Latent Tuberculosis in Healthcare Workers - the Reality of a Portuguese Tertiary Hospital

Study Overview
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Brief Summary
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Prospective, descriptive study to assess latent tuberculosis infection (LTBI) among healthcare worker (HCW) in a tertiary hospital in a low-risk area.

Detailed Description
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identiﬁcation and treatment of LTBI can substantially reduce the risk of development of disease and are important TB control strategies, especially in settings with a low tuberculosis (TB) incidence, where reactivation of LTBI often accounts for the majority of non-imported TB disease treatment of LTBI can substantially reduce the risk of development of disease. In Portugal the real prevalence of LTBI in low-risk HCWs has not been evaluated since they are not included in the periodic screening programs. It is important to diagnose TB infections in HCWs to prevent nosocomial transmission, particularly among immunocompromised patients. The risk for transmission varies by setting, occupational group, local prevalence of TB, patient population, and effectiveness of TB infection control measures. Prevention of active TB disease by treatment of LTBI is a critical component for public health. Tuberculin skin test (TST) is used worldwide to diagnose LTBI, whereas interferon-γ release assay (IGRA) are used in some countries according to their national TB programs. IGRA offers a potential method of serial testing to diagnose LTBI in HCWs, and it has better specificity than that of TST in one-time screening. Study participants should be identified and contacted by occupational health service. In association, study information should be disseminated through posters and institutional email.

Official Title
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Latent Tuberculosis in Healthcare Workers - the Reality of a Portuguese Tertiary Hospital

Conditions
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Tuberculosis

Intervention / Treatment
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* Diagnostic Test: IGRA/Tuberculin skin test


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All HCW from our hospital with risk of exposure, working in our hospital for at least 3 consecutive months Acceptance to participate and signed informed consent form Exclusion Criteria: History of previous tuberculosis Active Tuberculosis Refusal to sign the informed consent form

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Healthcare workers<br>Clinical evaluation, chest x-ray and Interferon-γ release assay (IGRA). Immunocompromised patients will be submitted to a tuberculin skin test. The patients will be evaluated in two or more separate appointments. In the first appointment, patients will be submitted to clinical evaluation and exam request. In the second appointment the results will be evaluated. | Diagnostic Test: IGRA/Tuberculin skin test<br>* All patients will receive: Clinical evaluation; Chest x-ray. IGRA (or tuberculin skin test if immunocompromised) Therapeutic proposal if eligible<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number and percentage of latent tuberculosis diagnosis in healthcare workers | Patients with positive IGRA/tuberculin test screening and without clinical or radiological features of active Tuberculosis | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Treatment acceptance for latent tuberculosis | Number of positive screening participants who accept and start treatment | 1 year | 
| Treatment completion | Number of patients who finished treatment | 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Latent Tuberculosis, Healthcare workers, IGRA