Incidence of Pulmonary Tuberculosis among health care workers of Mayo Hospital, Lahore

Author's: Arooj Ahsan, Muhammad Naeem Iqbal, Asfa Ashraf, Fakhar-un-Nisa Yunus, Muhammad Irfan, Mehwish Saleem

Corresponding Author: Muhammad Naeem Iqbal

Corresponding Author Email:

Article Type: Research Article

Published Online: May. 06, 2016

Pages: 26-30

Views: 885

Downloads: 34


The present study was designed to determine the incidence of tuberculosis (TB) in tertiary care hospital (Mayo hospital, Lahore) from January 2014 to June 2014. Several demographic factors analyzed were found to be significant in transmission of pulmonary tuberculosis (p < 0.05) except marital status (p=0.09) and age (p=0.212). Out of 50 suspected patients, 26 (52%) cases were recorded as a positive for pulmonary tuberculosis: out of which, six healthcare (HCWs) were found. Mean incidence of TB was 23% (6 out of 26) for all HCWs, 4 were nurses and 2 for other professionals, while for general population 79% (20 out of 26) cases were positive. The observed ratio among HCWs and general population was 60% and 50% respectively. It is concluded that incidence of TB among HCWs was more than general population. The reason is deprived medical conditions and facilities in Pakistan. Control programs to stop nosocomial transmission of TB should be adopted in hospitals to reduce risk for HCWs. Finding the risk of TB among HCWs is crucial to enable authorities to take preventive measures in health care facilities and shield HCWs.


Healthcare workers, pulmonary tuberculosis, latent TB infection, Mycobacterium tuberculosis.

To cite this article:

Ahsan, A., Iqbal, M.N., Ashraf, A., Yunus, F.N., Irfan, M., Saleem, M., 2016. Incidence of Pulmonary Tuberculosis among health care workers of Mayo Hospital, Lahore. PSM Biol. Res., 01(1): 26-30.


Tuberculosis is the most widespread infectious disease in the world. Mycobacterium tuberculosis (an obligate pathogenic bacterium) is the causative agent of this disease. It is highly contagious, chronic granulomatous disease; (McAdam et al., 2007). The determined vision endorsed by the World Health Organization (WHO) and Stop TB partnership is to eradicate TB as a public health problem by 2050 attaining an incidence rate of less than 1 case per million of the world population (WHO, 2006: WHO, 2013).

TB affects either lung as a respiratory disease named as pulmonary tuberculosis, or other parts of human body as extra pulmonary tuberculosis (Solovic et al., 2011). Fever, chills, loss of appetite, weight loss, night sweats, and fatigue are the prevailing symptoms of TB (Dolin et al., 2010). Certain diseases also increase the risk of development of TB, like diabetes mellitus, malnutrition, chronic lung disease (particularly silicosis), chronic renal failure, alcoholism, cancer and immunosuppression (Lim et al., 2013). The risk factors linked with hepatocellular carcinoma cancer include age, sex, diet, alcohol, and infection with hepatitis B virus (HBV) and/or hepatitis C virus (HCV) (Ali et al., 2015). Muhammad et al. (2013) found co-infection of diabetes mellitus with HCV and HBV. HCWs are at danger of getting many infections at their work place through airborne, blood borne, faecal oral transmission and direct contact.

The use of modern techniques like interferon gamma release assay and polymerase chain reaction (PCR) have made the diagnosis of TB quite easy which was a difficult task previously. The diagnosis of pulmonary as well as extra-pulmonary TB is convenient by these assays. However, the conventional methods Ziel Nielsen staining (ZN), Lowenstein Jensen (LJ) media and chest X-rays) are also very useful feasible methods to diagnosis the pulmonary tuberculosis. ZN staining is a good technique to identify AFB (acid fast bacilli) and LJ (Lowenstein Jensen) media is a gold method of culturing the M. tuberculosis and chest X-ray technique is also gold method to diagnose the growth of M. tuberculosis in lungs.  Modern methods are no doubt best methods but the conventional methods are feasible and somewhat good for identification (Dolin et al., 2010).

