/674855",
language = "English (US)",
volume = "35",
pages = "176--181",
journal = "Infection Control and Hospital Epidemiology",
issn = "0899-823X",
publisher = "University of Chicago Press",
number = "2",

}

TY - JOUR

T1 - Compliance with postexposure screening and treatment of latent tuberculosis infection among healthcare workers in a tertiary care hospital in Saudi Arabia

AU - Balkhy, Hanan H.

AU - Miller, Thaddeus L.

AU - Ali, Saira

AU - Nuzzo, Jennifer

AU - Kentenyants, Karine

AU - El-Saed, Aiman

AU - McNabb, Scott J.N.

PY - 2014/2/1

Y1 - 2014/2/1

N2 - BACKGROUND. Controlling tuberculosis (TB) infection among occupationally exposed healthcare workers (HCWs) may be challenging. methods. We retrospectively reviewed clinical records of HCWs who were exposed to patients diagnosed with infectious TB at King Abdulaziz Medical City, Riyadh, Saudi Arabia, between 2008 and 2010. The collected data included baseline tuberculin skin test (TST) status, potential predictors of TST positivity, postexposure diagnosis of latent TB infection (LTBI), and postexposure compliance with LTBI therapy. RESULTS. Thirteen patients were diagnosed with infectious pulmonary TB during the study period. A total of 298 HCWs met our definition for exposure. Exposed HCWs tended to be female (62.9%), non-Saudi (83.9%), nurses (68.6%), or respiratory therapists (24.0%) working in critical care locations (72.8%). Baseline (preemployment) TST documentation existed for 41.3% (123/298). Among those with documented baseline TSTs, 51.2% (63/123) were positive, representing 21.1% (63/298) of all HCWs. Only 48.9% (115/235) of exposed HCWs who had negative or unknown preexposure TST status had their TST tested after exposure. Approximately 46.1% (53/115) of them were diagnosed with postexposure LTBI, and 92.5% (49/53) of them were prescribed LTBI therapy. Among those, 93.9% (46/49) started LTBI therapy; however, 82.6% (38/46) failed to complete the recommended course. CONCLUSIONS. We found low rates of baseline TST documentation and postexposure screening among exposed HCWs. Compliance with initiating postexposure isoniazid prophylaxis among HCWs was fair, but only a small fraction of those who started prophylaxis completed the recommended course of therapy. These findings suggest substantial opportunities to implement administrative measures to enhance LTBI management among HCWs.

AB - BACKGROUND. Controlling tuberculosis (TB) infection among occupationally exposed healthcare workers (HCWs) may be challenging. methods. We retrospectively reviewed clinical records of HCWs who were exposed to patients diagnosed with infectious TB at King Abdulaziz Medical City, Riyadh, Saudi Arabia, between 2008 and 2010. The collected data included baseline tuberculin skin test (TST) status, potential predictors of TST positivity, postexposure diagnosis of latent TB infection (LTBI), and postexposure compliance with LTBI therapy. RESULTS. Thirteen patients were diagnosed with infectious pulmonary TB during the study period. A total of 298 HCWs met our definition for exposure. Exposed HCWs tended to be female (62.9%), non-Saudi (83.9%), nurses (68.6%), or respiratory therapists (24.0%) working in critical care locations (72.8%). Baseline (preemployment) TST documentation existed for 41.3% (123/298). Among those with documented baseline TSTs, 51.2% (63/123) were positive, representing 21.1% (63/298) of all HCWs. Only 48.9% (115/235) of exposed HCWs who had negative or unknown preexposure TST status had their TST tested after exposure. Approximately 46.1% (53/115) of them were diagnosed with postexposure LTBI, and 92.5% (49/53) of them were prescribed LTBI therapy. Among those, 93.9% (46/49) started LTBI therapy; however, 82.6% (38/46) failed to complete the recommended course. CONCLUSIONS. We found low rates of baseline TST documentation and postexposure screening among exposed HCWs. Compliance with initiating postexposure isoniazid prophylaxis among HCWs was fair, but only a small fraction of those who started prophylaxis completed the recommended course of therapy. These findings suggest substantial opportunities to implement administrative measures to enhance LTBI management among HCWs.

UR - http://www.scopus.com/inward/record.url?scp=84892684146&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84892684146&partnerID=8YFLogxK

U2 - 10.1086/674855

DO - 10.1086/674855

M3 - Article

C2 - 24442081

AN - SCOPUS:84892684146

VL - 35

SP - 176

EP - 181

JO - Infection Control and Hospital Epidemiology

JF - Infection Control and Hospital Epidemiology

SN - 0899-823X

IS - 2

ER -