Occupational Exposure to Tuberculosis among Health Care Workers: Retrospective Cohort Study at Health Facilities in Lusaka,Zambia
Date
2016
Authors
Nang'amba, Nachombe
Journal Title
Journal ISSN
Volume Title
Publisher
University of Zambia
Abstract
Tuberculosis (TB) is classified as one of the occupational diseases and Health Care Workers
(HCWs) are considered one of the vulnerable groups to acquiring TB due to its mode of
transmission. The health facility being a source of infection for the HCWs creates a vicious
cycle of TB infection back to the communities. This study aimed to establish the burden of
TB among HCWs, assess the working environment of HCWs working from high risk areas as
well as understand their perceptions with regards infection prevention and the use of Personal
Protective Equipment.
A concurrent mixed methods study design was used with the larger part being quantitative.
The study combined retrospective cohort and qualitative case study designs. Information on
TB cases amongst HCWs at facilities that offer TB services was gathered. A checklist was
used to assess environmental working conditions. Interviews with HCWs from high risk areas
using a semi-structured questionnaire was used in the qualitative study. The quantitative data
collected was analysed using Stata version 12. Descriptive characteristics, univariate and
multivariate analysis using logistic regression was done providing crude and adjusted odds
ratios. Thematic analysis was used to analyse the qualitative data by establishing themes.
Triangulation was done at discussion phase of the study.
The prevalence of TB among HCWs was 1801 per 100,000 persons. This is three times
higher than that of the general population in Zambia. The TB low risk area accounted for
70% of the TB cases recorded. Majority of cases recorded were female (61.5%).
Professionals had the highest recorded cases of 47%. Adjusting for professionals Community
volunteers and Support staff had increased odds of 8.6 (AOR 8.2 CI, 1.61-41.6) and 1.11
(AOR 1.4 CI, 0.23-8.52) of acquiring TB respectively. All health facilities largely depended
on natural ventilation although mechanical ventilation was applied where natural ventilation
was insufficient.
Interviews revealed that all HCWs were aware of TB, its modes of transmission and that they
were at risk. The respondents felt that they were better placed as they were more likely to
exercise caution compared to HCWs from low risk areas. This is largely due to the fact that
they handled confirmed cases of TB. Similar studies should be done for HCWs from TB low
risk areas. Periodic screening for TB among HCWs should be encouraged to provide better
monitoring and evaluation of surveillance data and infection prevention measures.
Description
MSC MEDICINE
Keywords
Tuberculosis--Transmission--Prevention--Standards--Zambia , Nosocomial infections--Prevention--Standards--Zambia