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Factors associated with mortality from tuberculosis in Iran: an application of a generalized estimating equation-based zero-inflated negative binomial model to national registry data
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Fatemeh Sarvi, Abbas Moghimbeigi, Hossein Mahjub, Mahshid Nasehi, Mahmoud Khodadost
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Epidemiol Health. 2019;41:e2019032. Published online July 9, 2019
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DOI: https://doi.org/10.4178/epih.e2019032
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Abstract
OBJECTIVES Tuberculosis (TB) is a global public health problem that causes morbidity and mortality in millions of people per year. The purpose of this study was to examine the relationship of potential risk factors with TB mortality in Iran.
METHODS This cross-sectional study was performed on 9,151 patients with TB from March 2017 to March 2018 in Iran. Data were gathered from all 429 counties of Iran by the Ministry of Health and Medical Education and Statistical Center of Iran. In this study, a generalized estimating equation-based zero-inflated negative binomial model was used to determine the effect of related factors on TB mortality at the community level. For data analysis, R version 3.4.2 was used with the relevant packages.
RESULTS The risk of mortality from TB was found to increase with the unemployment rate (βˆ=0.02), illiteracy (βˆ=0.04), household density per residential unit (βˆ=1.29), distance between the center of the county and the provincial capital (βˆ=0.03), and urbanization (βˆ=0.81). The following other risk factors for TB mortality were identified: diabetes (βˆ=0.02), human immunodeficiency virus infection (βˆ=0.04), infection with TB in the most recent 2 years (βˆ=0.07), injection drug use (βˆ=0.07), long-term corticosteroid use (βˆ=0.09), malignant diseases (βˆ=0.09), chronic kidney disease (βˆ=0.32), gastrectomy (βˆ=0.50), chronic malnutrition (βˆ=0.38), and a body mass index more than 10% under the ideal weight (βˆ=0.01). However, silicosis had no effect.
CONCLUSIONS The results of this study provide useful information on risk factors for mortality from TB.
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Prevalence of latent tuberculosis infection among tuberculosis laboratory workers in Iran
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Mahshid Nasehi, Abdolrazagh Hashemi-Shahraki, Amin Doosti-Irani, Saeed Sharafi, Ehsan Mostafavi
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Epidemiol Health. 2017;39:e2017002. Published online December 30, 2016
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DOI: https://doi.org/10.4178/epih.e2017002
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19,685
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367
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11
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Abstract
OBJECTIVES The risk of transmission of <i>Mycobacterium tuberculosis</i> from patients to health care workers (HCWs) is a neglected problem in many countries, including Iran. The aim of this study was to estimate the prevalence of latent tuberculosis (TB) infection (LTBI) among TB laboratory staff in Iran, and to elucidate the risk factors associated with LTBI.
METHODS All TB laboratory staff (689 individuals) employed in the TB laboratories of 50 Iranian universities of medical sciences and a random sample consisting of 317 low-risk HCWs were included in this cross-sectional study. Participants with tuberculin skin test indurations of 10 mm or more were considered to have an LTBI.
RESULTS The prevalence of LTBI among TB laboratory staff and low-risk HCWs was 24.83% (95% confidence interval [CI], 21.31 to 27.74%) and 14.82% (95% CI, 11.31 to 19.20%), respectively. No active TB cases were found in either group. After adjusting for potential confounders, TB laboratory staff were more likely to have an LTBI than low-risk HCWs (prevalence odds ratio, 2.06; 95% CI, 1.35 to 3.17).
CONCLUSIONS This study showed that LTBI are an occupational health problem among TB laboratory staff in Iran. This study reinforces the need to design and implement simple, effective, and affordable TB infection control programs in TB laboratories in Iran.
