OPA9 MANAGEMENT OF HEALTHCARE WORKERS WITH LATENT TB INFECTION: A SINGLE CENTRE EXPERIENCE

Kee Ying Yeoh1, Nur Husna Ibrahim1, Chee Kuan Wong1,2
1. Department of Medicine, Universiti Malaya Medical Centre, Kuala Lumpur 2. Faculty of Medicine, Universiti Malaya, Kuala Lumpur

INTRODUCTION

Healthcare workers (HCWs) have 3-fold risk of developing tuberculosis (TB) disease as compared to general population. TB preventive treatment has been recognized as a safe and effective means to achieve global TB elimination. This study aims to determine the incidence of LTBI among HCWs, treatment completion rate, barriers of treatment initiation and adverse events during treatment. 

METHODS

This is a retrospective study conducted at Universiti Malaya Medical Centre (UMMC) from 1 January 2022 to 31 December 2023. HCWs who had recent exposure to an index case of an infectious TB were screened with a tuberculin skin test (TST). Those with TST of ≥ 10mm were referred to LTBI clinic and screened with IGRA test (T. SPOT TB test) and chest radiograph (CXR). Data of asymptomatic HCWs with positive IGRA test and normal CXR were collected and analysed. 

RESULTS

A total of 1,332 HCWs were screened and 550 (41.3%) of them had a TST of ≥ 10mm. The attendance rate to LTBI clinic was only 49.3% (271/550). IGRA test was performed on 43.9% (119/271) of them, with 21% (25/119) had a positive result, indicating a 9% (25/271) incidence of LTBI. Out of the 25 HCWs, only 11 accepted the TB preventive treatment. Major reasons for declining treatment were fear of treatment side effects (42.9%) and family planning (21.4%). However, 35.7% did not give a specific reason. The treatment completion rate was high (81.8%) with only 2 of them developed mild adverse effects from treatment.

CONCLUSION

There is a high incidence of LTBI among HCW in our centre. The treatment acceptance is low as shown by the poor clinic attendance and treatment initiation. Strategies of TB preventive treatment among HCWs should incorporate an effective awareness and education program.