{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T07:32:34Z","timestamp":1787729554855,"version":"build-2784847793"},"reference-count":37,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T00:00:00Z","timestamp":1747699200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009530","name":"Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER)","doi-asserted-by":"publisher","award":["JIP\/Res\/Intramural\/Phs-4\/2021-22"],"award-info":[{"award-number":["JIP\/Res\/Intramural\/Phs-4\/2021-22"]}],"id":[{"id":"10.13039\/501100009530","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Healthcare workers (HCWs) face an increased risk of tuberculosis (TB) due to occupational exposure. This study aimed to estimate the point prevalence of TB infection (TBI) from the initial test performed, while the reversion and conversion were done by subsequent testing at one year among HCWs in Puducherry, India. A prospective cohort study was conducted among a sample of proportionately chosen HCWs based on their occupational strata of a tertiary hospital in 2022. TBI was assessed using IGRA (4th generation QuantiFeron\u2014TB gold plus kits) after TB symptom screening. The IGRA test was repeated at the end of one year. Reversion was defined as a positive IGRA test at the baseline and had values &lt; 0.2 IU\/L in TB1 or TB2 tubes during follow-up. Conversion was defined as a negative IGRA result at the baseline and had values of &gt;0.7 IU\/L in TB1 or TB2 tubes during follow-up. Of the 400 HCWs included, the mean (SD) age was 37 (7) years. Median (IQR) work experience was 15.7 (10\u201321) years. TBI was seen in 150 HCWs (37.7%, 95% CI: 33.0\u201342.7), and one had active TB. A total of 128\/150 HCWs with TBI at baseline were followed up, and 15 had TBI reversion (11.7 per 100 person-years; 95% CI: 6.7\u201318.5). Thirteen HCWs (5.6 per 100 person-years; 95% CI: 3.3\u20139.8) had TBI conversion.<\/jats:p>","DOI":"10.3390\/tropicalmed10050141","type":"journal-article","created":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T04:48:18Z","timestamp":1747716498000},"page":"141","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Prevalence, Conversion and Reversion of Tuberculosis Infection Among Healthcare Workers of Tertiary Care Centres in Puducherry, India: A Prospective Cohort Study"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6563-5910","authenticated-orcid":false,"given":"Sadhana","family":"Subramanian","sequence":"first","affiliation":[{"name":"Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605006, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8320-1016","authenticated-orcid":false,"given":"Palanivel","family":"Chinnakali","sequence":"additional","affiliation":[{"name":"Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605006, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Senbagavalli","family":"Prakashbabu","sequence":"additional","affiliation":[{"name":"Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605006, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guha Nandhini","family":"Visvanadane","sequence":"additional","affiliation":[{"name":"National Tuberculosis Elimination Programme, Puducherry State Health Mission, Puducherry 605006, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manju","family":"Rajaram","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605006, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay","family":"Viswanathan","sequence":"additional","affiliation":[{"name":"Prof. M. Viswanathan Diabetes Research Centre, Chennai 600013, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonali","family":"Sarkar","sequence":"additional","affiliation":[{"name":"Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry 605006, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles Robert","family":"Horsburgh","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Biostatistics, Global Health and Medicine, Boston University, Boston, MA 00215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1900655","DOI":"10.1183\/13993003.00655-2019","article-title":"The Global Prevalence of Latent Tuberculosis: A Systematic Review and Meta-Analysis","volume":"54","author":"Cohen","year":"2019","journal-title":"Eur. Respir. J."},{"key":"ref_2","unstructured":"(2019). World Health Organization Consolidated Guidelines on Tuberculosis Treatment, WHO."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Nasreen, S., Shokoohi, M., and Malvankar-Mehta, M.S. (2016). Prevalence of Latent Tuberculosis among Health Care Workers in High Burden Countries: A Systematic Review and Meta-Analysis. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0164034"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Kinikar, A., Chandanwale, A., Kadam, D., Joshi, S., Basavaraj, A., Pardeshi, G., Girish, S., Shelke, S., DeLuca, A., and Dhumal, G. (2019). High Risk for Latent Tuberculosis Infection among Medical Residents and Nursing Students in India. