Tuberculosis and HIV Infection Among Female Inmates in São Paulo, Brazil: A Prospective Cohort Study

Abstract

Prison populations are at increased risk of both human immunodeficiency virus (HIV) and Mycobacterium tuberculosis infections, but among female inmates information on such risks remains scarce, especially in developing countries. Between October 1992 and November 1993, 350 women incarcerated at a prison in São Paulo, Brazil, were prospectively evaluated for HIV and M. tuberculosis infection and disease. Among them, 87 (25%) were HIV seropositive, and 20 (5.7%) had tuberculosis (TB). During the incarceration period, the purified protein derivative test conversion rate was 29% for HIV-positive and 32% for HIV-negative women. However, the incidence of TB was 9.9 per 100 person-years for HIV-positive and 0.7 per 100 person-years of incarceration for HIV-negative women (p < 0.0001). A multivariate analysis indicated that HIV infection (p < 0.0001) and incarceration time < 12 months (p < 0.05) were each associated with TB. These findings indicate that new transmissions of M. tuberculosis infection are common among female inmates and that HIV-infected women are more likely to acquire active disease during the first 12 months of incarceration. Because of their role in childbearing and care female inmates are an important potential source of transmission of M. tuberculosis, and new strategies to control the spread of TB in prisons need to be developed.

Molecular genotyping and epidemiology of Mycobacterium tuberculosis isolates obtained from inmates of correctional institutions of Campinas, Southeast Brazil

“…Our results also demonstrate that most of the isolates may be allocated to two main clusters. This denotes that just a few strains may be responsible for the colonization of the hosts and prevail due to the close proximity between inmates, as corroborated by Ferreira et al [24], who studied 350 female inmates and found only seven RFLP patterns for the studied M. tuberculosis strains.…”

“…In the last years, considerable efforts have been made to precise the epidemiology and characteristics of M. tuberculosis strains isolated in different regions of Brazil [7,[24][25][26][27][28][29][30][31]. Some Brazilian authors [26,27,29,32] demonstrated the usefulness of the IS6110-restriction fragment length polymorphism for typing Brazilian M. tuberculosis strains, but Ferreira et al [24] were the first to apply it to determine strain types in female inmate populations in São Paulo City, Brazil.…”

“…Some Brazilian authors [26,27,29,32] demonstrated the usefulness of the IS6110-restriction fragment length polymorphism for typing Brazilian M. tuberculosis strains, but Ferreira et al [24] were the first to apply it to determine strain types in female inmate populations in São Paulo City, Brazil. Ferreira et al [24] suggested that in 50% inmates infection was a reactivation process of a previous latent infection, while in the 50%, TB was transmitted within prison (exogenous infection). This indicates an epidemiologic picture with harsh consequences for inmates, their families, and the community.…”

Saúde sexual e reprodutiva em penitenciária feminina, Espírito Santo, Brasil

“…4 Biópsia cervical (N=15*) Cervicite crônica 5 33,3 Hiperplasia epitelial escamosa (acantose) sem discariose significativa 6 40,0 NIC*** i + HPV*** 3 20,0 NIC** ii + HPV*** 1 6 , 7 *Três mulheres não participaram desta fase de exames **Mulheres que apresentaram alterações colposcópicas e necessitaram de biópsia ***NIC: neoplasia intra-epitelial cervical ****HPV: papilomavírus humano rência de comportamentos de risco para DST entre presidiárias do que na população geral. 5,9,11 As características sociodemográficas das participantes refletem as apresentadas pela maioria das mulheres de baixa renda do Estado do Espírito Santo: mulheres pardas, casadas ou amasiadas, na faixa etária média de 30 anos, com pouca escolaridade e trabalho sem qualificação. * No entanto, a amostra estudada no presente estudo não é representativa dessa população, pois difere em relação a outros aspectos analisados, como o uso de drogas e a criminalidade.…”

“…Há poucos trabalhos publicados que investigaram os problemas de saúde da mulher em prisões brasileiras, mais especificamente as doenças infecciosas e DST. 5 Confinada e acessível, a população encarcerada deveria receber uma abordagem orientada para a detecção e tratamento de doenças e identificação de fatores de risco, fundamentada por ações de educação e aconselhamento. Para orientar e viabilizar a implantação de tais medidas, o presente estudo teve por finalidade identificar os problemas de saúde e o perfil sociodemográfico da população feminina encarcerada, provendo, sempre que necessário, orientação e tratamento clínico às detentas.…”