Prevalence and risk factors of latent tuberculosis infection in healthcare workers in Eastern China.

BACKGROUND

Healthcare workers (HCWs) are at an increased risk of latent tuberculosis infection (LTBI) and active TB due to their occupational exposure to tuberculosis (TB). There are limited studies to assess the baseline prevalence of LTBI among HCWs in coastal eastern China. The purpose of this study was to evaluate the prevalence and risk factors of LTBI among HCWs.

METHODS

A cross-sectional study with stratified cluster sampling method was conducted. All HCWs with TB exposure from the selected healthcare institutions were recruited to complete a standardized questionnaire and to undergo testing by the creation tuberculin skin test (C-TST). Univariate and multivariate logistic regression was employed to identify determinants associated with LTBI.

RESULTS

A total of 342 HCWs were included in the analysis. The prevalence of LTBI was found to be 13.16% (95% CI: 9.76-17.21%). The results of multivariate regression analysis showed that healthcare institutions level (OR = 4.131, 95% CI:1.687-10.118, p = 0.002); physician (OR = 3.132, 95% CI:1.132-8.662, p = 0.028), laboratory technician (OR = 5.545, 95% CI:1.385-22.200, p = 0.016); working duration 10-14 years (OR = 5.721, 95% CI: 1.435-22.809, p = 0.013), 15-19 years (OR = 4.305, 95% CI: 1.028-18.032, p = 0.046) and 20 years above (OR = 4.047, 95% CI: 1.079-15.171, p = 0.038); household contact with TB (OR = 4.488, 95% CI: 1.051-19.166, p = 0.043) were significantly associated with a higher prevalence of LTBI.

CONCLUSIONS

The LTBI prevalence among HCWs in Yantai is relatively low. TB screening should be included in the annual health check-ups for HCWs, especially for high-risk groups such as frontline HCWs, long-serving workers, and those with household contact with TB, to reduce the risk of TB infection. These findings highlight the need to enhance infection control measures and active surveillance for at-risk HCWs, even in low TB incidence settings. Future research should focus on longitudinal studies to understand LTBI dynamics and the effectiveness of interventions in low-incidence settings.