Tuberculosis among healthcare trainees in South India

Background: Pulmonary tuberculosis (TB) is a mycobacterial infection which can lead to poor respiratory health and even death. Carried by airborne droplets, TB is well-transmitted in crowded hospitals where infectious individuals are in close proximity with others. For this reason, healthcare workers and trainees in high burden countries such as India are at great risk of being exposed to and acquiring TB.Objective: We investigated the prevalence of TB infection among healthcare trainees in a private university in Manipal and Mangalore, India. We also assessed knowledge, attitudes and practices (KAP) of TB infection control among trainees. Methods: Eligible medical and nursing undergraduate students in Manipal university (n=443) were recruited and assessed for exposure to TB, and latent TB status using the tuberculin skin test. Trainees with at least two years of exposure to hospital settings were compared with trainees with no exposure to hospital settings. Eligible internship year and post-graduate residents in medicine (n=486) were administered a questionnaire assessing their knowledge, attitudes and practices (KAP) related to TB infection control. Results: The prevalence of TB infection among undergraduate trainees in medicine and nursing was 5.1% (95% CI 3.1-7.2). Being posted in pulmonary medicine departments was associated with both an increase in TST induration size of 1.42mm (95% CI 0.66, 2.19) and 3.11 times adjusted odds of TST positivity (95% CI 1.31, 7.36). Among interns and post-graduate students, being a post-graduate was associated with a knowledge score increase of 3.6% (95% CI 1.4-6.0). Knowledge score for TB infection control at 50.5% (95% CI 48.7-52.2) was significantly lower than transmission and risk factors for TB 67.5% (95% CI 65.6-69.4). Overall, 76.75% reported that they do not always wear a mask when working with a TB patient. Conclusion: The prevalence of TB infection among healthcare undergraduate students is lower than reported elsewhere in India. However, the results are unique to this context and cannot be generalized to all healthcare undergraduates in India. We identified gaps in knowledge, attitudes and perception of TB infection control among medical interns and post-graduates. This presents a source of vulnerability to TB infection that is amenable to institutional interventions. %%%%Contexte: La tuberculose pulmonaire (TB) est une infection mycobacterienne qui peut conduire a une mauvaise sante respiratoire et meme la mort. Porte par des gouttelettes, la TB est bien transmise dans les hopitaux ou les individus infectieux sont proches d'autres. Ainsi, les travailleurs de la sante sont a grand risque d'etre exposes a la TB et infectees par la TB.Objectif: Cette recherche a etudie la prevalence de l'infection TB parmi les etudiants dans une ecole de medecine et un hopital prive en Inde. Nous avons evalue aussi les connaissances, attitudes et pratiques (CAP) de controle de la tuberculose chez les etudiants. Methodes: La prevalence de l'infection tuberculeuse et les facteurs de…