Risk of tuberculosis infection among community health agents

• Published in: Revista de saúde pública Vol. 44; no. 2; pp. 332 - 338
• Main Authors: Moreira, T R, Zandonade, E, Maciel, ELN
• Format: Journal Article
• Language: Portuguese
• Published: 01.04.2010
• Subjects: Mycobacterium; Brazil
• ISSN: 0034-8910

OBJECTIVE: To estimate the risk of tuberculosis infection among community health agents involved in disease control. METHODS: Aprospective cohort was followed up from April 2007 to May 2008 in the municipality of Cachoeiro de Itapemirim, Southeastern Brazil. The cohort was composed of 61 community agents, divided between unexposed individuals (n = 37) and exposed individuals (who were following up tuberculosis patients; n = 24). Over the 12-month follow-up, the tuberculin test was performed, using the tuberculin PPD RT23. The relative risk and 95% confidence interval were calculated, and the correlation between tuberculin response and the agents' occupational history was evaluated by means of Pearson's correlation. RESULTS: The incidence of the response was 41.7% in the exposed group and 13.5% in the unexposed group. The annual risk of infection was 52.8% in the exposed group and 14.4% in the unexposed group (p = 0.013) An association between tuberculin response and exposure to patients with tuberculosis was observed (RR = 3.08; 95% CI: 1.201; 7.914). CONCLUSIONS: The agents who followed up tuberculosis patients during their routine work presented a greater risk of infection than did those who were not following up such patients. Implementation of routine administrative biosafety measures, among which the tuberculin test, should. be prioritized, given the high risk of acquiring tuberculous infection among community health agents.Original Abstract: OBJETIVO: Estimar o risco de infeccao tuberculosa em agentes comunitarios de saude envolvidos no controle da doenca. METODOS: Foi seguida uma coorte prospectiva, de abril de 2007 a maio de 2008, no municipio de Cachoeiro de Itapemirim, ES. A coorte foi composta por 61 agentes comunitarios, divididos em nao-expostos (n=37) e expostos (que acompanharam pacientes com tuberculose, n=24). Durante os 12 meses de seguimento, foi realizado teste tuberculinico, utilizando atuberculina PPD RT23. Foi calculado o risco relativo e intervalo com 95% de confianca e foi avaliada a correlacao entre a viragem tuberculinica e a historia ocupacional dos agentes por meio do coeficiente de correlacao de Pearson. RESULTADOS: A incidencia da viragem foi de 41,7% no grupo dos expostos e 13,5% no grupo dos nao expostos. O risco anual de infeccao foi de 52,8% no grupo dos expostos e de 14,4% no grupo dos nao expostos (p= 0,013). Observou-se associacao entre viragem tuberculinica e exposicao a paciente com tuberculose (RR= 3,08; IC 95%: 1,201; 7,914). CONCLUSOES: Os agentes que acompanharam pacientes com tuberculose em suas rotinas de servico apresentaram risco de infeccao maior que aqueles que nao acompanharam pacientes com essa doenca. A implementacao de medidas administrativas de biosseguranca de rotina, entre as quais a prova tuberculinica, devem ser priorizadas, considerando o alto risco de infeccao tuberculosa entre os agentes comunitarios de saude.