Rukhsana Javed Farooqi, Mukhthiar Zaman Afridi.
The frequency of tuberculosis infection and tuberculin conversion among health care workers of Khyber Teaching Hospital.
Pak J Chest Med Jan ;14(3):15-20.

Tuberculosis is a fast growing health problem and health care workers are at the greater risk of acquiring it through their occupational exposure. Objective: To conduct a baseline screening of nursing students in Khyber Teaching Hospital (KTH) Peshawar and follow them prospectively for TB infection and Tuberculin conversion after 1 year. Design: A prospective observational cohort analysis. Place and Duration of Study: Department of Pulmonology and Nursing school Khyber Teaching Hospital Peshawar, between Jan 2000 to Jan 2001. Patient and Methods: Baseline screening of 108 newly recruited nursing students of session year 2000 was performed by administering a questionnaire recording their demographic data, previous contact with TB, BCG vaccine scar and any current TB related symptoms. The screening also consisted of physical examination, blood tests, Tuberculin test, and chest radiograph. The same students were evaluated after 1 year to see any change. They were encouraged to report to the study team if any TB related symptoms develop during the year and they were asked to keep diaries of their clinical duties and rotations. Results: The baseline data reveal mean age of 18.5 years and 51 (47.2%) belonged to low income group (Family income less then Rs. 5000.00). Only four (3.7%) had TB contact. BCG scar was present in 61(56.4%) students. Chest examination revealed abnormal findings in two (1.8%) but these were not TB specific. -ESR was normal in all the students. Only two x-rays were showing abnormal findings e.g. scoliosis, left apical and hillar calcification. Tuberculin reaction of >10mm was found in 21(19.4%) students but none of them had active TB. Follow-up at one year revealed that four nursing students have converted from tuberculin negative status to positive signifying recent infection and one student also revealed radiological changes consistent with Pulmonary TB Conclusion: There were no cases of active TB in the nursing students at base line but 3.7% became infected after one year follow up and 0.9% developed pulmonary TB. Nursing students are at higher risk of contracting TB and regular surveillance is recommended.

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