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Résumé :
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The transmission of Mycobacterium tuberculosis from patients to health-care workers (HCWs) is an issue of global concern, particularly in countries with a high burden of multidrug-resistant tuberculosis (MDR-TB), such as Tajikistan. This countrywide study (2009–2014) determined the number of registered tuberculosis (TB) cases and the notification rate among HCWs in TB health-care facilities, compared with the general population; their characteristics; and treatment outcomes. TB notification rates among staff working in TB facilities ranged from two to ten times higher than those in the general population (6-year average: 585/100 000 versus 89/100 000 respectively). There were 44 staff working in TB facilities with TB: 9 doctors, 13 nurses, 11 nurse assistants, 5 laboratory technicians and 6 non-medical staff (two gardeners, one guard, one electrician, one administrator and one cleaner). Six had previously treated TB and all previous episodes were related to work in TB facilities. Two others had MDR-TB and one had extremely drug-resistant TB (XDR-TB). Five staff (two with MDR-TB) had diabetes mellitus and one of these died. Treatment success was 89% on a short-course regimen, compared with 60% for retreatment and 33% for MDR/XDR-TB regimens. TB case notification among staff is high and all types of workers are being affected; the TB risk is recurrent and treatment outcomes for retreatment and drug-resistant TB are poor. We advocate urgent action to improve TB infection control in Tajikistan
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