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Volume 12, Number 9—September 2006
Perspective

Nosocomial Tuberculosis in India

Madhukar Pai*†Comments to Author , Shriprakash Kalantri†, Ashutosh Nath Aggarwal‡, Dick Menzies§, and Henry M. Blumberg¶
Author affiliations: *McGill University, Montreal, Quebec, Canada; †Mahatma Gandhi Institute of Medical Sciences, Sevagram, India; ‡Postgraduate Institute of Medical Education and Research, Chandigarh, India; §McGill University Montreal Chest Institute, Montreal, Quebec, Canada; ¶Emory University School of Medicine, Atlanta, Georgia, USA

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Table 1

Recent studies on TB among HCWs in India*

Author, city, year Setting Population Prevalence of latent TB Incidence of latent TB Incidence of active TB Comments
Pai et al., Sevagram, 2005 (26) Rural medical school 726 HCWs, including medical and nursing students (median age 22 y, 62% female) underwent both TST and IGRA 50% positive by TST or IGRA NA NA Prevalence of LTBI was probably underestimated because of nonresponse among senior physicians
Pai et al., Sevagram, 2006 (27) Rural medical school 216 medical and nursing students (median age 21 y) were tested with TST and IGRA; both tests were repeated after 18 mo to document conversions 22% positive by TST, 18% positive by IGRA 5% with TST and IGRA NA Annual risk for LTBI was probably underestimated because only students were included in the study
Rao et al., Chandigarh, 2004 (28) Urban tertiary care hospital 701 resident doctors (470 [group 1] were already working at the hospital and 231 [group 2] were newly admitted to the institute); mean age 28 y in group 1 and 26 y in group 2, 81% male NA NA TB developed in 4 of 231 newly admitted residents within 1 y of beginning work, incidence of 17 per 1,000; all except 1 had EPTB High rate of active TB (mostly EPTB) among HCWs in medical specialties; few cases were bacteriologically confirmed
Gopinath et al., Vellore, 2004 (29) Urban medical school Retrospective survey to identify HCWs who had TB treatment between 1992 and 2001 NA NA 125 HCWs underwent TB treatment between 1992 and 2001; 43% of all cases were EPTB, and 5% were MDRTB; incidence of pulmonary TB was 0.35–1.80 per 1,000; incidence of EPTB was 0.34–1.57 per 1,000 EPTB was common; largest number of cases was reported among nurses and nursing students
Mathew et al., Vellore, 2005 (30) Urban medical school 101 HCWs who had had TB disease were compared with 101 randomly selected controls from the same hospital NA NA NA Body mass index <19 kg/m2 and employment in medical wards were independent risk factors for TB disease

*TB, tuberculosis; HCWs, healthcare workers; TST, tuberculin skin test; IGRA, interferon-γ release assay; NA, not available; LTBI, latent TB infection; EPTB, extrapulmonary TB; MDRTB, multidrug-resistant TB.

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Page created: November 17, 2011
Page updated: November 17, 2011
Page reviewed: November 17, 2011
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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