Introduction: Jailed populations exhibit high rates of tuberculosis (TB) infection and active disease. Methods: A cross-sectional study was performed to estimate the prevalence of latent and active TB and to identify factors associated with latent infection in inmates. Results: The prevalence of latent TB was 49%, and the prevalence of active TB was 0.4%. The presence of a Bacille Calmette-Guérin (BCG) scar (prevalence ratio (PR)=1.65; 95% confi dence interval (CI): 1.09-2.50; p=0.0162) and the World Health Organization (WHO) score for active TB in prisons (PR=1.07; 95% CI: 1.01-1.14; p=0.0181) were correlated with infection. Conclusions:The identifi cation of associated factors and the prevalence of latent and active TB allows the development of plans to control this disease in jails.Keywords: Prisoners. Bacille Calmette-Guérin. Latent tuberculosis.Tuberculosis (TB) is the second leading cause of death due to infectious disease worldwide. In Brazil, the incidence of active TB is at least 20 times higher in the jailed population than in the general population (669.7-3,173 per 100,000 individuals versus 37.0 per 100,000 individuals) 1 . The prevalence of latent TB in the jailed Brazilian population varies between 40% and 72% 2 . The high rates of infection by Mycobacterium tuberculosis (MTB) are related to long terms of imprisonment and the poor sanitary conditions in jails 3,4 . Latent tuberculosis infection (LTBI) predisposes inmates to a greater risk of progression to active disease and increases the transmission rates inside and outside of the jail system 4 . The aim of this study was to estimate the prevalence of latent and active TB infection and to describe the risk factors associated with latent TB among inmates in a jail in the central-western region of Brazil.A cross-sectional study was performed in a population of inmates at the Harry Amorim da Costa Jail (HACJ) in Dourados City between July and August 2010. The inclusion criteria specified only that the participants be HACJ inmates and sign an informed consent form. A trained team administered 0.1ml of the purifi ed protein derivative, ready-to-use antigen (PPD-RT 23 ) produced by the Statens Serum Institute (Copenhagen, Denmark) intradermally on the anterior side of the lower left arm of each participant. The transverse diameter of the induration was measured 48h after application. Latent infection was diagnosed in cases of an induration greater than 10mm produced by the tuberculin skin test (TST). A standardized questionnaire was given to the participants, addressing the following parameters: habits (smoking, alcohol, and drug use), imprisonment length, and respiratory symptoms. The alcohol intake section of the questionnaire consisted of four questions. Alcoholism was established using the Cut down, Annoyed, Guilty, and Eye-opener (CAGE) questionnaire 5 . Respiratory symptoms were assessed according to the World Health Organization (WHO) clinical scoring system for identifying active TB in jails: a cough lasting for more than two weeks (2 ...

BackgroundDengue, an arboviral disease, is a public health problem in tropical and subtropical regions worldwide. In Brazil, epidemics have become increasingly important, with increases in the number of hospitalizations and the costs associated with the disease. This study aimed to describe the direct costs of hospitalized dengue cases, the financial impact of admissions and the use of blood products where current protocols for disease management were not followed.Methods and ResultsTo analyze the direct costs of dengue illness and platelet transfusion in Brazil based on the World Health Organization (WHO) guidelines, we conducted a retrospective cross-sectional census study on hospitalized dengue patients in the public and private Brazilian health systems in Dourados City, Mato Grosso do Sul State, Brazil. The analysis involved cases that occurred from January through December during the 2010 outbreak. In total, we examined 8,226 mandatorily reported suspected dengue cases involving 507 hospitalized patients. The final sample comprised 288 laboratory-confirmed dengue patients, who accounted for 56.8% of all hospitalized cases. The overall cost of the hospitalized dengue cases was US $210,084.30, in 2010, which corresponded to 2.5% of the gross domestic product per capita in Dourados that year. In 35.2% of cases, blood products were used in patients who did not meet the blood transfusion criteria. The overall median hospitalization cost was higher (p = 0.002) in the group that received blood products (US $1,622.40) compared with the group that did not receive blood products (US $550.20).ConclusionThe comparative costs between the public and the private health systems show that both the hospitalization of and platelet transfusion in patients who do not meet the WHO and Brazilian dengue guidelines increase the direct costs, but not the quality, of health care.

There is a potential relationship between exposure to sugar cane manufacturing processes and tuberculosis infection among indigenous populations.