Public Health and Preventive Medicine
Articles Information
Public Health and Preventive Medicine, Vol.1, No.3, Aug. 2015, Pub. Date: Jul. 20, 2015
Prevalence and Risk of Latent Tuberculosis Infection in Primary Health Care Workers at La Lisa Municipality, Havana, Cuba
Pages: 112-119 Views: 4149 Downloads: 1211
[01] Dalila Martínez-Hall, Pedro Kourí Institute of Tropical Medicine, Havana City, Cuba.
[02] Susana Borroto-Gutiérrez, Pedro Kourí Institute of Tropical Medicine, Havana City, Cuba.
[03] Lellanis Arroyo-Rojas, Pedro Kourí Institute of Tropical Medicine, Havana City, Cuba.
[04] Edilberto González-Ochoa, Pedro Kourí Institute of Tropical Medicine, Havana City, Cuba.
Background: Tuberculosis transmission is a risk to health care workers (HCW) Objectives: To determine the prevalence of latent tuberculosis infection (LTBI), the annual risk of infection and its possible association with some predictive variables. Methods: A cross-sectional study in 1063 HCW at La Lisa municipality policlinics, Havana, was carried out during 2009-2011; a Tuberculin Skin Test (TST) was applied, along with a structured questionnaire exploring general and on exposition data. The reading was performed in 905 HCW at 72 hours, defining as positive ≥10mm induration and tuberculin conversion as ≥10 mm increasing in the second TST of those previously negative. To prove the possible influence of predictive variables on the presence of infection, a bivariate analysis and a multivariate model were applied. Results: The prevalence of LTBI was 15,2%, with 3,7% of AIR. The highest prevalence in Berovides Policlinic (19,3%) and the lowest in Fernández (10,5%). The highest annual risk of infection was in Labra (6,4%) and the lowest in Fonseca (1%). The variables possibly associated to LTBI were: belonging to Labra and Berovides policlinics, having contact with tuberculosis patients, being ≥20 years working there and belonging to the following occupational groups: administrative, nurse, maintenance staff and health technicians. Conclusions: The transmission of tuberculosis infection, even in low levels, is possibly associated to the labor environment; so it would be advisable to value the application of preventive chemotherapy in these personnel and to maintain the appropriate measures of infection control in the institutions.
Tuberculosis, Latent Tuberculosis Infection, Prevalence, Primary Health Care
[01] Centers for Disease Control and Prevention. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005. MMWR 2005; 54(17):1-151.
[02] Ministry of Public Health. Annual Health Statistics Report 2009-2013. National Health Statistics Bureau. Minsap. Acceded 12/11/2014. Available in:
[03] Ministry of Public Health. National Program and Proceedings for Tuberculosis Prevention and Control. Havana, Cuba. 2013. ECIMED. Available in:
[04] Ministry of Public Health. Strengthening the national TB Control Program in the Republic of Cuba. Acceded 11/03/2014 Available in:
[05] Borroto S, Fernández R, Castro O, González E, Armas L. Evaluación del Riesgo de Tuberculosis en los Trabajadores del Instituto Pedro Kourí. Med. y Seguridad del Trab. 2000; (87):69-76.
[06] Borroto S, Gámez D, Martínez Y, Ferrer A I, Velásquez Y, Llanes M et al. Latent tuberculosis Infection among health care workers at a general hospital in Santiago de Cuba. Int J Tuberc Lung Dis. 2011; 15(11):1510-14
[07] Díaz A, Dueñas D, Lazo M, Borroto S, González E. Tuberculosis in health care workers of Psiquistric Hospital at Havana, 1997-2003. Rev Panam Infectol. 2005; 7(3):22-26.
[08] National Office of Statistics and Information. Annual Statistics of La Lisa. Acceded: 15-06-2015. Available at:
[09] Iñigas L. Territorio y contextos en la salud de la población. Simposio Juan Pérez de la Riva in Memorian. 2007.KNCV. Guidelines for conducting tuberculin skin test surveys in high-prevalence countries. Second Edition. IJTLD 2011;15(Suppl 1):S1-S26.
[10] Deddens J, Petersen M. Approaches for estimating prevalence ratios. Occup Environ Med 2008; 65:501-506.
[11] World Health Organization. Guidelines on the management of latent tuberculosis infection. WHO 2015. WHO/HTM/TB/2015.01. Available at:
[12] Thompson N J, Glassroth J L, Snider D E, Farer L S. The booster phenomenon in serial tuberculin testing. Am Rev Respir Dis 1979; 119:587–97.
[13] Farhat M, Greenaway C, Pai M, Menzies D. False-positive tuberculin skin tests: what is the absolute effect of BCG and non-tuberculous mycobacteria? Int J Tuberc Lung Dis. 2006 Nov;10(11):1192-204.
