IJID regions · 2026
The prevalence of latent tuberculosis infection among healthcare workers in Saudi Arabia: a systematic review and meta-analysis.
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Aljabr Mohammed, Boumarah Fatima N, Mortada Yara, Alhmidani Ghala, Almutairi Rakan, Msood Jory, Alfaraj Noor, Abohimed Shatha, Almaghrbi Adel, Algethami Reham, Alsaedi Refal, Maqeet Sadeem Al, Aljorayid Abdullah
Аннотация
OBJECTIVES: This systematic review and meta-analysis aimed to estimate the prevalence of latent tuberculosis infection (LTBI) among healthcare workers (HCWs) in Saudi Arabia and identify key associated risk factors.
METHODS: A systematic search of PubMed, Web of Science, and MEDLINE and Embase (via Ovid) was conducted for studies reporting LTBI prevalence among HCWs in Saudi Arabia. Data were pooled using a random-effects model. Subgroup analyses assessed variations by diagnostic method, professional category, and nationality.
RESULTS: The overall pooled prevalence was 24% (95% confidence interval [CI] = 16-34%), with high heterogeneity across studies (I² = 98.8%). Prevalence was numerically higher in tuberculin skin test (TST)-based studies (27%) than in interferon-gamma release assay (IGRA)-based studies (20%), although this difference did not reach statistical significance (P = 0.13). TST-positive/IGRA-negative discordance was the predominant pattern. Expatriate HCWs from high-burden countries showed prevalence rates of 45-46%, compared to 13% among Saudi nationals. Allied health professionals and nurses exhibited higher prevalence trends, though these did not reach statistical significance.
CONCLUSION: The LTBI burden among HCWs in Saudi Arabia is substantial and largely imported by expatriate workers from high-burden countries, with a possible secondary occupational contribution. TST-IGRA discordance suggests that TST may overestimate prevalence in this bacille Calmette-Guérin-vaccinated population. Based on discordance patterns and supporting evidence, transitioning to IGRA-based screening and implementing targeted surveillance for high-risk groups should be considered.
METHODS: A systematic search of PubMed, Web of Science, and MEDLINE and Embase (via Ovid) was conducted for studies reporting LTBI prevalence among HCWs in Saudi Arabia. Data were pooled using a random-effects model. Subgroup analyses assessed variations by diagnostic method, professional category, and nationality.
RESULTS: The overall pooled prevalence was 24% (95% confidence interval [CI] = 16-34%), with high heterogeneity across studies (I² = 98.8%). Prevalence was numerically higher in tuberculin skin test (TST)-based studies (27%) than in interferon-gamma release assay (IGRA)-based studies (20%), although this difference did not reach statistical significance (P = 0.13). TST-positive/IGRA-negative discordance was the predominant pattern. Expatriate HCWs from high-burden countries showed prevalence rates of 45-46%, compared to 13% among Saudi nationals. Allied health professionals and nurses exhibited higher prevalence trends, though these did not reach statistical significance.
CONCLUSION: The LTBI burden among HCWs in Saudi Arabia is substantial and largely imported by expatriate workers from high-burden countries, with a possible secondary occupational contribution. TST-IGRA discordance suggests that TST may overestimate prevalence in this bacille Calmette-Guérin-vaccinated population. Based on discordance patterns and supporting evidence, transitioning to IGRA-based screening and implementing targeted surveillance for high-risk groups should be considered.