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Matucci T, Riccardi N, Occhineri S, Pontarelli A, Tiseo G, Falcone M, Puci M, Saderi L, Sotgiu G. Treatment of latent tuberculosis infection in incarcerated people: a systematic review. Clin Microbiol Infect 2023:S1198-743X(23)00086-1. [PMID: 36868354 DOI: 10.1016/j.cmi.2023.02.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/07/2023] [Accepted: 02/22/2023] [Indexed: 03/05/2023]
Abstract
BACKGROUND The estimated number of people deprived of liberty is increasing, with 11.55 million incarcerated globally in 2021. Transmission of Mycobacterium tuberculosis (MTB) strains is facilitated in over-crowded, poorly ventilated settings such as jails and penitentiaries. Moreover, inmates may show individual risk factors for the development of tuberculosis (TB) disease. Treatment regimens for latent tuberculosis infection (LTBI) may require up to 9 months of drug exposure and are characterized by adverse events (AEs) and low completion rates. OBJECTIVES to describe current scientific evidence on feasibility, acceptability and completion rate of LTBI treatment in prison/correctional institutes. DATA SOURCES Articles were retrieved from MEDLINE/PubMed, no time restriction was applied. STUDY ELIGIBILITY CRITERIA Human retrospective and prospective studies published on LTBI treatment in incarcerated populations were included. ASSESSMENT OF RISK OF BIAS Bias assessment plots and Egger weighted regression test were used to determine the risk of bias. METHODS OF DATA SYNTHESIS Absolute and relative frequencies were assessed for qualitative data. Pooled proportion of included study groups and 95% confidence interval estimates, weighted for sample sizes, were illustrated in forest plots. I2 indicator association were used for true variability and overall variation. Fixed and random-effects models were chosen depending on the estimated between-study heterogeneity. RESULTS Of11 selected studies only 1 was conducted in a high TB incidence country. Overall, completion rates ranged from 26% to 100% across the included studies. Reason for discontinuation of treatment were transfer to other facilities, release, or loss to follow-up (LTFU) (range 0-74%), incidence of AEs (range 0-18%), and refusal or withdrawal from treatment (range 0-16%). CONCLUSIONS Implementation of short-course regimens in prisons should be considered given the low incidence of AEs observed; however, inmates consistently refused to complete LTBI treatment, thus underlining the need for improvement in retention in care.
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Affiliation(s)
- Tommaso Matucci
- StopTB Italia, Milan, Italy; Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Niccolò Riccardi
- StopTB Italia, Milan, Italy; Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy.
| | - Sara Occhineri
- StopTB Italia, Milan, Italy; Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Agostina Pontarelli
- StopTB Italia, Milan, Italy; Unit of Respiratory Infectious Diseases, Cotugno Hospital, Azienda Ospedaliera dei Colli, Naples, Italy
| | - Giusy Tiseo
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Marco Falcone
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Mariangela Puci
- University of Sassari, Department of Medicine, Surgery and Pharmacy, Italy
| | - Laura Saderi
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Giovanni Sotgiu
- StopTB Italia, Milan, Italy; Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
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Soltobekova N, Kozukeev T, Yiehdego G, Labib F, Hovhannesyan A, Rossi R. Time to start of tuberculosis treatment in penitentiary system of Kyrgyz Republic: A retrospective cohort study. PLoS One 2022; 17:e0264252. [PMID: 35263370 PMCID: PMC8906629 DOI: 10.1371/journal.pone.0264252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 02/01/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Tuberculosis burden among the incarcerated population is generally higher than that of general population. Early diagnosis and prompt initiation of treatment are key strategies to contain disease transmission. The aim of this study was to determine the time to treatment initiation among inmates with new smear or Xpert MTB/RIF positive pulmonary tuberculosis and explore risk factors associated with delayed treatment initiation in prison settings.
