Effectiveness of control measures to prevent occupational tuberculosis infection in health care workers: a systematic review

dc.contributor.authorSchmidt, Bey-Marrié
dc.contributor.authorEngel, Mark E
dc.contributor.authorAbdullahi, Leila
dc.contributor.authorEhrlich, Rodney
dc.date.accessioned2018-05-28T09:42:49Z
dc.date.available2018-05-28T09:42:49Z
dc.date.issued2018-05-25
dc.date.updated2018-05-27T03:30:08Z
dc.description.abstractBackground A number of guideline documents have been published over the past decades on preventing occupational transmission of tuberculosis (TB) infection in health care workers (HCWs). However, direct evidence for the effectiveness of these controls is limited particularly in low-and middle-income (LMIC) countries. Thus, we sought to evaluate whether recommended administrative, environmental and personal protective measures are effective in preventing tuberculin skin test conversion among HCWs, and whether there has been recent research appropriate to LMIC needs. Methods Using inclusion criteria that included tuberculin skin test (TST) conversion as the outcome and longitudinal study design, we searched a number of electronic databases, complemented by hand-searching of reference lists and contacting experts. Reviewers independently selected studies, extracted data and assessed study quality using recommended criteria and overall evidence quality using GRADE criteria. Results Ten before-after studies were found, including two from upper middle income countries. All reported a decline in TST conversion frequency after the intervention. Among five studies that provided rates, the size of the decline varied, ranging from 35 to 100%. Since all were observational studies assessed as having high or unclear risk of bias on at least some criteria, the overall quality of evidence was rated as low using GRADE criteria. Conclusion We found consistent but low quality of evidence for the effectiveness of combined control measures in reducing TB infection transmission in HCWs in both high-income and upper-middle income country settings. However, research is needed in low-income high TB burden, including non-hospital, settings, and on contextual factors determining implementation of recommended control measures. Explicit attention to the reporting of methodological quality is recommended. Trial registration This systematic review was registered with PROSPERO in 2014 and its registration number is CRD42014009087 .
dc.identifier.apacitationSchmidt, B., Engel, M. E., Abdullahi, L., & Ehrlich, R. (2018). Effectiveness of control measures to prevent occupational tuberculosis infection in health care workers: a systematic review. <i>BMC Public Health</i>, http://hdl.handle.net/11427/28164en_ZA
dc.identifier.chicagocitationSchmidt, Bey-Marrié, Mark E Engel, Leila Abdullahi, and Rodney Ehrlich "Effectiveness of control measures to prevent occupational tuberculosis infection in health care workers: a systematic review." <i>BMC Public Health</i> (2018) http://hdl.handle.net/11427/28164en_ZA
dc.identifier.citationBMC Public Health. 2018 May 25;18(1):661
dc.identifier.ris TY - Journal Article AU - Schmidt, Bey-Marrié AU - Engel, Mark E AU - Abdullahi, Leila AU - Ehrlich, Rodney AB - Background A number of guideline documents have been published over the past decades on preventing occupational transmission of tuberculosis (TB) infection in health care workers (HCWs). However, direct evidence for the effectiveness of these controls is limited particularly in low-and middle-income (LMIC) countries. Thus, we sought to evaluate whether recommended administrative, environmental and personal protective measures are effective in preventing tuberculin skin test conversion among HCWs, and whether there has been recent research appropriate to LMIC needs. Methods Using inclusion criteria that included tuberculin skin test (TST) conversion as the outcome and longitudinal study design, we searched a number of electronic databases, complemented by hand-searching of reference lists and contacting experts. Reviewers independently selected studies, extracted data and assessed study quality using recommended criteria and overall evidence quality using GRADE criteria. Results Ten before-after studies were found, including two from upper middle income countries. All reported a decline in TST conversion frequency after the intervention. Among five studies that provided rates, the size of the decline varied, ranging from 35 to 100%. Since all were observational studies assessed as having high or unclear risk of bias on at least some criteria, the overall quality of evidence was rated as low using GRADE criteria. Conclusion We found consistent but low quality of evidence for the effectiveness of combined control measures in reducing TB infection transmission in HCWs in both high-income and upper-middle income country settings. However, research is needed in low-income high TB burden, including non-hospital, settings, and on contextual factors determining implementation of recommended control measures. Explicit attention to the reporting of methodological quality is recommended. Trial registration This systematic review was registered with PROSPERO in 2014 and its registration number is CRD42014009087 . DA - 2018-05-25 DB - OpenUCT DP - University of Cape Town J1 - BMC Public Health LK - https://open.uct.ac.za PB - University of Cape Town PY - 2018 T1 - Effectiveness of control measures to prevent occupational tuberculosis infection in health care workers: a systematic review TI - Effectiveness of control measures to prevent occupational tuberculosis infection in health care workers: a systematic review UR - http://hdl.handle.net/11427/28164 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12889-018-5518-2
dc.identifier.urihttp://hdl.handle.net/11427/28164
dc.identifier.vancouvercitationSchmidt B, Engel ME, Abdullahi L, Ehrlich R. Effectiveness of control measures to prevent occupational tuberculosis infection in health care workers: a systematic review. BMC Public Health. 2018; http://hdl.handle.net/11427/28164.en_ZA
dc.language.isoen
dc.publisherBioMed Central
dc.publisher.departmentDepartment of Psychiatry and Mental Healthen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rights.holderThe Author(s).
dc.sourceBMC Public Health
dc.source.urihttps://bmcpublichealth.biomedcentral.com/
dc.subject.otherSystematic review
dc.subject.otherTuberculosis
dc.subject.otherHealth care workers
dc.subject.otherTransmission control
dc.subject.otherTuberculin skin test
dc.titleEffectiveness of control measures to prevent occupational tuberculosis infection in health care workers: a systematic review
dc.typeJournal Article
uct.type.filetypeText
uct.type.filetypeImage
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