Active and latent tuberculosis among inmates in La Esperanza prison in Guaduas, Colombia

Abstract

IntroductionActive tuberculosis (TB) and latent tuberculosis infection (LTBI) are a public health threat in prisons around the world. The objectives of the study were to estimate the prevalence of LTBI and TB as well as to investigate TB transmission inside one prison, in Colombia.MethodsA Cross-sectional study was conducted in inmates who agreed to participate. Inmates with respiratory symptoms (RS) of any duration underwent to medical evaluation and three sputum samples were taken for smear microscopy and culture for TB diagnosis. Drug susceptibility was analyzed using BACTEC MGIT 960 and GenoType MTBDRplus. Molecular genotyping of Mycobacterium tuberculosis isolates was performed by 24-Locus MIRU-VNTR and spoligotyping. LTBI was evaluated according to the result of the tuberculin skin test (TST). Close contact investigation was conducted inside the prison for inmates that shared the cell with the index TB case.ResultsAmong 301/2,020 (15%) inmates with RS of any duration, 8% were diagnosed with active TB. The prevalence of active TB was 1,026 cases/100,000 inmates. We isolated M. tuberculosis in 19/24 (79%) TB cases, 94.7% were susceptible to first line drugs and only one was monoresistant to isoniazid. The most prevalent sub-lineage was Haarlem (68.4%), followed by LAM (26.3%) and T superfamily (5.3%). 24-Locus MIRU-VNTR typing results alone or in combination with spoligotyping identified three clusters containing two isolates each. Two clusters corresponded to inmates that shared the same cell, but each one was located in different blocks of the prison. Inmates from the last cluster were in the same block in nearby cells. TST reading was performed in 95.6% inmates, and 67.6% had a positive reaction.ConclusionsThe prevalence of LTBI and TB was higher in prison than in the general population. Molecular genotyping suggests that TB in this prison is mainly caused by strains imported by inmates or endogenous reactivation.

Prevalence of latent tuberculosis infection and associated risk factors in prison in East Wollega Zone of western Ethiopia

“…The probable explanation for this difference might be due to the variation of study population from high-income countries, a prison environment in a country of low TB incidence, more efficient TB control programs both inside and outside prisons and prisonbased TB screening programs in these countries than in Ethiopia. However, it was congruent to study done in prison in Nigeria (52.4%) [32] and lower than those prison found in Spain (54.6%) [33]; in three Brazilian prisons: (61.5% [34], 64.1% [35], and 73% [36]); Colombia (67.6%) [37]; Northeastern Malaysia (87.6%) [38]; Malaysian (88.8%) [39]. The possible reasons for the difference might be associated with the variation of the diagnostic methods used, IGRA in our study and previous study were used Tuberculin skin test, the prevalence of LTB infection may be influenced by a prior BCG vaccination, which is known to cause false-positive TST results.…”

Tuberculosis y hacinamiento carcelario desde la perspectiva de las inequidades sociales en salud en Colombia, 2018

“…En los dos estudios, se concluyó que la prevalencia de todas las infecciones de transmisión aérea aumentaba en ambientes superpoblados o con ventilación inadecuada 8 . Otros estudios sobre tuberculosis y población privada de la libertad en el país, coinciden en cuanto a la alta prevalencia de esta enfermedad en instituciones carcelarias comparada con la de la población general 26 , 27 , 28 , situación en la que tiene un papel significativo el hacinamiento o sobrepoblación.…”

Tratamiento no exitoso de tuberculosis en reclusos ecuatorianos: hacinamiento y otros factores asociados

“…UU. (6,3%) (Katyal et al, 2018); Reino Unido (7,1%) (Gray et al, 2020), del mismo modo, se han reportado cifras un poco más altas como las de Australia (14,0%) (Levy et al, 2007); Italia (17,9%) (Carbonara et al, 2005); y cifras aún mayores como las informadas en Minas Gerais (25,2%) (Navarro et al, 2016); Canadá (32,3%) (Schwartz et al, 2014); España (40,3%) (Marco et al, 2012); Suiza (46,9%) (Ritter y Elger, 2012); Etiopia (51,7%) (Chekesa et al, 2020) y en Colombia (67,6%) (Guerra et al, 2019). Las posibles razones de la diferencia podrían estar asociadas con la variación de los métodos de diagnóstico utilizados, debido a esto, la técnica usada en nuestro estudio fue el frotis y cultivo, y en los otros trabajos se utilizaron la prueba cutánea de tuberculina, fluorescencia, el ensayo de liberación de interferón gamma, entre otras; reconociendo que la sensibilidad del frotis es relativamente baja (Steingart et al, 2006) y los cultivos necesitan de mayor infraestructura y consumen mucho más tiempo para su ejecución; además de, está afectado por variables como, cantidad del espécimen, tratamiento quimioterápico previo.…”