Methods
We conducted a retrospective cohort study using routine health care data from prison settings in Kzrgyz Republic on new pulmonary tuberculosis patients confirmed by smear microscopy or GeneXpert MTB/RIF during 2014–2019. We computed delay in start of treatment—days from specimen collection to treatment initiation—for exposure variables. We dichotomized treatment delay using 10-day cut-off point,and used logistic regression to identify factors associated with treatment delay.
Results
Among 406 cases included into analysis, the median delay to treatment initiation was 7 days [IQR: 2–16 days]. Using 10-day cut-off, 189 (46.6%) patients had delayed treatment initiation. Treatment delay was negatively associated with smear positivity [adjusted OR (aOR) = 0.44, 95% CI 0.29–0.68] compared to smear negative patients, while patients with isoniazid resistant (aOR = 2.61, 95%CI 1.49–4.56) and rifampicin resistant tuberculosis (aOR = 4.14, 95%CI 2.56–6.77) had increased delay compared to patients who were sensitive for both rifampicin and isoniazid.
Conclusion
Timely diagnosis and effective treatment remain the cornerstone of TB control program populations in the general and in prison settings in particular. Prison authorities need to address all potential areas of delay in TB diagnosis and treatment to strengthen their TB control efforts so that prisons remain free of TB for detainees, prison staff and visitors. These include improved supply of TB drugs, early detection of TB cases and improved collaboration with the health authorities outside the prison system.
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Affiliation(s)
- Nazgul Soltobekova
- Department for Medical and Sanitary Services of the State Service for Execution of Punishment, Bishkek, Kyrgyz Republic
| | - Turatbek Kozukeev
- International Committee of the Red Cross, Bishkek, Kyrgyz Republic
- * E-mail: (GY); (RR); (TK)
| | - Ghirmai Yiehdego
- International Committee of the Red Cross, Bishkek, Kyrgyz Republic
- * E-mail: (GY); (RR); (TK)
| | - Fatah Labib
- International Committee of the Red Cross, Bishkek, Kyrgyz Republic
- National Center of Phthisiology, Bishkek, Kyrgyz Republic
| | | | - Rodolfo Rossi
- International Committee of the Red Cross, Geneva, Switzerland
- * E-mail: (GY); (RR); (TK)
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SeyedAlinaghi S, Farhoudi B, Ataeinia B, Dadras O, Hosseini M, Jafari S, Mazaheri-Tehrani E, Alasvand R, Shahbazi M, Mohraz M. Comparison of tuberculosis indicators after implementation of the clinical protocol for tuberculosis and HIV management in Iranian prisons: a quasi-experimental study. JOURNAL OF HEALTH RESEARCH 2020. [DOI: 10.1108/jhr-04-2019-0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PurposeThe aim of this study was to compare the defined indicators of tuberculosis (TB) control program in the intervention and control prisons, after implementation of the national clinical protocol for TB and HIV management in Iranian prisons, suggesting active health service provision in all steps of service provision.Design/methodology/approachThis was quasi-experimental study conducted among inmates of two prisons in Iran. Great Tehran prison was purposively chosen as the intervention prison and Karaj prison was purposively chosen as control prison as well. Intervention and control prisons were compared in terms of the TB indicators within three periods (before intervention, during implementation and follow-up period) from October 2013 to June 2014.FindingsNumber of inmates with TB symptoms who underwent TB workup was four times more in intervention prison compared to control prison (9.3 vs 2.5 cases out of 1,000 inmates per month in the case prison compared to the control prison). Such difference was also significant in the intervention prison, comparing before and during the intervention period. The patient finding in case prison increased significantly after the intervention (223.6 vs 81.8 cases out of 100,000 inmates per year). The number of TB cases who received HIV testing increased from 50 to 100%.Originality/valueActive health service provision has significantly improved indicators in the intervention prison. The authors recommend implementation of this guideline in all prisons of Iran. Integration of other diseases with high burden among prisoners is also recommended in the active health services provision.