[14] Borroto S, Urbino A, Martínez A. Prevalence of tuberculin reactors in the staff of “Pedro Kourí” Institute for Tropical Medicine, 1996-2000. Rev Cubana Med Trop. 2006; 58(1):85-89.
[15] Borroto S, Sevy J, Fumero M, González E, Machado D. Tuberculosis risk assessment in the staff of the National University Pneumologic Hospital of Havana. Rev Cubana Med Trop. 2012; 64(1):55-60.
[16] Joshi R, Reingold AL, Menzies D, Pai M. Tuberculosis among health-care workers in low and middle-income countries: a systematic review. PLoS Med 2006; 3(12):494.
[17] Menzies D, Joshi R, Pai M: Risk of tuberculosis infection and disease associated with work in health care settings. Int J Tuberc Lung Dis. 2007; 11(6):593-605.
[18] Khanna P, Nikolayevskyy V, Warburton F, Dobson F, Drobniewski F. Rate of latent tuberculosis infection detected by occupational health screening of nurses new to a London teaching hospital. Infect Control Hosp Epidemiol 2009; 30(6):581-4.
[19] Drobniewski F, Balabanova Y, Zakamova E, Nikolayevskyy V, Fedorin I. Rates of Latent Tuberculosis in Health Care Staff in Rusia. PLoS Medicine 2007; 4(2):55.
[20] Škodric V, Savic B, Jovanovic M, Pesic I, Videnovic J, Zugic V, et al. Occupational Risk of Tuberculosis among health care workers at the Institute for Pulmonary Diseases of Serbia. Int J Tuberc Lung Dis 2000; 4(9):827-31.
[21] Torres J, Silva R, Sá R, Cardoso MJ, Nienhaus A. Results of five-years systematic screening for latent tuberculosis infections um healthcare workers in Portugal. J Occup Med Toxicology 2010; 5:22.
[22] Brito G, Iraizoz AM, Alburquerque F. Screening of alcoholism and bioethical analysis of damage provoked in Cuban population. Rev Cubana Med Gen Integr 2011;27(3):355-370.
[23] Vries G, Ebek MM, Langbregts-van Weezen C. Heath care workers with tuberculosis infected during work. Eur Resp J 2006; 28:1216-21.
[24] Hosoglu S, Tanrikulu AC, Dagli C, Akalin S. Tuberculosis among Health Care Workers in a short working period. Am J Infect Control 2005; 33:23-6.
[25] Jiamjarasrangsi W, Hirunsuthikul N, Kamonratanakul R. Tuberculosis among Health Care Workers at King Chulalongkorn Memorial Hospital, 1988-2002. Int J Tuberc Lung Dis 2005; 11:1253-8.
[26] Craven R, Wenzel R, Atuk N. Minimizing tuberculosis risk to hospital personnel and students exposed to unsuspected disease. Ann Intern Med 1975; 82: 628-32.
[27] Franchi A, Richeldi L, Parrinello G, Franco R. Room size is the major determinant for tuberculin conversion. Int Arch Occupational Envir Health 2007; 80:533-8.
[28] He GX, van den Hof S, van der Werf MJ, et al. Infection control and the burden of tuberculosis infection and disease in health care workers in China: a cross-sectional study. BMC Infect Dis 2010; 10:313.
[29] Brantsæter A B, Romanus V, Andersen P H, Heldal E. Evidence of protective effect of BCG vaccination in persons at low risk of tuberculosis in Nordic countries. Int J Tuberc Lung Dis 2009; 13:440–45.
[30] Jasmer R M, Nahid P, Hopewell P. Latent tuberculosis infection. N Engl J Med 2002; 347:1860–66.
[31] Werner E, Sevy J I. Tuberculin Skin Test with 2 PPD-RT23 units in 1588 scholars between 6 to 14 years old no BCG vaccinated. Bol Hig Epidemiol 1968; 6:411–423.
[32] Wilson R. Tuberculin sensibility in a 441 scholars group of middle education level. [Specialty thesis on pediatric]. Havana: Army Hospital ‘Carlos J. Finlay’, 1976.
[33] Joos T, Miller W, Murdoch D. Tuberculin reactivity in bacilli Calmette-Guérin vaccinated populations: a compilation of international data. Int J Lung Dis. 2006; 10(8):883-91.
[34] Fjällbrant H, Rutqvist A, Widström, Zetterberg G, Ridell M, Larson L-O. Tuberculin skin test reactivity of health care students in a country with a low prevalence of tuberculosis. Int J Tuberc Dis. 2010; 14(10):1272-79
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