{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T22:52:58Z","timestamp":1789858378122,"version":"4.0.1"},"reference-count":21,"publisher":"King Faisal Specialist Hospital and Research Centre","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Saudi Med"],"published-print":{"date-parts":[[2020,5]]},"abstract":"ABSTRACT<\/jats:title>\n \n BACKGROUND:<\/jats:title>\n Health-care workers (HCW) are susceptible to latent tuberculosis infection (LTBI). The prevalence of LTBI in HCW in Saudi Arabia has not been reported using the fourth-generation interferon gamma release assay QuantiFERON-TB Gold Plus (QFT-Plus).<\/jats:p>\n <\/jats:sec>\n \n OBJECTIVE:<\/jats:title>\n Determine the prevalence of LTBI in a large heterogeneous HCW population and assess risk factors for LTBI.<\/jats:p>\n <\/jats:sec>\n \n DESIGN:<\/jats:title>\n Cross-sectional and case-control study.<\/jats:p>\n <\/jats:sec>\n \n SETTING:<\/jats:title>\n Tertiary academic hospital, Riyadh, Saudi Arabia.<\/jats:p>\n <\/jats:sec>\n \n PATIENTS AND METHODS:<\/jats:title>\n Medical records of HCWs who had QFT-Plus performed between January to December 2018 were reviewed and included in the cross-sectional study. In a subset analysis, randomly selected positive QFT-Plus cases were compared with controls selected from the same areas of work. Univariate and binary logistic regression analyses were performed to assess the significance of other factors to QFT-PLus positivity.<\/jats:p>\n <\/jats:sec>\n \n MAIN OUTCOME MEASURES:<\/jats:title>\n Prevalence of LTBI in HCWs and potential risk factors for LTBI.<\/jats:p>\n <\/jats:sec>\n \n SAMPLE SIZE:<\/jats:title>\n 3024 HCWs in the cross-sectional analysis; 294 cases and 294 controls in the case-control analysis.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n Twenty-four percent (n=733) of the HCWs had a positive QFT-Plus. The median (interquartile range) age was 34.0 (31.0-37.1) years, 71% were female, and only 24.8% were of Saudi nationals. Nursing represented 57.7% of HCWs, and 24.7% were working in a non-clinical area. Only 20.3% worked in TB-related departments. A higher risk of LTBI was present in HCWs who were older than 50 years (OR=1.95), from either Philippines (OR=4.7) or the Indian subcontinent (OR=4.1), working as a nurse (OR=2.7), allied health profession (OR=2.1), radiology technician (OR=3.1), or in the emergency room (OR=2.4) or intensive care unit (OR=2.1). In the binary logistic regression, independent predictors for positive QFT-Plus were age group older than 50 years (aOR=2.96), known TB exposure (aOR=1.97), and not receiving BCG at birth (aOR=3.08).<\/jats:p>\n <\/jats:sec>\n \n LIMITATION:<\/jats:title>\n Single-center, retrospective, possible recall bias for BCG vaccination.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSION:<\/jats:title>\n The high prevalence of LTBI among HCW emphasizes the need to continue pre-employment screening, especially for employed personnel from high endemic areas, with targeted annual screening for the same group and other identified high-risk groups. These findings can aid in the development of national screening guidelines for LTBI in HCW.<\/jats:p>\n <\/jats:sec>\n \n CONFLICT OF INTEREST:<\/jats:title>\n None.<\/jats:p>\n <\/jats:sec>","DOI":"10.5144\/0256-4947.2020.191","type":"journal-article","created":{"date-parts":[[2020,6,4]],"date-time":"2020-06-04T02:50:37Z","timestamp":1591239037000},"page":"191-199","source":"Crossref","is-referenced-by-count":16,"title":["Latent tuberculosis infection among health-care workers using Quantiferon-TB Gold-Plus in a country with a low burden for tuberculosis: prevalence and risk factors"],"prefix":"10.5144","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4532-4626","authenticated-orcid":true,"given":"Abdulellah","family":"Almohaya","sequence":"first","affiliation":[{"name":"From the Infectious Diseases Unit, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulwahab","family":"Aldrees","sequence":"additional","affiliation":[{"name":"From the Infectious Diseases Unit, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Layan","family":"Akkielah","sequence":"additional","affiliation":[{"name":"From the Infectious Diseases Unit, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alshaima Talal","family":"Hashim","sequence":"additional","affiliation":[{"name":"From the Infectious Diseases Unit, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahad","family":"Almajid","sequence":"additional","affiliation":[{"name":"From the Infectious Diseases Unit, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Turki","family":"Binmoammar","sequence":"additional","affiliation":[{"name":"From the Occupational Health Unit, Family Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazin A.","family":"Barry","sequence":"additional","affiliation":[{"name":"From the Infectious Diseases Unit, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3134","reference":[{"key":"e_1_3_2_2_2","unstructured":"WHO | Global tuberculosis report 2019 [Internet]. WHO. World Health Organization; [cited 2020 Apr 30]. Available from: http:\/\/www.who.int\/tb\/publications\/global_report\/en\/"},{"key":"e_1_3_2_3_2","first-page":"2376","article-title":"Tuberculosis among health-care workers in low- and middle-income countries","volume":"3","author":"Joshi R","year":"2006","journal-title":"A systematic review"},{"key":"e_1_3_2_4_2","unstructured":"WHO | Update of WHO guidelines on the management of latent TB infection [Internet]. WHO. World Health Organization; [cited 2020 May 1]. Available from: http:\/\/www.who.int\/tb\/features_archive\/WHO-guidelines-management-latent-TB-infection\/en\/"},{"key":"e_1_3_2_5_2","first-page":"2127","volume-title":"New England Journal of Medicine","author":"Getahun H","year":"2015"},{"issue":"1","key":"e_1_3_2_6_2","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0054748","article-title":"Repeat IGRA Testing in Canadian Health Workers: Conversions or Unexplained Variability?","volume":"8","author":"Zwerling A","year":"2013","journal-title":"PLoS One"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12995-015-0044-y"},{"issue":"5","key":"e_1_3_2_8_2","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1183\/13993003.00510-2016","article-title":"First evaluation of QuantiFERON-TB gold plus performance in contact screening.","volume":"48","author":"Barcellini L","year":"2016","journal-title":"Eur Respir J"},{"key":"e_1_3_2_9_2","first-page":"25","volume-title":"International Journal of Mycobacteriology","author":"Petruccioli E","year":"2016"},{"issue":"8","key":"e_1_3_2_10_2","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1016\/j.cmi.2016.05.006","article-title":"Equal sensitivity of the new generation QuantiFERON-TB Gold plus in direct comparison with the previous test version QuantiFERON-TB Gold IT.","volume":"22","author":"Hoffmann H","year":"2016","journal-title":"Clin Microbiol Infect"},{"issue":"3","key":"e_1_3_2_11_2","doi-asserted-by":"crossref","first-page":"148","DOI":"10.4103\/1817-1737.114303","article-title":"Tuberculosis incidence trends in Saudi Arabia over 20 years: 1991-2010.","volume":"8","author":"Al-Orainey I","year":"2013","journal-title":"Ann Thorac Med"},{"key":"e_1_3_2_12_2","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.ijid.2017.03.024","article-title":"Prevalence of Latent Mycobacterium Tuberculosis Infection (LTBI) in Saudi Arabia; Population based survey.","volume":"60","author":"Balkhy HH","year":"2017","journal-title":"Int J Infect Dis"},{"issue":"10","key":"e_1_3_2_13_2","article-title":"The Global Burden of Latent Tuberculosis Infection: A Re-estimation Using Mathematical Modelling.","volume":"13","author":"Houben RMGJ","year":"2016","journal-title":"PLoS Med"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.5144\/0256-4947.2018.90"},{"issue":"5","key":"e_1_3_2_15_2","doi-asserted-by":"crossref","first-page":"e0154803","DOI":"10.1371\/journal.pone.0154803","article-title":"Inter-feron Gamma Release Assay versus Tuber-culin Skin Testing among Healthcare Workers of Highly Diverse Origin in a Moderate Tuberculosis Burden Country.","volume":"11","author":"Al Hajoj S","year":"2016","journal-title":"PLoS One"},{"key":"e_1_3_2_16_2","unstructured":"MOH S. Saudi MOH Annual Report 2017. 2018."},{"key":"e_1_3_2_17_2","volume-title":"Journal of Clinical Microbiology","author":"Hogan CA","year":"2019"},{"issue":"8","key":"e_1_3_2_18_2","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1164\/rccm.201305-0831OC","article-title":"Challenges with QuantiFERON-TB gold assay for large-scale, routine screening of U.S. healthcare workers.","volume":"188","author":"Slater ML","year":"2013","journal-title":"Am J Respir Crit Care Med"},{"issue":"1","key":"e_1_3_2_19_2","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1136\/thx.2010.143180","article-title":"Interferon-gamma release assays for tuberculosis screening of healthcare workers: A systematic review.","volume":"67","author":"Zwerling A","year":"2012","journal-title":"Thorax"},{"key":"e_1_3_2_20_2","unstructured":"Abbas MAF AlHamdan NAE Fiala LA AlEnezy AK AlQahtani MS. Prevalence of latent TB among health care workers in four major tertiary care hospitals in Riyadh Saudi Arabia. J Egypt Public Health Assoc [Internet]. 2010 [cited 2019 Dec 7];85(1\u20132):61\u201371. Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21073848"},{"key":"e_1_3_2_21_2","unstructured":"Mirtskhulava V Kempker R Shields KL Leonard MK Tsertsvadze T del Rio C et al. Prevalence and risk factors for latent tuberculosis infection among health care workers in Georgia. Int J Tuberc Lung Dis [Internet]. 2008 May [cited 2019 Dec 7];12(5):513\u20139. Available from: http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/18419886"},{"issue":"02","key":"e_1_3_2_22_2","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1086\/501869","article-title":"Factors Associated With Tuberculin Reactivity in Two General Hospitals in Mexico.","volume":"22","author":"Garc\u00eda-Garc\u00eda M de L","year":"2001","journal-title":"Infect Control Hosp Epidemiol"}],"container-title":["Annals of Saudi Medicine"],"original-title":[],"language":"en","deposited":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T12:24:54Z","timestamp":1595507094000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.annsaudimed.net\/doi\/10.5144\/0256-4947.2020.191"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5]]},"references-count":21,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,5]]}},"alternative-id":["10.5144\/0256-4947.2020.191"],"URL":"https:\/\/doi.org\/10.5144\/0256-4947.2020.191","relation":{},"ISSN":["0256-4947","0975-4466"],"issn-type":[{"value":"0256-4947","type":"print"},{"value":"0975-4466","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5]]}}}