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Navarro PDD, Almeida IND, Kritski AL, Ceccato MDG, Maciel MMD, Carvalho WDS, Miranda SSD. Prevalence of latent Mycobacterium tuberculosis infection in prisoners. J Bras Pneumol 2017; 42:348-355. [PMID: 27812634 PMCID: PMC5094871 DOI: 10.1590/s1806-37562016000000001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 07/31/2016] [Indexed: 11/22/2022] Open
Abstract
Objective: To determine the prevalence of and the factors associated with latent Mycobacterium tuberculosis infection (LTBI) in prisoners in the state of Minas Gerais, Brazil. Methods: This was a cross-sectional cohort study conducted in two prisons in Minas Gerais. Tuberculin skin tests were performed in the individuals who agreed to participate in the study. Results: A total of 1,120 individuals were selected for inclusion in this study. The prevalence of LTBI was 25.2%. In the multivariate analysis, LTBI was associated with self-reported contact with active tuberculosis patients within prisons (adjusted OR = 1.51; 95% CI: 1.05-2.18) and use of inhaled drugs (adjusted OR = 1.48; 95% CI: 1.03-2.13). Respiratory symptoms were identified in 131 (11.7%) of the participants. Serological testing for HIV was performed in 940 (83.9%) of the participants, and the result was positive in 5 (0.5%). Two cases of active tuberculosis were identified during the study period. Conclusions: Within the prisons under study, the prevalence of LTBI was high. In addition, LTBI was associated with self-reported contact with active tuberculosis patients and with the use of inhaled drugs. Our findings demonstrate that it is necessary to improve the conditions in prisons, as well as to introduce strategies, such as chest X-ray screening, in order to detect tuberculosis cases and, consequently, reduce M. tuberculosis infection within the prison system.
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Affiliation(s)
- Pedro Daibert de Navarro
- . Universidade Federal de Minas Gerais, Belo Horizonte (MG) Brasil.,. Secretaria de Estado de Saúde de Minas Gerais, Belo Horizonte (MG) Brasil
| | | | - Afrânio Lineu Kritski
- . Programa Acadêmico em Tuberculose, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro (RJ) Brasil
| | - Maria das Graças Ceccato
- . Departamento de Farmácia Social, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte (MG) Brasil
| | | | - Wânia da Silva Carvalho
- . Departamento de Farmácia Social, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte (MG) Brasil
| | - Silvana Spindola de Miranda
- . Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte (MG) Brasil
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Disparities in Tuberculosis Treatment Completion by Incarceration Status, U.S., 1999-2011. Am J Prev Med 2017; 52:483-490. [PMID: 28012812 PMCID: PMC6434686 DOI: 10.1016/j.amepre.2016.10.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 09/05/2016] [Accepted: 10/31/2016] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Treatment completion is the cornerstone of tuberculosis (TB) control strategy globally. Although the majority of reported TB cases in the U.S. have documented treatment completion, individuals diagnosed while incarcerated are less likely to have documentation of whether or not they completed treatment. This study assessed trends and correlates of no documented treatment completion among individuals incarcerated at diagnosis. METHODS U.S. National TB Surveillance System (1999-2011) data on cases eligible for treatment completion were analyzed during 2014-2015. Treatment outcomes and trends in no documented completion were assessed by incarceration status. Multivariable logistic regression identified correlates of no documented completion among people incarcerated at diagnosis. RESULTS A lower proportion of individuals incarcerated at diagnosis had documented TB treatment completion than non-incarcerated individuals (75.6% vs 93.7%), and a higher proportion were lost to follow-up (10.7% vs 2.2%) or moved (9.4% vs 2.3%) during treatment (p<0.001). The 1999-2011 trend in no documented completion significantly increased among those incarcerated at diagnosis and declined among non-incarcerated individuals. Being foreign born was the strongest correlate of no documented completion among people incarcerated at diagnosis (AOR=2.86, 95% CI= 2.35, 3.49). Social risk factors for TB (e.g., homelessness, substance abuse), although common among incarcerated individuals, did not emerge as correlates of no documented completion. CONCLUSIONS People diagnosed with TB disease at U.S. correctional facilities, especially the foreign born, require enhanced strategies for documenting TB treatment completion. Strengthened collaboration between correctional and public health agencies could improve continuity of care among released inmates.
