The Benefit of Quantiferon-TB Gold Plus in The Incidence of Tb Disease in Health Care Workers (Environment Control)

Abstract

This study detected the benefit of using a calculated air change model to prevent TB organisms’ transmission in Healthcare workers. The high-risk group contained Health care workers who usually contacted TB patients. 659 of 1351 Health care workers of Central Chest Institute of Thailand were enrolled and separated to 3 groups: 257 health care workers in high-risk group who work in the area which highly developed air change model, 55 health care workers in the high-risk group with the underdeveloped air change and 347 Health care workers in the low-risk group. This study used the QuantiFERON-TB Gold Plus test to diagnose Latent TB infection (LTBI). Result: 87 (13.2%) health care workers had positive results with IGRA, cut off point ≥ 0.35 iu/ml). Positive IGRA participants had an increased risk of active TB in one year, RR 13.10 (95% CI 2.4- 70.47), p=0.0001 (multivariate analysisadjusted age, sex, a period of employment, workplace). Sensitivity and specificity of IGRA ability to predicted TB disease was 66.7% (95% CI 22.3- 95.7%) and 87.3% (95% CI 84.4 - 89.7%). 38 of 257( 14.7%) high-risk group with highly developed air change model, 13 of 55 ( 23.6%) high-risk group with underdeveloped air change model, and 36 of 347 ( 10.3%) low-risk groups were positive IGRA. There was no significant difference in LTBI between high-risk patients with the highly developed area and low-risk, p= 0.33. 4 of 43 abnormal CXR participants and 2 of 45 positive IGRA results in last 2 years had positive IGRA in TB2-TB1 difference group. One participant who was in both of the mentioned groups had TB disease (interferon-γ concentration in TB2-TB1 difference was 2.59 iu/ml). Participants who positive in TB1 Ag, TB2 Ag and Citation: angsayunh, P., Sanchat, T., Janrodpai, W., Boonyasopun, J., Vijitsanguan, C. (2021) The Benefit of Quantiferon-TB Gold Plus in The Incidence of Tb Disease in Health Care Workers (Environment Control). J Pulm Med Respir Care, 3(1): 01-08. Journal of Pulmonary Medicine and Respiratory Care © 2021 Somato Publications. All rights reserved. Volume 3 Issue 1 - 1006 02 TB2- TB 1 difference group had proportion of TB disease in 11.1 %, 16.7% and 50%, respectively, significant difference p= 0.04. Summary: Having a Good environment, more than 12 ACH, was one of the best ways to prevent airborne transmission especially TB infection. In some situations, such as the high prevalence of TB infection, detecting CD8+ T lymphocyte response (in TB2-TB1 difference) would be better.