Latent tuberculosis infection among health care workers at a general hospital in Santiago de Cuba

OBJECTIVES: To determine the prevalence of latent tuberculosis infection (LTBI) and its predictors in general hospital personnel. METHODS: Two tuberculin skin tests (TSTs) were carried out within 2 years in a sample of 371 health care workers (HCWs) at a general hospital in Santiago de Cuba Province, along with an interview to explore the association of LTBI with age, sex, occupation, contact history of TB and bacille Calmette-Guérin scar. A 10 mm cut-off point was used; an increase of ≥10 mm in the second TST was considered as tubercu- lin conversion. RESULTS: Of the 350 HCWs with available TST re- sults, 82% were female; the mean age was 37.6 years. LTBI prevalence was 15.4%: it was highest in profes- sionals (20.6%); 60.3% were non-reactors, and at the second test a year later 1.4% were converters. Among the HCWs, physicians had the highest prevalence (21.8%), followed by nurses (19.6%), while administra- tive staff had the lowest prevalence (3.3%). The mean induration was 3.78 mm; it was highest in professionals (4.4 mm) and the lowest among support staff (2.6 mm). Contact with TB cases was found to be a risk factor for LTBI. CONCLUSIONS: Even at low levels, TB transmission in this hospital could be associated with risk exposure. It is recommended that preventive chemotherapy be given to tuberculin converters as an infection control measure in this hospital.