Evaluacion de la respuesta a la tuberculina en estudiantes del area de la salud / Evaluation of the response to tuberculin among university students in the health field

RESUMEN

Se realizo un estudio transversal con el fin de evaluar la respuesta a la tuberculina en estudiantes del area de la salud (medicina, odontologia, enfermeria y bacteriologia) en comparacion con estudiantes de otras areas de la Universidad de Antioquia (Medellin, Colombia) en tres niveles, (inicial, intermedio y final) del programa academico. La muestra comprendio 490 estudiantes, 273 del area de la salud y 217 de las otras areas; la seleccion se hizo de manera aleatoria con base en los listados del Departamento de Admisiones y Registros de la Universidad para el segundo semestre de 1998. Se determino la presencia de cicatriz de vacunacion BCG y factores de riesgo de tuberculosis. La tuberculina se evaluo 72 horas despues de la aplicacion intradermica de 2 UT de PPD, RT-23. La respuesta a la tuberculina no mostro deferencias por nivel de estudios ni nivel socioeconomico; solo la presencia de cicatriz BCG estuvo significativamente asociada (P=0,007). Estos resultados indican que los estudiantes del area de la salud tienen un contacto reducido con pacientes con tuberculosis o sus muestras durante su formacion, lo cual no descarta la tuberculosis como riesgo profesional para el personal de salud

ABSTRACT

A cross-sectional study was done at the University of Antioquia, Medellín, Colombia, to evaluate the response to a tuberculin skin test among students in undergraduate health programs (medicine, odontology, nursing, and bacteriology) as compared to undergraduate students in nonhealth programs. The study included students from the beginning, middle, and end of the university's academic programs. The sample of 490 students included 273 from health programs and 217 from nonhealth programs. Participants were randomly selected using lists provided by the university registrar, for the second semester of 1998. The presence of a BCG vaccination scar was determined, and all the participants were also questioned about TB-related risk factors. Tuberculin skin test reactivity was evaluated by the size of induration 72 hours after intradermal injection of two tuberculin units of purified protein derivative RT 23. There were no differences in tuberculin reactivity between students from the health programs and from the nonhealth programs, irrespective of the academic level. However, there was a significantly higher proportion of positive skin tests among students with a BCG scar. These results suggest that undergraduate health students do not have extensive contact with TB patients or with clinical samples from such patients. Nevertheless, the results do not rule out TB as an occupational risk for health personnel.