2018 Volume 18 Issue 4 Pages 223-228
The study aimed to clarify the current state and issues of tuberculosis examinations for medical facility employees to prevent tuberculosis infection.
A self-administered questionnaire survey was conducted at 10 facilities that consented to participate among 12 medical facilities with 100 or more beds in Ichinomiya city and Inazawa city of Aichi Prefecture. Results of an interview survey conducted on seven screening supervisors of the facilities regarding employee's tuberculosis examinations and subsequent support were qualitatively analyzed.
Tuberculosis had occurred at eight facilities in the previous five years. Between 3 and 80 individuals (maximum numbers at each facility) had undergone contact examinations. Six individuals at two facilities were infected but none were onset cases. Content analysis results extracted three categories in the current status and issues of tuberculosis examination：“mixing of individuals of registered and not-registered in tuberculosis infection baseline data at the time of employment,” “poor management of tuberculosis examination data,” and “lack of preparation to respond to interferon-gamma release assay-positive individuals.” Two categories were extracted in tuberculosis contact examinations：“difficulty of managing contact examination results from employee's data,” and “limitations of follow-ups using regular medical checkup.” The following issues were clarified by these categories：baseline data regarding tuberculosis infection was difficult to manage and utilize as the type of tuberculosis examinations performed at the time of employment differed depending on the year of employment；contact examination data was not accumulated in each employee's data；and tuberculosis cases repeatedly appeared within facilities and the number of individuals subjected to follow-up after contacts examination was accumulated, making it difficult to provide support. We found that it is important to establish methods to enable infection control to provide ongoing support for employee's following tuberculosis examinations.