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Summary
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Citations
Citations to this article as recorded by
- Prevalence and incidence of tuberculosis in health workers: A systematic review of the literature
Eni Hilário da Silva, Ercilia Lima, Talita Raquel dos Santos, Maria Clara Padoveze American Journal of Infection Control.2022; 50(7): 820. CrossRef - Mycobacterium tuberculosis infection and disease in healthcare workers in a tertiary referral hospital in Bandung, Indonesia
Lika Apriani, Susan McAllister, Katrina Sharples, Isni Nurul Aini, Hanifah Nurhasanah, Rovina Ruslami, Dick Menzies, Philip C Hill, Bachti Alisjahbana Journal of Infection Prevention.2022; 23(4): 155. CrossRef - Prevalence of modifiable risk factors of tuberculosis and their population attributable fraction in Iran: A cross-sectional study
Kamal Sadeghi, Jalal Poorolajal, Amin Doosti-Irani, Mohammad Asghari Jafarabadi PLOS ONE.2022; 17(8): e0271511. CrossRef - Prevalence of Latent Tuberculosis Infection in the Middle East and North Africa: A Systematic Review
Mazin Barry, Stefano Centanni Pulmonary Medicine.2021; 2021: 1. CrossRef - Meta-analysis of latent tuberculosis in healthcare workers in Iran: a retrospective review
NazaninZahra Sepehri, Seyed Mohammad Saghanezhad, Farshad Khoddami, Amin Arasteh, Marziyeh Delirakbariazar, Azad Khaledi Transactions of The Royal Society of Tropical Medicine and Hygiene.2021; 115(9): 965. CrossRef - Prevalence of latent tuberculosis infection among health workers in Afghanistan: A cross-sectional study
Ghulam Qader Qader, Mohammad Khaled Seddiq, Khakerah Mohammad Rashidi, Lutfullah Manzoor, Azizullah Hamim, Mir Habibullah Akhgar, Laiqullrahman Rahman, Sean Dryer, Mariah Boyd-Boffa, Aleefia Somji, Muluken Melese, Pedro Guillermo Suarez, Ramesh Kumar PLOS ONE.2021; 16(6): e0252307. CrossRef - Occupational Tuberculosis Among Laboratory Workers in South Africa: Applying a Surveillance System to Strengthen Prevention and Control
Jennica Garnett, David Jones, Graham Chin, Jerry M. Spiegel, Annalee Yassi, Nisha Naicker International Journal of Environmental Research and Public Health.2020; 17(5): 1462. CrossRef - Latent tuberculosis infection in healthcare workers in low- and middle-income countries: an updated systematic review
Lika Apriani, Susan McAllister, Katrina Sharples, Bachti Alisjahbana, Rovina Ruslami, Philip C. Hill, Dick Menzies European Respiratory Journal.2019; 53(4): 1801789. CrossRef - A Study of The Prevalence of Latent Tuberculosis in Household Contacts of Patients with Active Tuberculosis in Kurdistan Region of Iraq: A Brief Report
Nawfal Hussein, Amer A Balatay , Lokman A Almizori, Hilbeen H Saifullah International Journal of Infection.2019;[Epub] CrossRef - Is latent tuberculosis infection challenging in Iranian health care workers? A systematic review and meta-analysis
Mohammad Hossein YektaKooshali, Farahnaz Movahedzadeh, Ali Alavi Foumani, Hoda Sabati, Alireza Jafari, HASNAIN SEYED EHTESHAM PLOS ONE.2019; 14(10): e0223335. CrossRef - Investigating the Prevalence of Latent Tuberculosis among Healthcare Workers of Major Hospitals of Ahvaz, Iran
Amir Hooshang Bavarsad, Esmaiel Idani, Maryam Haddadzadeh Shoushtari Journal of Intellectual Disability - Diagnosis and Treatment.2019; 7(4): 237. CrossRef
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Comparison of the tuberculin skin test and the QuantiFERON-TB Gold test in detecting latent tuberculosis in health care workers in Iran
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Ehsan Mostafavi, Mahshid Nasehi, Abdolrazagh Hashemi Shahraki, Saber Esmaeili, Ebrahim Ghaderi, Saeed Sharafi, Amin Doosti-Irani
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Epidemiol Health. 2016;38:e2016032. Published online July 24, 2016
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DOI: https://doi.org/10.4178/epih.e2016032
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18,410
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Abstract
OBJECTIVES The tuberculin skin test (TST) and the QuantiFERON-TB Gold test (QFT) are used to identify latent tuberculosis infections (LTBIs). The aim of this study was to determine the agreement between these two tests among health care workers in Iran.
