Face of Nation : Resident doctors are twice as likely to contract tuberculosis (TB) as compared to other nursing students, a study conducted by the B J Medical College (BJMC) and Sassoon General Hospital has found. “Medical residents have been found to be at higher risk for Latent Tuberculosis Infection (LTBI) than other students in indicating high TB disease exposure in the workplace,” said Dr Aarti Kinikar, BJMC professor and one of the lead researchers of the study ‘High risk for latent tuberculosis infection among medical residents and nursing students in India’, which was published in PLoS ONE on July 8.
The researchers studied 200 healthcare workers comprising postgraduate medical residents and nursing students pursuing a bachelor’s degree at BJMC and Sassoon General Hospital (SGH) between May 2016 and December 2017.
Tuberculin skin test (TST) and QuantiFERON TB Gold In-tube Test (QFT-GIT) were performed at study entry and after 12 months. At the baseline, LBTI prevalence was found among 60 out of 200 students(90 nursing students and 110 medical residents). Of the 140 trainees without prevalent LTBI, nine were lost to follow-ups and were excluded from the analysis. Of the 131 remaining trainees, one medical resident developed active TB at nine months, and 35 (27 per cent) trainees tested positive for LTBI at the end of one year, including two medical residents diagnosed with active TB disease, the study found
“Our analysis indicates that medical residents are at two-fold higher risk of acquiring LTBI than nursing students, and time to incident LTBI was significantly shorter for medical residents. Such increased risk is expected given that medical residents have more direct interaction with patients in wards and clinics than nursing students in our setting,” said Kinikar.
According to the WHO, LTBI is defined as a state of persistent immune response to stimulation by myobacterium tuberculosis antigens with no evidence of clinically manifest active TB. According to estimates, at least one-third of the world’s population is infected with myobacterium tuberculosis, and on an average, 5-10 per cent who are infected will develop active TB disease during their lifetime. The risk for active TB disease after infection depends on several factors — the most important being a person’s immunological status.
“Medical residents have spent more time in the hospital during their MBBS training and internship. Since the exposure period is longer, they are also at a higher risk of incident TB infection,” said Kinikar. Efforts to prevent TB exposure and progression to active disease are critical in this high-risk population, the study said.
