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Tuberculosis (TB) in health care workers (HCWs) was not considered a serious problem following the advent of effective antibiotic therapy. Interest was re-stimulated by the occurrence of several major nosocomial outbreaks.

We have reviewed the available published literature regarding prevalence and incidence of TB infection and disease among HCWs in countries categorised by mean income. We included studies published in English since 1960 from low- and middle-income countries (LMICs) and since 1990 from high-income countries (HICs). We excluded outbreak reports and studies based only on questionnaires.

The median prevalence of latent TB infection (LTBI) in HCWs was 63% (range 33–79%) in LMICs and 24% in HICs (4–46%). Among HCWs from LMICs, LTBI was consistently associated with markers of occupational exposure, but in HICs it was more often …