METHODS This cross-sectional study included 177 tuberculosis (TB) laboratory staff and 67 non-TB staff. TST indurations of 10 mm or more were considered positive. The Student’s t-test and the chi-square test were used to compare the mean score and proportion of variables between the TB laboratory staff and the non-TB laboratory staff. Kappa statistics were used to evaluate the agreement between these tests, and logistic regression was used to assess the risk factors associated with positive results for each test.
RESULTS The prevalence of LTBIs according to both the QFT and the TST was 17% (95% confidence interval [CI], 12% to 21%) and 16% (95% CI, 11% to 21%), respectively. The agreement between the QFT and the TST was 77.46%, with a kappa of 0.19 (95% CI, 0.04 to 0.34).
CONCLUSIONS Although the prevalence of LTBI based on the QFT and the TST was not significantly different, the kappa statistic was low between these two tests for the detection of LTBIs.
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Citations
Citations to this article as recorded by
- Tuberculin test using Indian indigenous purified-protein derivative (PPD) shows only moderate agreement with international standard PPD
Devasahayam J. Christopher, N. Priya, Deepa Shankar, Barney Isaac, Andrea DeLuca, Sonali Sarkar, Senbagavalli Prakash Babu, Prasanna Samuel, Adithya Cattamanchi, Amita Gupta, Jerrold Ellner, Sudha Srinivasan, Samyra Cox, Balamugesh Thangakunam Journal of Clinical Tuberculosis and Other Mycobacterial Diseases.2024; 34: 100404. CrossRef - Performance of Current Diagnostic Tools in Detecting Latent Tuberculosis Among Healthcare Workers: A Systematic Review
Aishwarya R, Maheshwary D, Leela KV, Vijay R Suriya, Kanya R Cureus.2024;[Epub] CrossRef - Meta-analysis of latent tuberculosis in healthcare workers in Iran: a retrospective review
NazaninZahra Sepehri, Seyed Mohammad Saghanezhad, Farshad Khoddami, Amin Arasteh, Marziyeh Delirakbariazar, Azad Khaledi Transactions of The Royal Society of Tropical Medicine and Hygiene.2021; 115(9): 965. CrossRef - Risk of Occupational Latent Tuberculosis Infection among Health Personnel Measured by Interferon-Gamma Release Assays in Low Incidence Countries—A Systematic Review and Meta-Analysis
Claudia Peters, Agnessa Kozak, Albert Nienhaus, Anja Schablon International Journal of Environmental Research and Public Health.2020; 17(2): 581. CrossRef - Latent tuberculosis infection in healthcare workers in low- and middle-income countries: an updated systematic review
Lika Apriani, Susan McAllister, Katrina Sharples, Bachti Alisjahbana, Rovina Ruslami, Philip C. Hill, Dick Menzies European Respiratory Journal.2019; 53(4): 1801789. CrossRef - Latent Tuberculosis Infection among Healthcare Workers in Duhok Province: From Screening to Prophylactic Treatment
Hind Bahzad Almufty, Ibtesam Salih Abdulrahman, Muayad Aghali Merza Tropical Medicine and Infectious Disease.2019; 4(2): 85. CrossRef - Is latent tuberculosis infection challenging in Iranian health care workers? A systematic review and meta-analysis
Mohammad Hossein YektaKooshali, Farahnaz Movahedzadeh, Ali Alavi Foumani, Hoda Sabati, Alireza Jafari, HASNAIN SEYED EHTESHAM PLOS ONE.2019; 14(10): e0223335. CrossRef - Interferon-gamma release assay for the diagnosis of latent tuberculosis infection: A latent-class analysis
Tan N. Doan, Damon P. Eisen, Morgan T. Rose, Andrew Slack, Grace Stearnes, Emma S. McBryde, Lei Gao PLOS ONE.2017; 12(11): e0188631. CrossRef - Prevalence of latent tuberculosis infection among tuberculosis laboratory workers in Iran
Mahshid Nasehi, Abdolrazagh Hashemi-Shahraki, Amin Doosti-Irani, Saeed Sharafi, Ehsan Mostafavi Epidemiology and Health.2016; 39: e2017002. CrossRef
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