Conversion Rate of Tuberculin Skin Test among Medical Students in Songklanagarind Hospital

Main Article Content

Sarinpant Pongpant, MD
Chanon Kongkamol, MD

Abstract

OBJECTIVE:
Airborne and Tuberculosis (TB) control measures have been implemented in Songklanagarind hospital. The infection control unit of the hospital has provided a voluntary two-step tuberculin skin test (TST) for pre-clinical medical students and serial TST for clinical medical students. This study aimed to determine the incidence of negative outcome and booster phenomenon from two-step TST as well as the TST conversion rate from serial TST among medical students in the hospital.

MATERIALS AND METHODS:
Percentages of negative cases and boosting phenomenon were calculated from the two-step TST records. Conversion rates of each year were calculated from serial TST data. Then the TST conversion rates were predicted based on the Jointpoint model.

RESULTS:
Two-step TSTs performed from 2001 to 2016 showed 40 to 100% of negative cases and zero to 14% of boosting phenomenon among 2,271 medical students. Serial TSTs from 2002 to 2016 among 665 medical students showed 60 conversion cases. Conversion rates varied from zero to 13.6%. The decline of conversion rates after the year 2006 is demonstrated in 1-Joinpoint model with statistical significance (p = 0.0129). The model corresponded with the timeline data of airborne infection control measures which were mostly implemented after 2006.

CONCLUSIONS:
A decline in TST conversion rate was shown after 2006. This coincided with airborne infection control measures at the institute.

Downloads

Download data is not yet available.

Article Details

How to Cite
1.
Pongpant S, Kongkamol C. Conversion Rate of Tuberculin Skin Test among Medical Students in Songklanagarind Hospital. BKK Med J [Internet]. 2018Sep.20 [cited 2020Jul.15];14(2):17. Available from: https://he02.tci-thaijo.org/index.php/bkkmedj/article/view/222460
Section
Original Article

References

1. World Health Organization. Ending TB in the South-East Asia region : regional strategic plan 2016-2020. India: WHO, Regional Office for South-East Asia; 2016.
2. World Health Organization. Global tuberculosis report 2017. Geneva: WHO; 2015.
3. Committee on regulating occupational exposure to tuberculosis, division of health promotion and disease prevention. Tuberculosis in the workplace. Washington, D.C. United States of America: National Academy Press; 2001.
4. Bonnoci FG, Nair N, Kamble SP. Tuberculosis control in the workplace. In: Schaaf HS, Zumala A, editors. Tuberculosis. A comprehensive clinical reference: Saunders Elsavier; 2009:903-7.
5. World Health Organization. Guidelines on the management of latent tuberculosis infection. Spain: WHO; 2015.
6. Joshi R, Reingold AL, Menzies D, et al. Tuberculosis among health-care workers in low- and middle-income countries: a systematic review. PLoS Med 2006;3:e494.
7. Nasreen S, Shokoohi M, Malvankar-Mehta MS. Prevalence of latent tuberculosis among health care workers in high burden countries: a systematic review and meta-analysis. PLoS One 2016;11.
8. Hohmuth BA. Latent tuberculosis infection: risks to health care students at a hospital in Lima, Peru. Int J Tuberc Lung Dis 2006;10:1146-51.
9. Jirasmitha S, Natekaew P, Siriwat T, et al. Tuberculous infection among clinical year medical students in Budhachinaraj Hospital at Phitsanulok. Thai J Tuberc Chest Dis Cnt Care 2007;28:129-34.
10. Na Narong M, Thongpiyapoom S, Dilpapajakul K, et al. Tuberculin skin test conversion in health care personnel in a university hospital. J Infect Dis Antimicrob Agents 1999;16: 13-5.
11. Schepisi MS, Sotgiu G, Contini S, et al. Tuberculosis transmission from healthcare workers to patients and co-workers: a systematic literature review and meta-analysis. PLoS One 2015;10:e0121639.
12. Menzis D, Schwartzman K, Pai M. Immune-bases tests for tuberculosis. In: Schaaf HS, Zumala A, editors. Tuberculosis. A comprehensive clinical reference: Saunders Elsevier; 2009:179-85.
13. Udompanich V. TB diagnosis. Thai J Tuberc Chest Dis Cnt Care 2009;30:3-22.
14. Casas I, Esteve M, Guerola R, et al. Incidence of tuberculosis infection among healthcare workers: risk factors and 20-year evolution. Respir Med 2013;107:601-7.
15. da Costa PA, Trajman A, Mello FC, et al. Administrative measures for preventing Mycobacterium tuberculosis infection among healthcare workers in a teaching hospital in Rio de Janeiro, Brazil. J Hosp Infect 2009;72:57-64.
16. Incidence of tuberculosis [Internet]. The World Bank Group, 2018 (Accessed Janaury 19, 2018, at https://databank. worldbank.org/data/reports.aspx?source=2&series=SH.TBS. INCD&country=)