End-tidal concentrations of SEVO and CO₂ and physiological variables recorded during MAC determinations.

<p>End-tidal concentrations of SEVO and CO₂ and physiological variables recorded during MAC determinations.</p

Tuberculosis Transmission from Healthcare Workers to Patients and Co-workers: A Systematic Literature Review and Meta-Analysis

<div><p>Healthcare workers (HCWs) are at risk of becoming infected with tuberculosis (TB), and potentially of being infectious themselves when they are ill. To assess the magnitude of healthcare-associated TB (HCA-TB) transmission from HCWs to patients and colleagues, we searched three electronic databases up to February 2014 to select primary studies on HCA-TB incidents in which a HCW was the index case and possibly exposed patients and co-workers were screened.We identified 34 studies out of 2,714 citations. In 29 individual investigations, active TB was diagnosed in 3/6,080 (0.05%) infants, 18/3,167 (0.57%) children, 1/3,600 (0.03%) adult patients and 0/2,407 HCWs. The quantitative analysis of 28 individual reports showed that combined proportions of active TB among exposed individuals were: 0.11% (95% CI 0.04–0.21) for infants, 0.38% (95% CI 0.01–1.60) for children, 0.09% (95% CI 0.02–0.22) for adults and 0.00% (95% CI 0.00–0.38) for HCWs. Combined proportions of individuals who acquired TB infection were: 0.57% (95% CI 7.28E-03 – 2.02) for infants, 0.9% (95% CI 0.40–1.60) for children, 4.32% (95% CI 1.43–8.67) for adults and 2.62% (95% CI 1.05–4.88) for HCWs. The risk of TB transmission from HCWs appears to be lower than that recorded in other settings or in the healthcare setting when the index case is not a HCW. To provide a firm evidence base for the screening strategies, more and better information is needed on the infectivity of the source cases, the actual exposure level of screened contacts, and the environmental characteristics of the healthcare setting.</p></div

Proportion meta-analysis (random effects).

<p>Forest plots for: A. Proportion of active TB cases among infants; B. Proportion of active TB cases among children; C. Proportion of active TB cases among adult patients; D. Proportion of active TB cases among HCWs. (A B C D elements are ordered from top to bottom and left to right).</p

First and second determinations of MAC_SEVO, MAC_SN, MAC_SNA, MAC_SA, and MAC_SEVO in the form of pooled data.

<p>First and second determinations of MAC_SEVO, MAC_SN, MAC_SNA, MAC_SA, and MAC_SEVO in the form of pooled data.</p

Characteristics of 117 Health Care Workers index cases of pulmonary Tuberculosis in 34 included studies.

<p>Characteristics of 117 Health Care Workers index cases of pulmonary Tuberculosis in 34 included studies.</p

HPV genotypes distribution in cervical and plasma samples.

<p>Correlation of HPV types identified in cervical and plasma samples with cervical cytology.</p

Regional grouping of countries of origin used in the analysis of determinants of site of TB, EU/EEA countries, 2003–2014.

<p>The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement.</p

Correlation of HPV positivity identified in cervical and plasma samples and cervical cytology.

<p>Correlation of HPV positivity identified in cervical and plasma samples and cervical cytology.</p

Bivariate and multivariable (logistic regression) analysis for risk factors associated with exclusive extrapulmonary tuberculosis in 27 European Union and European Economic Area countries¹, 2003–2014 (N = 564,916 cases with full data).

<p>Bivariate and multivariable (logistic regression) analysis for risk factors associated with exclusive extrapulmonary tuberculosis in 27 European Union and European Economic Area countries<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0186499#t002fn002" target="_blank">¹</a>, 2003–2014 (N = 564,916 cases with full data).</p

Distribution of TB cases in the 27 countries included in the multivariable analysis of determinants of site of TB, EU/EEA countries, 2003–2014.

<p>SOURCE OF GRAPHIC: ECDC Map Maker (EMMa), available at <a href="https://emma.ecdc.europa.eu" target="_blank">https://emma.ecdc.europa.eu</a></p> <p>The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement.</p