Treatment of latent tuberculous infection among health care workers at a tertiary hospital in Korea

Int J Tuberc Lung Dis. 2018 Nov 1;22(11):1336-1343. doi: 10.5588/ijtld.18.0280.

Abstract

Objective: To evaluate the acceptance of, adherence to, and outcomes of latent tuberculous infection (LTBI) treatment among health care workers (HCWs).

Design: This was a retrospective study in a tertiary hospital in Korea. From May to August 2017, 2190 HCWs simultaneously underwent a tuberculin skin test (TST) and interferon-gamma release assay (IGRA). LTBI was diagnosed if the TST induration was 10 mm or IGRA results were positive.

Results: Of 2190 HCWs tested, 1006 (45.9%) were diagnosed with LTBI. Of these, 655 (65.1%) HCWs visited out-patient clinics, 234 (35.7%) of whom were advised treatment by physicians. Among these, 120 (51.3%) accepted the physicians' recommendations. In general, HCWs who were older, male and smoked were less likely to visit out-patient clinics. Sixty (50%) HCWs received 3 months of isoniazid plus rifampicin (3HR) and 57 (47.5%) HCWs received 4 months of rifampicin (4R). The proportion of HCWs with 2 side effects (3HR 20% vs. 4R 7.0%, P = 0.041) and drug stoppage rate (3HR 20% vs. 4R 5.3%, P = 0.017) were higher in the 3HR group than in the 4R group. Of the 120 HCWs, 78 (65%) completed LTBI treatment.

Conclusion: Overall, the acceptance and completion rate for LTBI treatment was not adequate. For effective LTBI management in HCWs, further programmatic strategies are needed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibiotics, Antitubercular / adverse effects
  • Antibiotics, Antitubercular / therapeutic use*
  • Assessment of Medication Adherence*
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Health Personnel / statistics & numerical data*
  • Humans
  • Interferon-gamma Release Tests
  • Isoniazid / therapeutic use
  • Latent Tuberculosis / diagnosis
  • Latent Tuberculosis / drug therapy*
  • Latent Tuberculosis / epidemiology*
  • Male
  • Middle Aged
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • Rifampin / therapeutic use
  • Tertiary Care Centers
  • Tuberculin Test
  • Young Adult

Substances

  • Antibiotics, Antitubercular
  • Isoniazid
  • Rifampin