Practical method of control of TBC in a population of students belonging to the Sapienza University of Rome, Italy.

AIM: To describe the surveillance and control protocol for tuberculosis in healthcare students in use at the CMO of University "Sapienza" and founded on a dedicated database. METHODS: Analysis of health certificates through a dedicated data storage software based on Microsoft Access 2007. RESULTS: Students resulting positive to Mantoux test who did not undergo second-level examination (chest X-ray, TB Gold, prophylaxis) are invited to refer themselves within ten days to the infectious disease specialist. CONCLUSION: the methodological analysis, refined over the years by the CMO staff of the Sapienza University of Rome, allowed to match clinical certification data, to rapidly focus upon TBC spread control among healthcare settings, to register new students time zero before their admission to courses and potential professional exposure, to perform epidemiological studies aimed to increase TBC control through healthcare system released clinical certification confirmation.

Skin test screening for tuberculosis among healthcare students: a retrospective cohort study.

BACKGROUND: Aim of the study was to document the baseline prevalence of healthcare students positive to tuberculosis skin tests screening. METHODS: Between 2008-2010, students admitted to healthcare courses (medicine, nursing, physiotherapy...) at Sapienza university in Rome were requested to carry out personal tuberculosis skin test screening in their local district or town healthcare centers according to the italian guidelines. At the time interferongamma release assays (IGRA) testing was not adopted for large screening. Demographic characteristics, tuberculosis screening results, healthcare course, tuberculosis vaccination status were recorded. RESULTS: A cohort of 2,500 university healthcare students were screened by several Italian Hygiene Offices using tuberculin skin test and Tine test. Overall 131 (5.2%) healthcare students resulted positive to some tuberculosis skin test screening. Tuberculin skin test was carried out on 2,029 students (81.2%) and conversion was observed in 107 (5.3%), whereas Tine test was carried out on 498 students (19.9%) and positive result was observed in 24 (4.8%). The Tine test use and non optimal (<72h) recording of the forearm induration in tuberculin skin tests was related mostly to some healthcare centers in Lazio and Campania regions. Previous BCG vaccination was reported by 27 healthcare students (1.1%), and only two of them showed tuberculin skin test conversion, whereas the large majority 105 (98.1%) of Mantoux positives had not been vaccinated. In univariate analysis positive tuberculin skin test was associated to growing students age (29.2 ± 10.3 vs. 23.1 ± 6.0; p<0.01). Positive tuberculin skin test was recorded in 25 (20.3%) foreign and 82 (4.3%) italian students showing a higher risk for International students (RR 4.72; 95%CI 3.14 - 7.11; p<0.01). There was no significant correlation between the different Italian regions, the various healthcare courses or gender. CONCLUSION: The study evaluated the baseline positive skin test rate for tuberculosis among healthcare students in their first university year, showing a higher risk for the international group and revealed some problematic screening practices which need to be improved in the future screening programs.

[Revision of the behavior of Italian universities towards the HBV vaccination and tuberculosis prophylaxis]. / Revisione del comportamento degli Atenei italiani nei con- fronti della vaccinazione anti-HBV e della profilassi anti tubercolare.

Diagnostic screening for hepatitis B and tuberculosis infection bears a very important role for health care professionals even considering the decreasing epidemiological trends. According to the WHO predictions in 2030 these diseases will remain at third and fourth places among the causes of death for infectious diseases in industrial countries. The aim of this study is to verify the presence of hepatitis B and tuberculosis prophylaxis among the entry requirements for Medical Schools (MED) and Healthcare Professions Degree (PS) courses in 2011/2012 enrollment announcements. We examined 39 websites of Italian Public and Private Universities and we discovered 38 different announcements for MED and PS courses looking for any reference about hepatitis B and tuberculosis vaccinations and Mantoux skin test. The statistical analysis is descriptive (frequency tables). Hepatitis B vaccination was required in 7 (18.4%) enrollment announcements for MED and 6 (13.6%) for PS, respectively. Tuberculosis vaccination and/or Mantoux skin test were found among requirements of only 10 announcements for MED and 7 for PS, respectively. According to this study there is a great and unexpected variability among the different universities. A homologation of these requirements would be strongly desirable among Italian regions and on the entire national territory.