Tuberculosis in Staff and Students of Patan Hospital

  • Poojan Shrestha Oxford University Clinical Research Unit, Patan Academy of Health Sciences, Kathmandu, Nepal
  • Mila Shakya Oxford University Clinical Research Unit, Patan Academy of Health Sciences, Kathmandu, Nepal
  • Maxine Caws Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
  • Surendra Shrestha Oxford University Clinical Research Unit, Patan Academy of Health Sciences, Kathmandu, Nepal
  • Bibek Karki Oxford University Clinical Research Unit, Patan Academy of Health Sciences, Kathmandu, Nepal
  • Shreejana Shrestha Patan Hospital, Kathmandu, Nepal
  • Dan Bahadur Karki Patan Hospital, Kathmandu, Nepal
  • Bhagwan Maharjan Nepal Anti-Tuberculosis Association/ German Nepal TB Project (GENETUP), Kalimati, Kathmandu, Nepal.
  • Bhawana Shrestha Nepal Anti-Tuberculosis Association/ German Nepal TB Project (GENETUP), Kalimati, Kathmandu, Nepal.
  • Amit Arjyal Oxford University Clinical Research Unit, Patan Academy of Health Sciences, Kathmandu, Nepal
  • Abhilasha Karkey Oxford University Clinical Research Unit, Patan Academy of Health Sciences, Kathmandu, Nepal
  • Krishna G. Prajapati Patan Hospital, Kathmandu, Nepal.
  • Buddha Basnyat Oxford University Clinical Research Unit, Patan Academy of Health Sciences, Kathmandu, Nepal

Abstract

Background: There is a high risk of occupational exposure to tuberculosis among healthcare workers in endemic countries. Regular screening for tuberculosis among healthcare workers is not carried out in Nepal. Infection control measures are also not routinely implemented. The aim of this study was to determine the prevalence of active tuberculosis among staff/students at Patan Hospital.
Methods: Participants were given a self-administered questionnaire and invited to undergo chest radiography. Cases were scored and reviewed based on predetermined criteria, and presumptive tuberculosis cases were invited to undergo sputum smear and culture. Participants were categorized according to the extent of patient contact and asked about history of tuberculosis medication.
Results: Among 560 participants, 76.8% had direct contact with patients. Fifty-eight (10.4%) gave history of cough >2 weeks. Based on symptom history and chest radiography, 20.0% (n=112) cases were reviewed, and 12.5% (n=14) of those reviewed had sputum tested for acid-fast bacilli. One participant had culture-positive tuberculosis. Fifty participants (8.9%) reported tuberculosis in the past, among which 42.0% (n=21) occurred after employment at Patan Hospital and 42.0% before joining Patan Hospital. Security staff, radiology technicians and ward cleaning staff had the highest proportion of cases with a history of tuberculosis.History of tuberculosis medication had no relation with age, sex, education, body mass index and smoking.The incidence rate of tuberculosis at Patan Hospital was 3.6 per 1000 person-years.
Conclusions: Overall incidence of tuberculosis among healthcare workers is noteworthy. However, this study suggests when symptomatic tuberculosis occurs in healthcare worker at Patan Hospital, it is diagnosed and there is not a large pool of undiagnosed tuberculosis.
Keywords: Health personnel; occupational health; tuberculosis.

Published
2018-01-01
How to Cite
SHRESTHA, Poojan et al. Tuberculosis in Staff and Students of Patan Hospital. Journal of Nepal Health Research Council, [S.l.], v. 15, n. 3, p. 268-274, jan. 2018. ISSN 1999-6217. Available at: <http://jnhrc.com.np/index.php/jnhrc/article/view/1172>. Date accessed: 23 oct. 2018.