%0 Article
%A Starshinova, A.A., 
%A Sabirova, A., 
%A Sharipov, R.A., 
%A Tukfatullin, R.K., 
%A Panteleev, A.M., 
%A Nazarenko, M.M., 
%A Kudlay, D.A., 
%T Detection of latent tuberculosis infection in healthcare workers
%D 2026
%R 10.3389/fmed.2026.1835510
%J FRONTIERS IN MEDICINE
%X Introduction: Identification of tuberculosis infection at different stages following
exposure to a patient with tuberculosis is essential for improving epidemiological
control, particularly during pathogen elimination and the stage of latent tuberculosis infection (LTBI). Detection of LTBI enables timely preventive interventions
that may reduce the incidence of active tuberculosis. Healthcare workers represent an important risk group in whom LTBI screening using modern immunodiagnostic methods is required.
Objective: To compare the prevalence of latent tuberculosis infection among
healthcare workers in the general healthcare system, healthcare workers in
tuberculosis facilities, and individuals with documented contact with patients
with tuberculosis.
Subjects and methods: A prospective comparative study was conducted including healthcare workers of the general healthcare system (n = 49), healthcare
workers of tuberculosis institutions (n = 60), and individuals with documented
contact with tuberculosis patients (n = 43). A control group consisted of healthy
individuals without a history of contact with tuberculosis patients, clinical manifestations of tuberculosis, radiological signs of infection, or significant comorbidities (n = 51). Among healthcare workers in tuberculosis institutions, occupational
contact with tuberculosis patients was reported in 91.7% (55/60; 95% CI 84.67–
98.66). Among contact persons, exposure to a bacteriologically confirmed
tuberculosis case occurred in 76.7% (33/43; 95% CI 64.12–89.37). All participants
underwent immunodiagnostic testing using a test with recombinant tuberculosis
antigen (ATR). Individuals with positive ATR results underwent comprehensive
examination, including computed tomography of the chest, to exclude active
tuberculosis. The prevalence of LTBI was defined as the proportion of positive
ATR results. Statistical analysis was performed using χ2
 tests with a significance
threshold of p < 0.05 using Microsoft Excel 2019.
Results: Positive ATR test results were detected in 8.2% of healthcare workers in
the general healthcare system (95% CI 0.50–15.83), which did not significantly
differ from the control group (5.8%; 95% CI 1.41–16.54; χ2 = 0.200, p = 0.655).
In contrast, positive ATR results were significantly more frequent among healthcare workers in tuberculosis institutions (23.3%; 95% CI 12.63–34.04) compared
with controls (5.8%; χ2 = 6.473, p = 0.011). The highest prevalence of positive
ATR results was observed among contact persons (51.2%; 95% CI 36.22–66.10), which was significantly higher than in the control group (χ2 = 24.502, p = 0.001).
Comparison between risk groups demonstrated that positive ATR results were
significantly more common among healthcare workers in tuberculosis institutions than among healthcare workers in the general healthcare system (23.3% vs.
8.2%; χ2 = 4.502, p = 0.034). Furthermore, contact persons showed significantly
higher positivity rates than both healthcare workers in the general healthcare
system (51.2% vs. 8.2%; χ2 = 20.886, p = 0.001) and healthcare workers in tuberculosis institutions (51.2% vs. 23.3%; χ2 = 8.533, p = 0.004).
Conclusion: The prevalence of LTBI detected using ATR immunodiagnostics was
lowest among healthcare workers in the general healthcare system (8.2%), with
values comparable to those observed in the control group (5.8%). Healthcare
workers in tuberculosis institutions demonstrated a significantly higher prevalence
of LTBI (23.3%), reflecting increased occupational exposure. The highest prevalence was observed among contact persons (51.2%), highlighting the substantial
risk associated with close exposure to tuberculosis patients and emphasizing the
importance of immunodiagnostic screening for early detection of LTBI.
%U https://repo.bashgmu.ru/publication/6188