Active and latent tuberculosis in prisoners in the Central-West Region of Brazil

Estevan, Anderson Oliveira; Oliveira, Sandra Maria do Valle Leone de; Croda, Júlio

doi:10.1590/0037-8682-1441-2013

Cited by 37 publications

(40 citation statements)

References 9 publications

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“…Measures of association between TB and HIV positivity were variable amongst those studies that reported it, with some finding no significant association [40,58,60,65,73,75] whilst others reported highly significant associations between the two infections, with relative risks of co-infection ranging from 2.0 to 10.75 [51,58]. …”

Section: Resultsmentioning

confidence: 99%

“…Few studies retrieved were recorded as performed in jails (used to hold individuals awaiting trial or sentencing) [39,40,47,73,74], meaning most of the conclusions drawn were based on those resident in prisons, who are likely to be less transient than jail or remand populations. One jail study found HIV positivity predictive of TB (odds ratio (OR) 3.07; p <0.01) [73], whilst another found very few cases of co-infection (n=2/2103) [47], making it hard to draw conclusions on co-infection risk in jail.…”

Section: Resultsmentioning

confidence: 99%

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Prisoners co‐infected with tuberculosis and HIV: a systematic review

Edge

King

Dolan

et al. 2016

Journal of the International AIDS Society

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IntroductionAlmost from the beginning of the HIV epidemic in 1981, an association with tuberculosis (TB) was recognized. This association between HIV and TB co-infection has been particularly evident amongst prisoners. However, despite this, few studies of TB in prisons have stratified results by HIV status. Given the high prevalence of HIV-positive persons and TB-infected persons in prisons and the documented risk of TB in those infected with HIV, it is of interest to determine how co-infection varies amongst prison populations worldwide. For this reason we have undertaken a systematic review of studies of co-infected prisoners to determine the incidence and/or prevalence of HIV/TB co-infection in prisons, as well as outcomes in this group, measured as treatment success or death.MethodsA literature search was undertaken using the online databases PubMed, Embase, IBSS, Scopus, Web of Science, Global Health and CINAHL Plus. No restrictions were set on language or publication date for article retrieval, with articles included if indexed up to 18 October 2015. A total of 1975 non-duplicate papers were identified. For treatment and outcome data all eligible papers were appraised for inclusion; for incidence/prevalence estimates papers published prior to 2000 were excluded from full text review. After full text appraisal, 46 papers were selected for inclusion in the review, 41 for incidence/prevalence estimates and nine for outcomes data, with four papers providing evidence for both outcomes and prevalence/incidence.ResultsVery few studies estimated the incidence of TB in HIV positive prisoners, with most simply reporting prevalence of co-infection. Co-infection is rarely explicitly measured, with studies simply reporting HIV status in prisoners with TB, or a cross-sectional survey of TB prevalence amongst prisoners with HIV. Estimates of co-infection prevalence ranged from 2.4 to 73.1% and relative risks for one, given the other, ranged from 2.0 to 10.75, although some studies reported no significant association between HIV and TB. Few studies provided a comparison with the risk of co-infection in the general population.ConclusionsPrisoners infected with HIV are at high risk of developing TB. However, the magnitude of risk varies between different prisons and countries. There is little evidence on treatment outcomes in co-infected prisoners, and the existing evidence is conflicting in regards to HIV status influence on prisoner treatment outcomes.PROSPERO Number: CRD42016034068

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Prisoners co‐infected with tuberculosis and HIV: a systematic review

Edge

King

Dolan

et al. 2016

Journal of the International AIDS Society

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“…16 Multiple studies in prisons throughout Brazil have documented active TB prevalence in excess of 2,000 cases per 100,000 inmates. 14,[17][18][19][20] The central west state of Mato Grosso do Sul has the highest incarceration rate in the country. In this setting, we obtained empirical data on architecture, ventilation, and occupancy and projected the impact of diagnostic and environmental interventions on TB transmission.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Ventilation and Early Diagnosis on Tuberculosis Transmission in Brazilian Prisons

Urrego¹,

Ko²,

Carbone³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. Prisoners have among the highest incidence of tuberculosis (TB) globally. However, the contribution of the prison environment on transmission is not well understood and structural characteristics have received little attention as effective epidemiological interventions in TB control. We evaluated architectural characteristics and estimated ventilation rates in 141 cells in three prisons in central west Brazil using steady-state exhaled carbon dioxide (CO 2 ) levels. We used a modified Wells-Riley equation to estimate the probability of infection for inmates sharing a cell with an infectious case and projected the impact of interventions, including early diagnosis and improved ventilation. Overall, prison cells were densely populated (mean 2.1 m 2 per occupant) and poorly ventilated, with only three cells meeting World Health Organization (WHO) standards for per-person ventilation (60 L/s) applied in infection control settings. In the absence of interventions, projected mean risk of infection was 78.0% during a 6-month period. Decreasing timeto-diagnosis by 25% reduced transmission risk by 8.3%. Improving ventilation to WHO standards decreased transmission by 38.2%, whereas optimizing cross-ventilation reduced transmission by 64.4%. Prison environments promote high infection risk over short-time intervals. In this context, enhanced diagnostics have a limited impact on reducing transmission. Improving natural ventilation may be required to effectively control TB in prisons.

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“…Brazil has the fourth largest incarcerated population in the world and a tuberculosis (TB) incidence that is 20 times higher among prisoners than among the general population ( 1 , 2 ). It has been hypothesized that prisons serve as institutional amplifiers for TB, wherein poorly controlled transmission among incarcerated persons is a driver of TB in the broader population ( 3 , 4 ).…”

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confidence: 99%