RT Journal Article
SR Electronic
T1 Cross sectional screening of health care workers (HCW) at a regional chest clinic with an interferon gamma release assay (IGRA): First report from Sri Lanka
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2680
VO 44
IS Suppl 58
A1 Dushantha Madegedara
A1 Champa Ratnatunga
A1 Vasanthi Thevanesam
A1 Dhamith Nandadeva
A1 Athula Kumara
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P2680.abstract
AB Introduction:Screening of HCW for latent tuberculosis (LTBI) is not a routine practice in Sri Lanka, even in moderate risk health care settings.Aim: To evaluate the use of a commercial IGRA (TSPOT.TB Oxford Immunotec, Abingdon, UK) for HCW screening in an intermediate burden, endemic setting.Method:39 HCW (70% of total) working at a regional chest clinic (outpatient treatment of over 200 smear positive TB patients per year) were screened with the IGRA. The Mantoux test had been done on 36 participants as a part of another study 6 months earlier. All participants were BCG vaccinated at birth and none had active TB.Results: Mantoux and IGRA positivity in HCW was 47% and 16% respectively, with a significantly lower IGRA positive rate (p=0.003). Of the HCW who had valid results in both tests, 5 were both IGRA and Mantoux positive, 12 were Mantoux positive and IGRA negative, and 18 were negative with both tests. None had a negative Mantoux with a positive IGRA. Multiple logistic regression showed that working in crowded poorly ventilated areas was a significant risk factor for Mantoux positivity (p=0.020, OR(adj)=10.02) but age, gender, working in high risk areas and duration of service at the clinic were not. Though short duration of service (p=0.036) and male gender (p=0.035) were significantly associated with IGRA positivity in univariate analysis, multiple regression showed that none of the above risk factors were associated. Agreement between the two tests was fair (κ=0.3).Conclusion:The IGRA offers more specific evidence for LTBI than the Mantoux, but positivity is not associated with known risk factors in this setting.