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Oliveira LGDD, Natal S, Camacho LAB. [Analysis of the implementation of the Tuberculosis Control Program in Brazilian prisons]. CAD SAUDE PUBLICA 2015; 31:543-54. [PMID: 25859721 DOI: 10.1590/0102-311x00042914] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 09/29/2014] [Indexed: 11/22/2022] Open
Abstract
Tuberculosis control measures in Brazil's prison population have been regulated for ten years under the National Prison Health System Plan. Brazilian states have different organizational models for the Tuberculosis Control Program (TCP) in their prison systems. This study evaluated TCP implementation in prisons in two Brazilian states, using a multiple case study design with a qualitative approach and a log-frame analysis and assessment. According to predefined criteria, two state cases were selected, with two analytical units for each case and one prison hospital in Case 2. We identified partial program implementation in the Case 1 prisons and prison hospital and low implementation in non-hospital prison health services in Case 2. Lack of financial investment and resources, lack of integration between the courts and law enforcement system and health institutions, and poor access to health services in prisons were adverse factors for program implementation.
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Alavi SM, Bakhtiarinia P, Eghtesad M, Albaji A, Salmanzadeh S. A comparative study on the prevalence and risk factors of tuberculosis among the prisoners in khuzestan, South-west iran. Jundishapur J Microbiol 2014; 7:e18872. [PMID: 25741435 PMCID: PMC4335546 DOI: 10.5812/jjm.18872] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 04/19/2014] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND High prevalence of Tuberculosis (TB) among prisoners is reported as an alarming public health problem in the world, especially in the developing countries. OBJECTIVES Since there is almost no information from TB in this population in Khuzestan province, the current study aimed to assess the prevalence and identify risk factors of TB among the prisoners of this region. PATIENTS AND METHODS In a retrospective study, medical files of patients with Tuberculosis in Khuzestan Health Center (KHC), from 2005 to 2010, were studied. Patients with Pulmonary TB were placed in two groups as the Inmate Prison (IP) and Non-Inmate Prison (NIP) groups. Data extracted from the patients' records in the two groups were compared by SPSS software system using Chi square and Fisher exact tests. P-value was considered less than 0.05. RESULTS From the reported 4562 patients with Tuberculosis, 363 (7.9%) were prison inmates at the time of TB diagnosis. Prevalence of TB cases among the prison inmates was 403.3 per 100'000.The annual TB case rate in the general population during this period was 16.4 per 100,000. Among the TB risk factors close contact [odds ratio (OR), 95% confidence interval (CI), 19.4, 8.9-41.8, P < 001] especially in the recent 2 years, injection drug use (IDU) [OR, 95% CI, 4.61, 1.7-12.4, P = 006], and Human Immunodeficiency Virus (HIV) infection [OR, 95% CI, 2.4, 1.1-5.0, P = 025] were more frequent in the prisoners than in the general population with TB. CONCLUSIONS In the region under study the prevalence of TB among the prisoners was higher than the general population. The main risk factors for Pulmonary TB in this population were close contact, IDU and HIV infection.