Pulmonary TB is a curable disease but it is increasing in Pakistan because of lack of awareness and low literacy rate. Many patients have accepted it as a part of their lives and no steps are being taken to prevent it from spreading.

There are no safety measures adopted in hospitals to save HCWs from this occupational disease. Moreover, there are no isolated wards for the TB patients. Therefore, the present study is designed to find out the frequency of pulmonary TB patients among general population and health care workers. Besides, it will make the patients and HCWs are of the possible risk factors and co-morbid conditions associated with pulmonary TB.

The aims of the present study are to identify the risk factors and assess the population-attributable fraction (PAF) (percentage) of pulmonary TB in the general population associated with exposure to HCWs in their working settings.


Ali, H.M., Bhatti, S., Iqbal, M.N., Ali, S., Ahmad, A., Irfan, M., Muhammad, A., 2015. Mutational analysis of MDM2 gene in hepatocellular carcinoma. Sci. Lett., 3(1):33-36.

Dolin, A., Gerald, L., Mandell, J.E., Bennett, R., 2010. Mandell, Douglas and Bennett’s principles and practice of infectious diseases. Philadelphia. pp. 250. PA: Churchill Livingstone/Elsevier.

Kruijshaar, M.E., Abubakar, I., 2009. Increase in extrapulmonary tuberculosis in England and Wales 1999-2006. Thorax., 64: 1090-5.

Lim, S.S., Vos, T., Flaxman, A.D., Danaei, G., Shibuya, K., Adair-Rohani, H., Amann, M., Anderson, R.H., Andrews, K.G., Aryee, M., et al. 2013. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet., 380: 2224-2260.

McAdam, A.J., Kumar, V., Abbas, A.K., Fausto, N., Mitchell, R.N. 2007. Robbins Basic Pathology (8th ed.). pp. 516-522.

Muhammad, A., Farooq, M.U., Iqbal, M.N., Ali, S.,Ahmad, A. Irfan, M., 2013. Prevalence of diabetes mellitus type II in patients with hepatitis C and associated with other risk factors. Punjab Univ. J. Zool., 28(2): 69-75.

Ndugga, L.K., Cleef, M.V., Juma, E.,  Kimwomi, J., Githul, W., Oskam, L., Schuitema, A., Soolingen, D.V., Nganga, L., Kibuga, D., Odhiambo, J., Klaster, P., 2004. Comparison of PCR with the Routine Procedure for diagnosis of Tuberculosis in a Population with High Prevalence of Tuberculosis and Human Immunodeficiency Virus. J. Clin. Microbiol., 4293: 1012-1015.

Satapathy, P., Das, D., Murmu, B.N., Kar, S.K., 2014. Decontamination of sputum for longer time in sodium hydroxide for isolation of Mycobacterium tuberculosis. Int. J. Mycobacteriol., 3(4): 290-292.

Singhal, R., Myneedu, V.P., 2015. Microscopy as a diagnostic tool in pulmonary tuberculosis. Int. J. Mycobacteriol., 4(1): 1-6.

Solovic, I., Jonsson, J., Korzeniewska- Kosela, M., Chiotan, D.I., Pace-Asciak, A., Slump, E., Rumetshofer, R., Abubakar, I., Kos, S., Svetina-Sorli, P., Haas, W., Bauer, T., Sandgren, A., van-der-Werf, M.J., 2013. Challenges in diagnosing extra pulmonary tuberculosis in the European Union.Eurosurveil.,13: 230-280.

Warren, D., Johnson, J.R., Johnson, C.W., Franklin, C., 2002. Genitourinary Tuberculosis Campbell’s Urology. (8th edition). 1: 17-21.

WHO. 2006. The global plan to stop TB 2006–2015: Stop TB partnership. Geneva, Switzerland: World Health Organization.

WHO. 2013. Global tuberculosis report 2013. Geneva, Switzerland: World Health Organization.