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Correlation Between Frequency of Tuberculosis and Compliance With Control Strategies

Published online by Cambridge University Press:  02 January 2015

Marie-Claude Roy ,
Mary Fredrickson ,
Natalie L. Good ,
S. Ann Hunter  and
Mary D. Nettleman
Marie-Claude Roy*
Affiliation:
Division of General Medicine, Clinical Epidemiology and Health Services Research, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Mary Fredrickson
Affiliation:
Iowa City Veterans' Administration Medical Center, Iowa City, Iowa
Natalie L. Good
Affiliation:
Iowa City Veterans' Administration Medical Center, Iowa City, Iowa
S. Ann Hunter
Affiliation:
Iowa City Veterans' Administration Medical Center, Iowa City, Iowa
Mary D. Nettleman
Affiliation:
Medical College of Virginia, Richmond, Virginia
*
Hôpital L'Enfant-Jésus, Microbiologie, 1401-18 Rue, Québec G1J 1Z4, Canada
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Abstract

Objective:

To determine if compliance with annual tuberculosis skin testing correlated with the number of cases of tuberculosis seen in patients and healthcare workers.

Design:

Survey using a written questionnaire.

Setting and Participants:

159 Veterans' Administration facilities.

Results:

Hospitals that reported that >80% of their healthcare workers received annual skin tests saw 12.7 patient cases per 10,000 admissions and 4.0 healthcare worker cases per 10,000 personnel. Facilities in which <20% of their healthcare workers were given annual skin tests saw 4.5 cases per 10,000 admissions and 1.6 cases in healthcare workers per 10,000 personnel (P<.001 for patients and P=.31 for healthcare workers). The ratio of the median number of patients placed in acid-fast bacilli (AFB) isolation to the median number of patients with confirmed tuberculosis was 12. There was no correlation of this ratio with the number of cases of tuberculosis in patients or healthcare workers seen in each facility.

Conclusion:

Compliance with annual tuberculosis skin testing was related directly to the rate of tuberculosis seen in patients. More standardized policies for placing patients in AFB isolation are needed to control for potentially costly variation among facilities. These measures should have highest priority in the control of tuberculosis in the healthcare setting, before implementing still more expensive interventions.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 18 , Issue 1 , January 1997 , pp. 28 - 31
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1997

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