Background: The screening of both healthcare workers and students attending teaching hospitals for latent\r\ntuberculosis infection (LTBI) is recommended in hospitals of many countries with a low-incidence of TB, including\r\nItaly, as a fundamental tool of tuberculosis (TB) control programs. The aim of the study was to estimate the\r\nprevalence of LTBI and evaluate the main risk-factors associated with this condition in a cohort of healthcare Italian\r\nstudents.\r\nMethods: In a cross-sectional study, performed between January and May 2012, 881 undergraduate students\r\nattending the Medical, Nursing, Pediatric Nursing and Midwifery Schools of the University of Genoa, trained at the\r\nIRCCS San Martino-IST Teaching Hospital of Genoa, were actively called to undergo the Tuberculin Skin Test (TST).\r\nAll the TST positive cases were also tested with an Interferon-Gamma Release Assay (IGRA) to confirm the diagnosis\r\nof LTBI. A standardized questionnaire was collected for risk-assessment analysis.\r\nResults: Seven hundred and thirty-three (83.2%) subjects underwent TST testing. The prevalence of TST positives\r\nwas 1.4%, and in 4 (0.5%) out of 10 TST positive cases LTBI diagnosis was confirmed by IGRA. No difference in the\r\nprevalence of subjects who tested positive to TST emerged between pre-clinical (n = 138) and clinical (n = 595)\r\nstudents. No statistically significant association between TST positivity and age, gender, and BCG vaccination was\r\nobserved. The main independent variable associated with TST positivity was to be born in a country with a high TB\r\nincidence (i.e., =20 cases per 100,000 population) (adjusted OR 102.80, 95% CI 18.09-584.04, p < 0.001).\r\nConclusions: The prevalence of LTBI among healthcare students resulted very low. The only significant association\r\nbetween TST positivity and potential risk factors was to be born in high TB incidence areas. In countries with a low\r\nincidence of TB, the screening programs of healthcare students before clinical training can be useful for the early\r\nidentification and treatment of the sporadic cases of LTBI.
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