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Table 4 Risk factors associated with active TB disease or latent TB infection (LTBI) in health care workers

From: The epidemiology of tuberculosis in health care workers in South Africa: a systematic review

Study ID Age Employment duration Occupation HIV status Diabetes TB IPC training
Incidence of active TB disease
Ayuk et al. [20] Not significantly associated with odds of acquiring TB disease; age 40–49 years most affected by TB disease Not significantly associated with odds of acquiring TB disease Not assessed HIV+ HCWs have significantly increased odds of acquiring TB disease (OR: 67.08 95%CI: 7.5–596.6) Not significantly associated with odds of acquiring TB disease (OR: 1.7 95%CI: 0.8–3.8) No previous training in TB prevention (OR: 2.97 95%CI: 1.2–7.7); no knowledge of TB risk profile of work place (OR: 8.7 95%CI: 1.1–67.96) significantly associated with increased odds of acquiring TB disease
Tudor et al. [18] Not significantly associated with incidence of TB disease Years worked in hospital not significantly associated with incidence of TB disease No significant association between occupational category and incidence of TB disease; history of working in TB ward significantly associated with increased incidence of TB disease (IRR: 2.87 95 % CI: 1.67–4.93) HIV-positivity significantly associated with increase incidence of TB disease (adjIRR: 3.2 95%CI: 1.54–6.66) Not reported on Not reported on
Incidence of latent TB infection
Adams et al. [14] Age 31–40 years significantly associated with increased odds of LTBI (OR: 2.08 95%CI: 1.04, 4.17) Employment in primary level health care facility > 20 years significantly associated with increased odds of LTBI (OR: 3.47, 95%CI 1.01–11.97) Not assessed 3/5 HCWs with TB disease were HIV + HIV+ significantly associated with decreased odds of TSTpos (OR: 0.41 95%CI: 0.17–0.95) Not significantly associated with odds of LTBI In secondary level staff “some training on self-protection from TB infection” significantly associated with decreased odds of LTBI (OR: 0.38 95%CI: 0.16–0.91)
McCarthy et al. [22] IGRA: ≥ 31 years significantly associated with increased risk of latent TB infection (crude IRR: 2.3 95%CI: 0.9, 5.8) TST: No significant association Not reported on IGRA: HCWs had a significantly greater risk of acquiring latent TB infection (crude IRR: 4.32, 95%CI: 1.7–12.2) TST: No significant association No significant association between HIV status and risk of latent TB infection with both IGRA and TST Not reported on IGRA: Higher TB knowledge score (crude IRR: 0.4, 95%CI: 0.1, 1.3) and TB infection control training (crude IRR: 0.4, 95%CI: 0.1, 1.2) significantly reduced risk of latent TB infection TST; TB infection control practiced by participants significantly reduced risk of latent TB infection (crude IRR: 0.4, 95%CI: 0.1, 1.3)
Prevalence of latent TB infection
Van Rie [23] Prevalence of LTBI No significant association with LTBI in medical students or health care workers Not reported on Not assessed in medical students No significant association with LTBI in health care workers Medical students all HIV-negative HIV-negative health care workers significantly reduced odds of TST positive (OR: 0.28 95%CI: 0.1–0.74) Not reported on Medical students: TB knowledge score > 7 (median score) significantly decreased odds of LTBI (adjOR: 0.29 95 % CI: 0.09–0.98) Health care workers: no significant association