Risk of Tuberculosis in Correctional Healthcare Workers

Abstract

Although the prevalence of tuberculin reactivity was high in this population, the risk factors were predominantly demographic rather than occupational. Nevertheless, continued vigilance to control occupational exposure to this and other respiratory pathogens is warranted, given the potential for future outbreaks of tuberculosis, as well as other known and emerging airborne pathogens.

Prevalence and correlates of latent tuberculosis infection among employees of a high security prison in Malaysia

“…A tuberculin screening involving 1323 prison employees in a New Mexico State prison system reported a prevalence of TST positivity of 10.5% (range 6.7–14.5%) 26. In another TST screening among yet another high-risk group, health workers in multiple correctional institutions in the USA showed high (17.7%) prevalence of LTBI, but a place of birth from a TB endemic region rather than occupational risk factor was independently associated with TST positivity 27. In Australia, another low TB incidence country, deployment of TB control measures, including improved prisoner housing conditions, was associated with a lower overall prevalence of TST positivity among prison staff compared to inmates (6% and 11%, respectively)28 and the relatively low LTBI prevalence (6%) was similar to that in the Australian general population (4–6%).…”

High prevalence and risk factors associated with latent tuberculous infection in two Colombian prisons

“…Although LTBI screening is not recommended in high TB incidence settings, it is important to study the impact of both initial and annual LTBI testing in prisons for prisoners and correctional workers. The LTBI incidence rate ratio in prisons compared to the general population ranges between 5.03 and 83.74 in the United States and 61.76 in Brazil; 2 the annual incidence rate of TST converters among correctional officers reported in the United States was 1.3%, 28 1.9% 29 and 3.8% in low TB incidence states, 4.9% in medium TB incidence states, and 8.3% in high TB incidence states. 30 The estimated ARTI in the present study reflects the higher risk of infection among incarcerated individuals than among the general population.…”

Infection Control in Jails and Prisons

“…HIV-infected persons can progress extraordinarily rapidly from LTBI to active contagious disease [31,32]. MTB transmission has been documented from inmates to employees, visitors, volunteers, and other inmates [30,[32][33][34]. Overcrowding, poor ventilation, delayed diagnosis, and failure to adhere to recognized standards for prevention, screening, and containment have all contributed to the transmission of MTB within jails and prisons and, from there, to the nonincarcerated population [30][31][32][33][34].…”

“…MTB transmission has been documented from inmates to employees, visitors, volunteers, and other inmates [30,[32][33][34]. Overcrowding, poor ventilation, delayed diagnosis, and failure to adhere to recognized standards for prevention, screening, and containment have all contributed to the transmission of MTB within jails and prisons and, from there, to the nonincarcerated population [30][31][32][33][34]. Essential MTB infection pre-vention and control measures include early identification of persons with LTBI and active disease, prompt isolation of contagious persons, appropriate use of airborne precautions, swift performance of contact investigations, and successful completion of treatment for LTBI and active MTB infection [30].…”