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0219131"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"177","DOI":"10.7326\/0003-4819-149-3-200808050-00241","article-title":"Systematic Review: T-Cell-Based Assays for the Diagnosis of Latent Tuberculosis Infection: An Update","volume":"149","author":"Pai","year":"2008","journal-title":"Ann. Intern. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"210149","DOI":"10.1183\/20734735.0149-2021","article-title":"New Developments in Tuberculosis Diagnosis and Treatment","volume":"18","author":"Gill","year":"2022","journal-title":"Breathe"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1093\/cid\/ciae357","article-title":"Conversion or Reversion of Interferon Gamma Release Assays for Mycobacterium Tuberculosis Infection: A Systematic Review and Meta-Analysis","volume":"80","author":"Wang","year":"2024","journal-title":"Clin. Infect. Dis. Off. Publ. Infect. Dis. Soc. Am."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Pai, M., and O\u2019Brien, R. (2007). Serial Testing for Tuberculosis: Can We Make Sense of T Cell Assay Conversions and Reversions?. PLoS Med., 4.","DOI":"10.1371\/journal.pmed.0040208"},{"key":"ref_9","unstructured":"National Tuberculosis Elimination Programme (2021). Central TB Division. India TB Report 2021, National Tuberculosis Elimination Programme."},{"key":"ref_10","unstructured":"National Tuberculosis Elimination Programme (2020). Training Modules for Programme Managers and Medical Officers, National Tuberculosis Elimination Programme."},{"key":"ref_11","unstructured":"(2023, November 08). Centers for Disease Control and Prevention About Adult BMI|Healthy Weight, Nutrition, and Physical Activity|CDC, Available online: https:\/\/www.cdc.gov\/bmi\/adult-calculator\/bmi-categories.html."},{"key":"ref_12","first-page":"1","article-title":"Updated Guidelines for Using Interferon Gamma Release Assays to Detect Mycobacterium Tuberculosis Infection\u2014United States, 2010","volume":"59","author":"Mazurek","year":"2010","journal-title":"MMWR. Recomm. Rep. Morb. Mortal. Wkly. Rep. Recomm. Rep."},{"key":"ref_13","first-page":"84","article-title":"T-Cell Assay Conversions and Reversions among Household Contacts of Tuberculosis Patients in Rural India","volume":"13","author":"Pai","year":"2009","journal-title":"Int. J. Tuberc. Lung Dis. Off. J. Int. Union Against Tuberc. Lung Dis."},{"key":"ref_14","unstructured":"(2024, December 04). Qiagen QuantiFERON-TB Gold Plus (QFT-Plus). Available online: https:\/\/www.qiagen.com\/us\/products\/diagnostics-and-clinical-research\/tb-management\/quantiferon-tb-gold-plus-us."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e002576","DOI":"10.1136\/bmjresp-2024-002576","article-title":"Why Do Healthcare Workers Refuse Tuberculosis Preventive Treatment (TPT)? A Qualitative Study from Puducherry, South India","volume":"11","author":"Subramanian","year":"2024","journal-title":"BMJ Open Respir. Res."},{"key":"ref_16","unstructured":"(2018). World Health Organisation Latent Tuberculosis Infection: Updated and Consolidated Guidelines for Programmatic Management, WHO."},{"key":"ref_17","unstructured":"National TB Elimination Programme (2021). Central TB Division. National TB Prevalence Survey in India 2019\u20132021, National TB Elimination Programme."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"ofx137","DOI":"10.1093\/ofid\/ofx137","article-title":"Risk of Tuberculosis Infection and Disease for Health Care Workers: An Updated Meta-Analysis","volume":"4","author":"Uden","year":"2017","journal-title":"Open Forum Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Christopher, D.J., Daley, P., Armstrong, L., James, P., Gupta, R., Premkumar, B., Michael, J.S., Radha, V., Zwerling, A., and Schiller, I. (2010). Tuberculosis Infection among Young Nursing Trainees in South India. PLoS ONE, 5.","DOI":"10.1371\/journal.pone.0010408"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Dabhi, P.A., Thangakunam, B., Gupta, R., James, P., Thomas, N., Naik, D., and Christopher, D.J. (2020). Screening for Prevalence of Current TB Disease and Latent TB Infection in Type 2 Diabetes Mellitus Patients Attending a Diabetic Clinic in an Indian Tertiary Care Hospital. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0233385"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2746","DOI":"10.1001\/jama.293.22.2746","article-title":"Mycobacterium Tuberculosis Infection in Health Care Workers in Rural India: Comparison of a Whole-Blood Interferon Gamma Assay with Tuberculin Skin Testing","volume":"293","author":"Pai","year":"2005","journal-title":"JAMA"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Ringshausen, F.C., Nienhaus, A., Schablon, A., Schl\u00f6sser, S., Schultze-Werninghaus, G., and Rohde, G. (2010). Predictors of Persistently Positive Mycobacterium-Tuberculosis-Specific Interferon-Gamma Responses in the Serial Testing of Health Care Workers. BMC Infect. Dis., 10.","DOI":"10.1186\/1471-2334-10-220"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1513\/AnnalsATS.201310-378OC","article-title":"IFN-\u03b3 Release Assay Conversions and Reversions. Challenges with Serial Testing in U.S. Health Care Workers","volume":"11","author":"Joshi","year":"2014","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1164\/rccm.200604-472OC","article-title":"Serial Testing of Health Care Workers for Tuberculosis Using Interferon-\u03b3 Assay","volume":"174","author":"Pai","year":"2006","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2376","DOI":"10.1371\/journal.pmed.0030494","article-title":"Tuberculosis among Health-Care Workers in Low- and Middle-Income Countries: A Systematic Review","volume":"3","author":"Joshi","year":"2006","journal-title":"PLoS Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1093\/infdis\/jit418","article-title":"Reversion and Conversion of Interferon- \u03b3 Release Assay Results in HIV-1\u2014Infected Individuals Baseline Characteristics of the Study Participants","volume":"209","author":"Aichelburg","year":"2014","journal-title":"J. Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/1745-6673-1-7","article-title":"Persistently Elevated T Cell Interferon-Gamma Responses after Treatment for Latent Tuberculosis Infection among Health Care Workers in India: A Preliminary Report","volume":"1","author":"Pai","year":"2006","journal-title":"J. Occup. Med. Toxicol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1111\/tid.12489","article-title":"Serial Testing for Latent Tuberculosis Infection in Transplant Candidates: A Retrospective Review","volume":"18","author":"Roth","year":"2016","journal-title":"Transpl. Infect. Dis. Off. J. Transplant. Soc."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e13087","DOI":"10.1111\/tid.13087","article-title":"High Rates of Indeterminate Interferon-Gamma Release Assays for the Diagnosis of Latent Tuberculosis Infection in Liver Transplantation Candidates","volume":"21","author":"Wigg","year":"2019","journal-title":"Transpl. Infect. Dis. Off. J. Transplant. Soc."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"van Zyl-Smit, R.N., Zwerling, A., Dheda, K., and Pai, M. (2010). Within-Subject Variability of Interferon-g Assay Results for Tuberculosis and Boosting Effect of Tuberculin Skin Testing: A Systematic Review. PLoS ONE, 4.","DOI":"10.1371\/journal.pone.0008517"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1017\/S0950268809002751","article-title":"Estimation of Incidence of Tuberculosis Infection in Health-Care Workers Using Repeated Interferon-\u03b3 Assays","volume":"137","author":"Yoshiyama","year":"2009","journal-title":"Epidemiol. Infect."},{"key":"ref_32","unstructured":"National TB Elimination Programme (2021). Central TB Division Guidelines for Programmatic Managment of Tuberculosis Preventive Treatment in India, National TB Elimination Programme."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Aggerbeck, H., Ruhwald, M., Hoff, S.T., Borregaard, B., Hellstrom, E., Malahleha, M., Siebert, M., Gani, M., Seopela, V., and Diacon, A. (2018). C-Tb Skin Test to Diagnose Mycobacterium Tuberculosis Infection in Children and HIV-Infected Adults: A Phase 3 Trial. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0204554"},{"key":"ref_34","first-page":"498","article-title":"Thinking in Three Dimensions: A Web-Based Algorithm to Aid the Interpretation of Tuberculin Skin Test Results","volume":"12","author":"Menzies","year":"2008","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1111\/ina.12639","article-title":"Effect of Ventilation Improvement during a Tuberculosis Outbreak in Underventilated University Buildings","volume":"30","author":"Du","year":"2020","journal-title":"Indoor Air"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1034\/j.1600-0668.2003.00189.x","article-title":"Risk of Indoor Airborne Infection Transmission Estimated from Carbon Dioxide Concentration","volume":"13","author":"Rudnick","year":"2003","journal-title":"Indoor Air"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.5588\/ijtld.13.0571","article-title":"Cost-Effectiveness of the Three I\u2019s for HIV\/TB and ART to Prevent TB among People Living with HIV","volume":"18","author":"Gupta","year":"2014","journal-title":"Int. J. Tuberc. Lung Dis."}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/10\/5\/141\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:35:28Z","timestamp":1760031328000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/10\/5\/141"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,20]]},"references-count":37,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["tropicalmed10050141"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed10050141","relation":{},"ISSN":["2414-6366"],"issn-type":[{"value":"2414-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,20]]}}}