Prevalence, perception of risk and mycobacterium tuberculosis control practices among healthcare workers in HIV care and treatment centres in North Central Nigeria.

Background: Globally, Healthcare workers (HWs) are known to be at higher risk of Tuberculosis (TB), especially those working in HIV settings. Understanding HW's alertness of TB risk is an important step to ensure safety in such settings. Hence, we assessed the perception of the risk of TB and its associated factors among HWs in HIV care and treatment centres in North-Central Nigeria.

Methods: This study is a nested cross-sectional descriptive study conducted among HWs in North-Central Nigeria. HWs were recruited across 14 health facilities with dedicated HIV clinics (n = 337). Perception of risk to TB was captured using a binary outcome and a sliding scale of 1-10 on a structured questionnaire, and blood samples were collected and tested for mycobacterium TB infection at the biorepository of the Institute of Human Virology Nigeria. Univariate and Multivariate analysis were performed using STATA version 18, with statistical significance set at 5%.

Results: Overall, 86.9% of HWs in HIV centres perceived themselves to be at risk of TB. Perception of risk to TB was significantly lower among male HWs (crude Odds Ratio: 0.50; 95% Confidence Interval (CI): 0.26-0.95). Findings from the multivariable analysis further revealed that perception of risk to TB was significantly lower among HWs < 20years (adjusted Odds Ratio (aOR): 0.13; 95%CI: 0.02-0.83), HW with no formal/primary education (aOR: 0.10; 95%CI: 0.01-0.73) and HWs working in primary (aOR: 0.24; 95%CI: 0.06-0.92) or secondary (aOR: 0.41; 95%CI: 0.18-0.95) healthcare facilities. Also, daily monitoring of TB Infection Control (IC) practices (aOR: 2.53; 95%CI: 1.27-5.04) and having a designated area for sputum samples collection (aOR: 3.68; 95%CI: 1.38-9.77) were associated with increased odds of perception of risk to TB while the presence of annual HIV testing was associated with decreased perception of risk to TB.

Conclusion: There is a high perception of risk to TB among HWs working in HIV clinics. However, perception of risk to TB is influenced by age, educational status, level of care at healthcare facilities, and level of TB IC practices. TB IC trainings should target younger HWs, who are males, with no formal education and working in primary health facilities.