Although the proportion of global tuberculosis cases that arise from nosocomial transmission is unknown, many studies document that ongoing transmission in health-care facilities, primarily from undetected cases, is an important driver of the tuberculosis epidemic. Health-care workers are disproportionally affected by the occupational hazard of tuberculosis transmission, with at least a three times higher incidence of active tuberculosis shown in low-income and middle-income countries. A similar situation is also likely to affect community care providers in regions with a high tuberculosis burden, although data are scarce.
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