Latent Tuberculosis Infection among Health Workers in Germany—A Retrospective Study on Progression Risk and Use of Preventive Therapy

Nika Zielinski, Johanna Stranzinger, Hajo Zeeb, Jan Felix Kersten and Albert Nienhaus
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Nika Zielinski: Faculty 11, Human and Health Sciences, University of Bremen, 28359 Bremen, Germany
Johanna Stranzinger: Department of Occupational Medicine, Toxic Substances, Health Service Research, German Statuary Institution for Accident Insurance and Prevention for Health and Welfare Services (BGW), 22089 Hamburg, Germany
Hajo Zeeb: Faculty 11, Human and Health Sciences, University of Bremen, 28359 Bremen, Germany
Jan Felix Kersten: Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Centre Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
Albert Nienhaus: Department of Occupational Medicine, Toxic Substances, Health Service Research, German Statuary Institution for Accident Insurance and Prevention for Health and Welfare Services (BGW), 22089 Hamburg, Germany

IJERPH, 2021, vol. 18, issue 13, 1-9

Abstract: Despite the decline in tuberculosis incidence (TB) in Germany, health workers (HW) are at greater risk of becoming infected with Mycobacterium tuberculosis . To date, little is known about the risk of progression of latent tuberculosis infections (LTBI) and the use of Tuberculosis Preventive Therapy (TPT) among HW. Routine data from the German Statutory Institution for Accident Insurance and Prevention for Health and Welfare Services (BGW) were analysed and a retrospective survey was conducted. A self-administered questionnaire was sent to 1711 HW who had received recognition of an LTBI as an occupational disease between the years 2009 and 2018. The response rate was 42.3% after correcting for those with no actual address (20.4%). We included 575 HW in the data analysis of the retrospective survey. The cumulative incidence of progression, the incidence density and the associated 95% confidence interval (95% CI) were calculated. Three progressive cases were identified in the analysis of the routine data. In the survey cohort, three HW developed TB during the observation period of 5.4 years on average (standard deviation: 2.8 years; interquartile range: 5.0 years). The cumulative TB incidence was 0.52% in the survey group (95% CI: 0.14% to 1.65%). The incidence density was 0.97 cases per 1000 person years (95% CI: 0.25 to 3.10). One-third of the respondents underwent TPT. Significant differences were observed between age and activity groups in the use of TPT, but not between the genders, year of diagnosis or the reason for performing the screening. The data indicate that the risk of progression of an LTBI is low for HW. However, one-third of the HW had undergone TPT. Information about the expected progression risk is important so that it can be weighed against the risk of side effects of TPT.

Keywords: latent tuberculosis infection (LTBI); progression; Tuberculosis Preventive Therapy (TPT); health workers; occupational health (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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