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Affiliation(s)
- Seyed Mohammad Alavi
- Health Research Institute, Infectious and Tropical Disease Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Pejman Bakhtiarinia
- Khuzestan Health Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
- Corresponding author: Pejman Bakhtiarinia, Khuzestan Health Center, Ahvaz Jundishapur University of Medical Sciences, IR Iran. Tel: +98-6113387724, E-mail:
| | - Mehdi Eghtesad
- Khuzestan Health Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Ali Albaji
- Khuzestan Health Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Shokrolah Salmanzadeh
- Infectious Diseases Department of Razi Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
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Kowada A. Cost-effectiveness of interferon-gamma release assay for entry tuberculosis screening in prisons. Epidemiol Infect 2013; 141:2224-34. [PMID: 23286364 PMCID: PMC9151422 DOI: 10.1017/s0950268812002907] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 11/18/2012] [Accepted: 11/22/2012] [Indexed: 11/07/2022] Open
Abstract
The incidence of active tuberculosis (TB) and latent tuberculosis infection (LTBI) in inmates and prison staff is higher than that in the general population. Mycobacterium tuberculosis-specific interferon-gamma release assays (IGRAs) provide more accurate diagnosis of M. tuberculosis infection with higher specificity than the tuberculin skin test (TST). To assess the cost effectiveness of QuantiFERON®-TB Gold In-Tube (QFT) compared to TST, TST followed by QFT and chest X-ray, we constructed Markov models using a societal perspective on the lifetime horizon. The main outcome measure of effectiveness was quality-adjusted life-years (QALYs) gained. The incremental cost-effectiveness was compared. The QFT-alone strategy was the most cost-effective for entry TB screening in prisons in developed countries. Cost-effectiveness was not sensitive to the rates of BCG vaccination, LTBI, TB, HIV infection and multidrug-resistant TB. Entry TB screening using an IGRA in prisons should be considered on the basis of its cost-effectiveness by public health intervention.
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Affiliation(s)
- A Kowada
- Kojiya Haneda Healthcare Service, Ota City Public Health Office, Tokyo, Japan.
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Tuberculosis control in a large urban jail: discordance between policy and reality. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2008; 14:442-7. [PMID: 18708887 DOI: 10.1097/01.phh.0000333878.55572.ed] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study evaluated adherence to tuberculosis control guidelines, published by the Centers for Disease Control and Prevention in 1996, in a large urban jail. Jails are a critical locale because of high risk for tuberculosis transmission in a congregate setting. METHODS Symptom screening at intake into the facility was systematically observed. Medical records were reviewed to measure timing of tuberculin skin testing (TST) and chest radiograph (CXR) screening. Isolation records were examined for airborne infectious isolation practices. Contact investigation practices were evaluated for ease of data retrieval and adherence to CDC guidelines. RESULTS A TB symptom screening question was asked correctly during 28/97 of intake health interviews. Median time from intake to TST was 3 days for men and 2 days for women. Median time from referral to CXR was 2 days for men and 7 days for women. Delays were noted in diagnostic testing of 51 detainees isolated for suspected TB. Contact investigations lacked comprehensive procedures, data collection forms, and databases for managing information. CONCLUSION Findings were used to refine protocols for TB control. This evaluation illustrated the need for ongoing assessment of adherence to TB control protocols in short-term correctional settings to prevent the spread of TB.
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Levy MH, Butler TG, Zhou J. Prevalence of Mantoux positivity and annual risk of infection for tuberculosis in New South Wales prisoners, 1996 and 2001. NSW PUBLIC HEALTH BULLETIN 2007; 18:119-24. [PMID: 17854540 DOI: 10.1071/nb07051] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This study compares the prevalence of Mantoux positivity among prisoners in NSW in 1996 and 2001 and examines factors associated with Mycobacterium tuberculosis infection. DESIGN Cross-sectional random samples of prisoners, including a longitudinal cohort of prisoners screened in both 1996 and 2001. SETTING 29 correctional centres. PARTICIPANTS 747 men and 167 women participated in the 2001 NSW Inmate Health Survey; a cohort of 104 prisoners from the 1996 and 2001 NSW Inmate Health Surveys. RESULTS The prevalence of Mantoux positivity remained stable between 1996 and 2001 (12% and 14%, p = 0.2), and increased among prisoners from Asian backgrounds (21% and 47%, p = 0.02). The annual risk of infection in the cohort among those detained continuously between 1996 and 2001 was 3.1%, and among recidivists it was 2.7% (p = 0.6). CONCLUSION The risk of M. tuberculosis infection for Australian prisoners is assessed to be approximately four times higher than that for the community, however there is no attributable risk to the prison environment itself.
