In patients who sought treatment at the dental clinic of a tertiary hospital in Nigeria, we found an unexpectedly high rate of unrecognized infection with pathogenic mycobacteria. Ten (13%) of 78 study participants who provided sputum samples were infected with M. tuberculosis. Our findings corroborate other studies of TB cases and show that AFB smears alone would miss some infected patients. M. tuberculosis is transmitted with high efficiency to household contacts (9), and transmission of mycobacteria, including multidrug-resistant M. tuberculosis strains, from dental patients to dental practitioners, probably occurs (10). Accordingly, infected participants in this study, especially those who had positive AFB smears, were, in principle, capable of infecting dental practitioners and other patients. Reports from other settings suggest that the threat of TB transmission from clients to dentists is not only theoretical (11). This extremely high percentage of undiagnosed AFB positivity is of public health concern because dental clinics in TB-endemic areas are not usually considered a place of high risk for TB transmission; therefore, preventive measures are not routinely implemented.
http://www.cdc.gov/eid/content/16/9/1479.htm
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