Tuberculosis at a university hospital, Thailand: A surprising incidence of TB among a new generation of highly exposed health care workers who may be asymptomatic

PLoS One. 2022 Aug 24;17(8):e0273027. doi: 10.1371/journal.pone.0273027. eCollection 2022.

Abstract

Objectives: There are a few reports of TB disease among healthcare workers (HCWs) in Thailand. The authors assessed the demographic data and incidence of overall TB disease including specific profession among HCWs in order to reduce the incidence rate.

Methods: This was a descriptive, cross-sectional study of 195 HCWs at King Chulalongkorn Memorial Hospital (KCMH), Bangkok, Thailand, who had TB disease from 2003-2020.

Results: The average incidence of TB disease in HCWs at KCMH was 164 per 100,000 HCWs with 95% confidential interval [CI], 107 to 220; (94.4% had pulmonary TB). Most of the HCWs were from a young age group (43.08% were 20-29 years old) and the duration of work was short (58.82% had worked at KCMH for less than 5 years). Radiological technicians had the highest incidence of TB, followed by supportive teams, scientists, and physicians (429, 241, 205, and 193 per 100,000 HCWs according to their profession, respectively). Seventy five percent of TB disease was found in physicians who worked at KCMH within 2 years. TB incidence was highest among residents (688 per 100,000 residents) in a subgroup of physicians.

Conclusions: The incidence of TB disease in HCWs was close to the general population of Thailand (153 per 100,000 population with 95% CI, 116 to 195). A higher incidence was observed in the profession that had contact with TB patients and their specimens. A high proportion of asymptomatic HCWs also had TB disease and TB incidence was found in a new generation of HCWs who have worked for less than 5 years. More rigorous epidemiology investigations are needed to establish a definitive relation to subsequently developing TB after working in a hospital. The authors suggest active surveillance in all new incoming HCWs and TB preventive therapy should also be provided to recent converters.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Health Personnel
  • Hospitals, University
  • Humans
  • Incidence
  • Thailand / epidemiology
  • Tuberculosis* / epidemiology
  • Young Adult

Grants and funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The information and material resource were supported from Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn University; Air Borne Isolation Clinic; and Human Resource Department of King Chulalongkorn Memorial Hospital. These organizations had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors received no specific funding for this work.