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Tuberculin Skin Testing Among Healthcare Workers in the University of Malaya Medical Centre, Kuala Lumpur, Malaysia

Published online by Cambridge University Press:  02 January 2015

Lian-HuatTan ,
Adeeba Kamarulzaman ,
Chong-Kin Iiam  and
Toong-Chow Lee
Lian-HuatTan*
Affiliation:
Infectious Diseases Division, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
Adeeba Kamarulzaman
Affiliation:
Infectious Diseases Division, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
Chong-Kin Iiam
Affiliation:
Respiratory Diseases Division, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
Toong-Chow Lee
Affiliation:
Clinical Investigation Centre, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
*
Department of Medicine, University of Malaya Medical Centre, 59100, Kuala Lumpur, Malaysia
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Abstract

Objectives:

To determine the occupational risk of Mycobacterium tuberculosis infection among healthcare workers (HCWs) and to examine the utility of tuberculin skin testing in a developing country with a high prevalence of bacille Calmette-Guerin vaccination.

Design:

Tuberculin skin test (TST) survey.

Setting:

A tertiary-care referral center and a teaching hospital in Kuala Lumpur, Malaysia.

Participants:

HCWs from medical, surgical, and orthopedic wards.

Intervention:

Tuberculin purified protein derivative RT-23 (State Serum Institute, Copenhagen, Denmark) was used for the TST (Mantoux method).

Results:

One hundred thirty-seven (52.1%) and 69 (26.2%) of the HCWs tested had indurations of 10 mm or greater and 15 mm or greater, respectively. Medical ward HCWs were at significantly higher risk of a positive TST reaction than were surgical or orthopedic ward HCWs (odds ratio, 2.18; 95% confidence interval, 1.33 to 3.57; P = .002 for TST positivity at 10 mm or greater) (odds ratio, 2.61; 95% confidence interval, 1.44 to 4.70; P = .002 for TST positivity at 15 mm or greater). A previous TST was a significant risk factor for a positive TST reaction at either 10 mm or greater or 15 mm or greater, but a duration of employment of more than 1 year and being a nurse were only significantly associated with a positive TST reaction at a cut-off point of 15 mm or greater.

Conclusions:

HCWs at the University of Malaya Medical Centre had an increased risk for M. tuberculosis infection that was significantly associated with the level of occupational tuberculosis exposure. A TST cut-off point of 15 mm or greater may correlate better with M. tuberculosis infection than a cut-off point of 10 mm or greater in settings with a high prevalence of bacille Calmette-Guerin vaccination (Infect Control Hosp Epidemiol 2002;23:584-590).

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 23 , Issue 10 , October 2002 , pp. 584 - 590
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

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