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Affiliation(s)
- Michael H Levy
- Centre for Health Research in Criminal Justice, Justice Health, University of Sydney, Australia
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White MC, Cuttler S, Xin Zhao. Linking Released Inmates to TB Clinic for Treatment of Latent Tuberculosis Infection: Why Is it so Difficult? JOURNAL OF CORRECTIONAL HEALTH CARE 2007. [DOI: 10.1177/1078345807302999] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Mary Castle White
- Department of Community Health Systems, University of California, School of Nursing, San Francisco
| | - Sasha Cuttler
- Department of Community Health Systems, University of California, School of Nursing, San Francisco
| | - Xin Zhao
- Tuberculosis Prevention Project, Department of Community Health Systems, University of California, School of Nursing, San Francisco
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Roberts CA, Lobato MN, Bazerman LB, Kling R, Reichard AA, Hammett TM. Tuberculosis prevention and control in large jails: a challenge to tuberculosis elimination. Am J Prev Med 2006; 30:125-30. [PMID: 16459210 DOI: 10.1016/j.amepre.2005.10.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2005] [Revised: 09/01/2005] [Accepted: 10/10/2005] [Indexed: 11/19/2022]
Abstract
BACKGROUND This study assessed the extent to which 20 large jail systems have implemented national recommendations for tuberculosis (TB) prevention and control in correctional facilities. METHODS Data were collected through questionnaires to jail medical directors and TB control directors, observation at the jails, and abstraction of medical records of inmates with TB disease and latent TB infection. RESULTS Twenty percent of jail systems (4/20) had conducted an assessment of risk for TB transmission in their facilities, and 55% (11/20) monitored tuberculin skin test conversions of inmates and staff. Sixty-five percent (13/20) of jails had an aggregate record-keeping system for tracking TB status and treatment, which was usually paper based. Forty-five percent of jails (9/20) had policies to offer HIV counseling and testing to tuberculin skin test-positive patients, and 75% (15/20) screen HIV-infected inmates with chest radiographs. Three quarters of jails (15/20) had policies to always isolate patients with suspected or confirmed pulmonary TB in an airborne infection isolation room. Half of jails with airborne infection isolation rooms (6/12) conformed to Centers for Disease Control and Prevention (CDC) guidelines for monitoring negative pressure. CONCLUSIONS Improvements are needed in conducting TB risk assessments and evaluations to determine priorities and reduce risk of transmission. Inadequate medical information systems are impeding TB control and evaluation efforts. Although HIV infection is the greatest cofactor for development of TB disease, jails have inadequate information on patients' HIV status to make informed decisions in screening and management of TB and latent TB infection. Jails need to improve the use of environmental controls.
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MacNeil JR, Lobato MN, Moore M. An unanswered health disparity: tuberculosis among correctional inmates, 1993 through 2003. Am J Public Health 2005; 95:1800-5. [PMID: 16186458 PMCID: PMC1449439 DOI: 10.2105/ajph.2004.055442] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We sought to describe disparities and trends in tuberculosis (TB) risk factors and treatment outcomes between correctional inmate and noninmate populations. METHODS We analyzed data reported to the national TB surveillance system from 1993 through 2003. We compared characteristics between inmate and non-inmate men aged 15-64 years. RESULTS Of the 210976 total US TB cases, 3.8% (7820) were reported from correctional systems. Federal and state prison case rates were 29.4 and 24.2 cases per 100000 inmates, respectively, which were considerably higher than those in the noninmate population (6.7 per 100000 people). Inmates with TB were more likely to have at least 1 TB risk factor compared with noninmates (60.1% vs 42.0%, respectively) and to receive directly observed therapy (65.0% vs 41.0%, respectively); however, they were less likely to complete treatment (76.8% vs 89.4%, respectively). Among inmates, 58.9% completed treatment within 12 months compared with 73.2% of noninmates. CONCLUSIONS Tuberculosis case rates in prison systems remain higher than in the general population. Inmates with TB are less likely than noninmates to complete treatment.
