Analysis Of Latent Tuberculosis Infection And Related Factors In A Medical Institution

Objective:Through questionnaire surveys and screening of latent tuberculosis infection among all medical staff and some close contacts of tuberculosis patients(referring to family members and nursing workers)in a medical institution,we can understand the status of latent tuberculosis infection and related factors,and strengthen the focus of medical institutions.Provide scientific basis for population protection and control of latent tuberculosis infection.Methods:Select all medical staff who did not have obvious symptoms of tuberculosis in a hospital in Jilin Province from June 2019 to December 2019.Use convenient sampling methods to select some close contacts of hospitalized tuberculosis patients for questionnaire surveys,and collect blood samples for tuberculosis branches Bacillus-specific cellular immune response detection(Quanti FERON-TB experiment).The research content includes description of the general population characteristics in medical institutions,general demographic characteristics of medical staff,past history,general demographic characteristics of close contacts,past history,contact with tuberculosis patients;analysis of medical staff and close contacts of latent tuberculosis infection Related factors.The Epidata3.1 software was used to establish the database,and the data statistics and analysis used SPSS24.0software.The measurement data were described using the mean±standard deviation;the counting data was described using the rate and composition ratio;the univariate analysis was using the chi-square test;the multivariate analysis was using the unconditional Logistic regression model,and P<0.05 considered the difference to be statistically significant.Results:1.In this study,450 questionnaires were distributed and 450 were returned.There were 423 valid questionnaires,with an effective rate of 94%.A total of 423 cases of personnel in the medical institution were collected,including 330 medical staff(78.01%);93 close contacts(including 59 patients’ family members and 34nurses),(21.99%).2.Among the medical staff,there are 93 males(28.18%)and 237 females(71.82%).The oldest age is 64 years old,the youngest age is 21 years old,and the average age is 40.27±10.87 years old.Among them,31-50 years old are the most,with a total of 181 cases(54.85%);the maximum number of associates/undergraduates is 267(80.91%)).The highest number of medical staff who never smoked but had passive smokers was 135(40.91%).276 medical staff had been vaccinated with BCG vaccine(83.64%).3.A total of 59 cases(63.44%)of close contacts and patients were family members,and 34 cases(36.56%)of nursing staff.There were 47 males(50.54%)and46 females(49.46%).The oldest age was 77 years old,the youngest age was 26 years old,and the average age was 48.60±12.61 years old;the number of close contacts who never and did not have passive smokers was the largest There were 37cases(accounting for 40.86%);62 cases had been vaccinated with BCG vaccine(accounting for 66.67%).50 cases(53.76%)were in contact with tuberculosis patients within two months of diagnosis;43 cases(46.24%)were in contact with tuberculosis patients for more than 8 hours;55 cases(59.14%)were exposed to windows every day.%);The number of people in contact with tuberculosis patients with an area of 0-60m2 is at most 48 cases(51.61%).4.Among the 423 survey subjects,there were 147 cases of latent tuberculosis infection,accounting for 34.75%;among them,128 cases of medical staff were infected(accounting for 30.26%);19 cases of close contacts(accounting for 4.49%).5.The results of a single factor analysis of the latent tuberculosis infection group and the uninfected group of medical staff showed that factors such as gender,age,education level,body mass index,average monthly income,smoking history,anemia,whether to inoculate BCG vaccination and other factors in the tuberculosis latent infection group were compared with those in the uninfected group.The distribution difference of the uninfected group was statistically significant(P<0.05).The results of multivariate analysis showed that: male(OR=2.766;95%CI:1.548～4.942);31-50 years old(OR=2.912;95%CI: 1.340～6.328),≥51 years old(OR=14.466;95%CI):5.477～38.212);never smoked but passive smoking,smoking(OR=2.135;95%CI: 1.145～3.983),(OR=2.792;95%CI: 1.145～3.983);anemia(OR=5.721;95 %CI: 2.222～14.729)medical staff have an increased risk of latent tuberculosis infection.6.The results of a single factor analysis of the latent tuberculosis infection group and the uninfected group of close contacts showed that factors such as gender,age,education level,smoking history,whether to inoculate BCG,relationship with the patient,and the length of daily contact with tuberculosis patients,etc.The distribution difference between the infected group and the uninfected group was statistically significant(P<0.05).The results of multivariate analysis showed that:males(OR=9.632;95%CI: 1.208～76.776);close contacts with tuberculosis patients for more than 8 hours a day(OR=7.096;95%CI: 1.366～36.868)tuberculosis latency The risk of infection increases.Conclusions:1.The latent tuberculosis infection rate of this medical institution is at a low level nationwide,and the infection rate of medical staff is higher than that of close contacts.2.Medical staff with latent tuberculosis infections are mostly those aged 31-50 years old,most of whom have been vaccinated with BCG;males,older persons,with a history of smoking or non-smokers but with a history of passive smoking,and patients with anemia are at risk of latent tuberculosis infection increase.3.Close contacts with latent tuberculosis infection are mostly low-educated,never vaccinated with BCG vaccine,and contact with patients for longer than 8 hours;males,contact with patients longer than 8 hours have an increased risk of latent tuberculosis infection.