Tuberculosis in healthcare workers: Importance of surveillance and controlprograms.

Objective. To describe tuberculosis surveillance results among healthcare w orkers of a tertiary care center. Material and methods. All medical records of workers from 1992-1998 were reviewed. Demographics, labor, medical hist ory, previous resting, PPD, booster shots and follow-up were analyzed. Stat istical analysis was performed with odds ratios, p-values, and 95% confiden ce intervals. Subgroup analysis were done with chi(2). Kaplan-Meier estimat es were used to analyze times to conversion. Results. Surveillance was done in 1617 workers (68% female and 32% male). Mean age was 26.9+/-7.6(15-68) years. Job positions were 30.5% nurses, 14.6% residents and 14.1% interns. Place of origin was Mexico City in 65.8%. BCG vaccination was present in 71 .6% and 15.1% had previous PPD. Admission PPD was positive in 39.6%, negati ve in 48.3% and 12.1% were lost to follow-up. On negatives, 483 booster sho ts were applied, and 49 additional positives were found. Follow-up was done in 231 workers, of which 100 (43.3%) converted. The mean time for conversi on was 22.8+/-12.4 months. The conversion rate at twelve months was 20%. Fi fty workers received/accepted isoniazid prophylaxis. Conclusions. A high pe rcentage of workers were PPD-positive; booster shots allowed the detection of an additional 10%. A high conversion rate underscores the need to organi ze tuberculosis control programs in Mexico.