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Affiliation(s)
- Jessica R MacNeil
- Division of Tuberculosis Elimination, National Center for HIV, STD, and TB Prevention, Office of Communications, Centers for Disease Control and Prevention, 1600 Clifton Road, Mail Stop E-06, Atlanta, GA 30333, USA
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Abstract
This paper examined risk factors associated with TB among inmates, over a 7-year period, and the association of ethnicity and gender with these risk factors. We performed retrospective analysis of data on former inmates from a county jail. TB status at admission was explained with demographics, behavioral risk factors, and incarceration factors. We examined ethnicity and gender defenses on the risk factors. A total of 441 TB cases and 478 non-TB cases were included. Inmates were more likely to have TB if they were whites, unmarried, homeless, alcohol abusers, and HIV positive. Inmates with TB had even lower socioeconomic status and more behavioral risk factors than other inmates. They had fewer incarcerations and less serious crimes, but longer jail stays. TB risk factors differed by ethnicity and gender. TB control in jails requires intervention in the communities where inmates live. Correctional health is a critical part of public health. Public health nurses are responsible for better understanding and improving health care for this high-risk and difficult-to-reach population.
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Affiliation(s)
- Seijeoung Kim
- Hektoen Research Institute, Chicago, Illinois 60612, USA.
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Lobato MN, Roberts CA, Bazerman LB, Hammett TM. Public health and correctional collaboration in tuberculosis control. Am J Prev Med 2004; 27:112-7. [PMID: 15261897 DOI: 10.1016/j.amepre.2004.04.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To assess the extent that 20 large jail systems and their respective public health departments collaborate to prevent and control tuberculosis (TB). METHODS Data were collected through questionnaires sent to jail medical directors and TB control directors, interviews, and on-site observation in each of the jails. RESULTS Only 35% of jail systems and health departments reported having effective collaboration in TB prevention and control activities. Four barriers were reported by a majority of the jail systems: funding (65%), staffing (60%), staff training (55%), and communication (55%). Lack of advance notice of a patient's release was rated as the greatest barrier to discharge planning. Fifty percent of the jail systems reported that they scheduled appointments for soon-to-be released patients with TB, and 10% did so for patients being treated for latent TB infection (LTBI). Fewer patients actually received appointments: seven (39%) of 33 released patients with TB had documentation in their medical record of appointments, and one of 46 released patients on treatment for LTBI had them. Characteristics associated with increased collaboration include having designated liaisons between jail systems and health departments and holding periodic meetings of staff. CONCLUSIONS Health departments and jail systems in the same jurisdiction have implemented recommendations regarding collaboration to a limited extent. Such collaborations need strengthening, especially discharge planning and evaluation of TB control activities.
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Affiliation(s)
- Mark N Lobato
- Centers for Disease Control and Prevention, National Center for HIV, STD, and TB Prevention, Division of Tuberculosis Elimination, Atlanta, Georgia, USA.
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Hayden CH, Mangura BT, Channer I, Patterson GE, Passannante MR, Reichman LB. Tuberculin Testing and Treatment of Latent TB Infection Among Long–term Jail Inmates. JOURNAL OF CORRECTIONAL HEALTH CARE 2004. [DOI: 10.1177/107834580401100107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Christopher H. Hayden
- Christopher H. Hayden is a consultant with the National Tuberculosis Center, New Jersey Medical School (NJMS), University of Medicine and Dentistry of New Jersey (UMDNJ), Newark
| | - Bonita T. Mangura
- UMDNJ Department of Medicine, NJMS National Tuberculosis Center, Newark
| | - Ileen Channer
- Bergen County Jail Medical Department, Hackensack, New Jersey
| | | | | | - Lee B. Reichman
- UMDNJ Department of Medicine, NJMS National Tuberculosis Center, Newark
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