The association between Latent TB Infection and Environmental Risk Factors

• Main Authors: Chang, Heng-Cheng, 張恆誠
• Other Authors: Ku chin-hung
• Format: Others
• Language: zh-TW
• Published: 2010
• Online Access: http://ndltd.ncl.edu.tw/handle/51986076203022054970

碩士 === 國防醫學院 === 公共衛生學研究所 === 98 === Tuberculosis(TB) is one of the most important diseases in the world. The World Health Organization(WHO) have been working hard on imm- ediately finding and curing active TB cases, and also focusing on detec- ting latent TB infection(LTBI) earlier, and researching preventive treat- ment for subjects. This is the core of〝The Global Plan To Stop TB 2006- 2015〞from Stop TB Partnership, and〝The Plan To decrease TB Incidence Half 2006-2015〞from the Centers for Disease Control in R.O.C.(Taiwan). There are lots of research which has shown that utilizing the newly developed, Interferon Gamma Release Assay (IGRAs) in screening LTBI is less time consuming and more cost-effective. Also validity inclu- ding sensitivity and specificity, aren’t affected by the bacillus calmette -guérin(BCG) vaccination (in Taiwan BCG is mandatory), nor by non- tuberculous mycobacteria (NTM) infection. This is the reason we choose to use Quanti-FERON-TB Gold In-Tube (QFT-GIT) instead of the much more restricted century-old Tuberculin skin test (TST). The purpose of this study is to recognize environmental risk factors associated with LTBI. So we conducted a cross-sectional study of an annual employee health examination of a selected enterprise. We collect- ed blood samples and handed out questionnaires for each employee who voluntary took part in this study. A total of 885 subjects had agreed to take part in this study. The positive rate of QFT-GIT was 19.21%(170/885). The risk factors asso- ciated with LTBI included age (OR =1.027, 95% CI=1.006-1.048), living area (>80/106) (OR=7.8, 95% CI=5.055- 12.036), TB history (OR=5.542, 95% CI=1.246- 24.656), severe coughing from relative or friends in the vicinity (OR= 2.223, 95%CI=1.036- 4.769), and ventilation of living spa- ce (OR= 2.121, 95%CI=1.026-4.384). We referred QFT-GIT positive subjects to hospital, to rule out active TB cases. We also recommend subjects open doors and windows of their living spaces for adequate ventilation because the increase in air change per hour (ACH) lowers the risk of LTBI. At the end, we suggested sub- jects follow up, and take preventive treatment for LTBI to avoid progre- ssing into active TB after increasing years or during periods of general- ized immunosuppression. The conclusion and recommendation as aforesaid could help deci- sion-making units(DMU) from the selected enterprises to develop pre- vention strategies, and to establish background database for futher study.