1.A Systematic Review of Prevalence and Risk Factors of Latent Tuberculosis Infection Among Medical and Nursing Students
Zarini Ismail ; Lailatul Hazzliza Musa ; Muslimah Ithnin ; Nurul Azmawati Mohamed ; Nizam Baharom ; Shalinawati Ramli ; Siva Gowri Pathmanathan
Malaysian Journal of Medicine and Health Sciences 2022;18(No.6):270-279
Introduction: Clinical training may expose medical and nursing students to workplace hazards comparable to those
encountered by healthcare workers (HCWs). This study was designed to investigate the prevalence of latent tuberculosis infection (LTBI) and associated risk factors among medical and nursing students. Methods: Following the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, a systematic review was
conducted utilising four electronic databases to appraise and synthesise the literature on LTBI which used the tuberculin skin test (TST) and the blood interferon-gamma release assay (IGRA). Results: Original articles published in the
English language between 2010 and 2020 were included, yielding 14 relevant articles. The average prevalence of
LTBI in high-burden countries was 38.2% for TST and 20.6% for the IGRA test. According to TST and IGRA findings,
the average prevalence of LTBI in nations with an intermediate burden was 16.7% and 4.7 %, respectively. The average prevalence was 2.8% and 1.1% from the TST and IGRA tests for low-burden countries, respectively. A greater
risk of LTBI was shown to be related with an increase in age among postgraduate medical school students, a history
of Bacillus Calmette-Guerin (BCG) vaccination, origin from high-risk tuberculosis (TB) countries, increased hours of
hospital exposure, a history of contact with TB cases, a high body mass index, older age group students, and a lower
TB knowledge score. Conclusion: The available evidence from this review emphasised the importance of developing
and implementing efficient and cost-effective TB infection-control programmes, particularly in high-burden countries and amongst students at risk.