Just over one in three healthcare workers in a Dublin teaching hospital suspected of having a dormant form of tuberculosis attended a dedicated clinic for follow-up, newly published research has found.
Dr Joe Keane and his colleagues from the departments of respiratory medicine and occupational health at St James's Hospital, Dublin looked at the records of staff in the hospital who had tested positive in a skin test for TB.
Between 2004 and 2006 a total of 243 healthcare workers were referred to the hospital's TB clinic for further evaluation, but just 85 staff attended.
People with a positive tuberculin skin test have latent tuberculosis infection (LTBI). This is a dormant form of the infectious disease, with the bug living harmlessly in the body. However, the TB germ may become active in 10 per cent of people with LTBI. And while the latent form of the disease cannot be transmitted to another person, if it becomes active in a health professional, then this could pose a risk to hospital patients.
LTBI can be treated with a nine-month course of the drug isoniazid: this will stop the affected person from becoming sick and will prevent TB spreading to their family or to those with whom they work. However, it is left to each healthcare worker to accept treatment.
The study, presented at the annual meeting of the Irish Thoracic Society (ITC), found that just 23 per cent of hospital staff accepted LTBI treatment with 13 per cent completing the nine-month course of medication. "These results are alarming and indicate poor awareness of LTBI among healthcare workers in St James's Hospital," the authors say.
Dr Keane told The Irish Times that the recent case of a doctor in another Irish hospital developing TB and leading to the preventive treatment of 200 patients, could have been avoided if our health system encouraged staff education and offered LTBI treatment to health workers.
Meanwhile, the latest report on TB from the Health Protection Surveillance Centre (HPSC) shows a slight increase in the number of TB cases in 2005, compared with the previous year. Approximately 450 cases of TB were notified to the HPSC, giving an incident rate of 10.6 cases per 100,000 population.
Certain communities in north inner city Dublin and northern parts of Cork city experienced TB infection rates of greater than 20 per 100,000 people.
TB was more common in men than women. The percentage of TB cases occurring in recent immigrants continues to rise - 34 per cent of cases notified in 2005. And the first case of drug- resistant TB (XDR-TB) was identified in the Republic in 2005, the report notes.