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Determinants of Tuberculosis Infection Control–Related Behaviors Among Healthcare Workers in the Country of Georgia

Published online by Cambridge University Press:  04 February 2015

Veriko Mirtskhulava ,
Jennifer A. Whitaker ,
Maia Kipiani ,
Drew A. Harris ,
Nino Tabagari ,
Ashli A. Owen-Smith ,
Russell R. Kempker  and
Henry M. Blumberg
Veriko Mirtskhulava*
Affiliation:
National Center for Tuberculosis and Lung Diseases, Tbilisi, Georgia “AIETI” Medical School, David Tvildiani Medical University, Tbilisi, Georgia
Jennifer A. Whitaker
Affiliation:
Divisions of General Internal Medicine and Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA
Maia Kipiani
Affiliation:
National Center for Tuberculosis and Lung Diseases, Tbilisi, Georgia
Drew A. Harris
Affiliation:
Department of Pulmonary, Critical Care and Sleep Medicine, Yale University New Haven, Connecticut, USA
Nino Tabagari
Affiliation:
“AIETI” Medical School, David Tvildiani Medical University, Tbilisi, Georgia
Ashli A. Owen-Smith
Affiliation:
Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
Russell R. Kempker
Affiliation:
Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, Georgia, USA
Henry M. Blumberg
Affiliation:
Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta, Georgia, USA Departments of Epidemiology and Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
*
Address correspondence to Veriko Mirtskhulava, MD, MPH. “AIETI” Medical School, David Tvildiani Medical University, 2/6 Ljubljana Street, Tbilisi 0159, Georgia ([email protected]).
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Abstract

OBJECTIVE

To better understand tuberculosis (TB) infection control (IC) in healthcare facilities (HCFs) in Georgia.

DESIGN

A cross-sectional evaluation of healthcare worker (HCW) knowledge, beliefs and behaviors toward TB IC measures including latent TB infection (LTBI) screening and treatment of HCWs.

SETTING

Georgia, a high-burden multidrug-resistant TB (MDR-TB) country.

PARTICIPANTS

HCWs from the National TB Program and affiliated HCFs.

METHODS

An anonymous self-administered 55-question survey developed based on the Health Belief Model (HBM) conceptual framework.

RESULTS

In total, 240 HCWs (48% physicians; 39% nurses) completed the survey. The overall average TB knowledge score was 61%. Only 60% of HCWs reported frequent use of respirators when in contact with TB patients. Only 52% of HCWs were willing to undergo annual LTBI screening; 48% were willing to undergo LTBI treatment. In multivariate analysis, HCWs who worried about acquiring MDR-TB infection (adjusted odds ratio [aOR], 1.7; 95% confidence interval [CI], 1.28–2.25), who thought screening contacts of TB cases is important (aOR, 3.4; 95% CI, 1.35–8.65), and who were physicians (aOR, 1.7; 95% CI, 1.08–2.60) were more likely to accept annual LTBI screening. With regard to LTBI treatment, HCWs who worked in an outpatient TB facility (aOR, 0.3; 95% CI, 0.11–0.58) or perceived a high personal risk of TB reinfection (aOR, 0.5; 95% CI, 0.37–0.64) were less likely to accept LTBI treatment.

CONCLUSION

The concern about TB reinfection is a major barrier to HCW acceptance of LTBI treatment. TB IC measures must be strengthened in parallel with or prior to the introduction of LTBI screening and treatment of HCWs.

Infect Control Hosp Epidemiol 2015;00(0): 1–7

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 36 , Supplement 5 , May 2015 , pp. 522 - 528
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

PREVIOUS PRESENTATION. Presented in part at the 43rd World Conference on Lung Health of the International Union of Tuberculosis and Lung Diseases (the Union), Kuala Lumpur, Malaysia, 2012 (abstract, poster #PC-280-16).

*

These authors contributed equally to this work.

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