Tuberculosis in prisoners and their contacts in Chile: estimating incidence and latent infection

Aguilera, Ximena; González, Claudia; Ferrari, Manuel Nájera-De; Hirmas, Macarena; Delgado, Iris; Olea, Andrea; Lezaeta, L.; Montaña, A.; González, Patricia I. Sosa; Hormazábal, J-C.; Fernández, Jorge Onrubia; Garcia, Carlos; Herrera, Tania

doi:10.5588/ijtld.15.0056

Cited by 18 publications

(22 citation statements)

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“…The multivariate analysis confirmed the observations of the univariate approach. Three factors were highlighted as risk factors: malnutrition (low BMI), overcrowding (more than 50 prisoners per 40 m 2 ), and a length of detention equal to or greater than 12 months, in accordance with previous reports [ 26 – 28 ]. These factors showed a very high PAF; their suppression would prevent 35.6 to 88.2 % of TB cases recorded in prison.…”

Section: Discussionsupporting

confidence: 87%

Prevalence of tuberculosis and associated risk factors in the Central Prison of Mbuji-Mayi, Democratic Republic of Congo

Kalonji

Connick

Ngongo³

et al. 2016

Trop Med Health

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BackgroundTuberculosis still remains a major public health concern in several provinces of the Democratic Republic of Congo, especially in prison settings. The present study aimed at determining tuberculosis (TB) prevalence and associated risk factors in inmates of the Mbuji-Mayi Central Prison.MethodsThis cross-sectional study was performed over a 6-month period (January to June 2015) in Mbuji-Mayi Central Prison. A total of 733 inmates were screened systematically for TB. The diagnosis was based on clinical examination and bacteriological tests.ResultsTuberculosis was diagnosed in 130 inmates, what amounts to a 17.7 % prevalence (95 % confidence interval [CI] 15.1–20.6 %). The mean age ± SD of infected inmates was 31 ± 9.5 years old, and 94.8 % of them were male. Inmates were detained for a median period of 24 months (range: 3 months to 12 years). A cough lasting more than 2 weeks, body temperature higher than 39 °C, and weight loss were the predominating clinical signs. Factors independently associated with TB infection were overcrowding; highest population attributable fraction ([PAF] 88.2 %; adjusted odds ratio [OR] 9.8 [95 % CI 3.1–31.6]); malnutrition (body mass index of less than 18.5 kg/m2) (PAF 35.6 %; adjusted OR 2.1 [1.3–3.0]); and a detention period equal to or greater than 12 months (PAF 38.7 %; adjusted OR 2.1 [1.4–3.1]).ConclusionsImproving detention and sanitary conditions, as well as providing an adequate and early healthcare, are urgently needed to reduce TB prevalence in the prison environment.

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Section: Discussionsupporting

confidence: 87%

Prevalence of tuberculosis and associated risk factors in the Central Prison of Mbuji-Mayi, Democratic Republic of Congo

Kalonji

Connick

Ngongo³

et al. 2016

Trop Med Health

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“…In Italy, although previous imprisonment was not associated with TST positivity, current detention was an independent risk factor (aOR 1.1, 95% CI 1.0-1.2) (20). Previous incarceration or duration of current incarceration was also confirmed in studies in Pakistan, Colombia, Brazil, and Chile (18,21,22,26). Similar to previous studies, in our study, the history of incarceration and current duration in prison increased the risk for LTBI, which reflected cumulative TB transmission among prisoners.…”

Section: Discussionmentioning

confidence: 79%

High Prevalence of and Risk Factors for Latent Tuberculosis Infection among Prisoners, Tianjin, China

Guo-qin¹,

Zhang²,

Zhong³

et al. 2020

Emerg. Infect. Dis.

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T uberculosis (TB) remains a global threat to human health. In 2018, a total of 10 million cases of TB and 1.5 million deaths from TB were reported by the World Health Organization (WHO) (1). Globally, TB notification rates for prisoners are 11-81 times higher than those for local general populations (2). An estimated 10.4 million persons are held in penal institutions throughout the world, and each year the number of persons passing through prison gates could be 4-6 times higher because of high turnover of inmates (3). TB in prisons might spread to the civilian population through staff, visitors, and released prisoners because of inadequate treatment for TB and thus could affect TB control in the general population (4,5). China has the second highest burden of TB in the world (0.9 million incident TB cases during 2018) (1). There were ≈1.7 million prisoners in China during 2016 (3). However, similar to the situation in other countries, TB control in prisons remained largely neglected (6,7). Tianjin, located in northern China, has ≈16 million permanent residents and is one of the pioneering regions for TB control in China. This city had systematically implemented active TB case-finding and directly observed treatment using short-course chemotherapy in all prisons according to the guidelines (8,9). However, despite major achievements, TB incidence among prisoners is still much higher than in the general population in Tianjin (10). It is essential to conduct interventions to identify latent TB infection (LTBI) through screening and prophylaxis in prisons (11). To achieve this goal, we conducted a study to evaluate the prevalence of and risk factors for LTBI by using an interferon-γ release assay (IGRA) in 8 prisons in Tianjin, China. Methods We conducted a baseline cross-sectional study in Tianjin during 2016, followed by providing prophylaxis to prisoners with LTBI and consecutive surveillance of TB incidence. We determined the necessary sample size as >880 persons by using Epi Info (https://www. cdc.gov/epiinfo) to satisfy a cross-sectional design for estimation of LTBI (>480 persons) and a community randomized control trial design (>880 persons). The 8 prisons contained 14,401 prisoners (>18 years of age) and were composed of separate wards, each containing ≈200 persons. Sampling was performed by using a 2-stage process and ward clustering; persons in selected wards participated in a screening procedure for the study.

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“…A pesar que el porcentaje de PPL en pacientes con TB no ha aumentado en los últimos años, la detección de casos depende de los esfuerzos locales que pueden variar entre los diferentes centros penitenciarios. Estudios recientes sobre TB en cárceles en Chile han demostrado una incidencia cerca de 8 veces superior a la población general (105 vs ~12 por 100.000 habs hacia el 2013) y en el caso de infección latente, una alta tasa de transmisión en prisiones 53 . Chile tiene una de las más altas tasas poblacionales de PPL dentro de los países de la OCDE con un hacinamiento crítico haciendo favorable la transmisión tanto de cepas susceptibles como resistentes de M. tuberculosis [54][55][56][57][58] .…”

Section: Discussionunclassified

El deterioro de la tuberculosis en Chile

2019

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Background:Recent data suggest an increase in tuberculosis (TB) incidence in Chile. Aim: To evaluate recent epidemiological trends, geographic extension and potential factors associated with TB reemergence in Chile. Material and Methods: Data analysis from official sources and trend analysis. Results: TB incidence rate increased from 12.3 (2014) to 14.7 (2017) per 100,000 inhabitants. Morbidity rates also increased in nine out of 15 regions. The proportion of TB cases in specific groups has also increased in the last six years: HIV/AIDS (68%), immigrants (118%), drug users/alcoholics (267%) and homeless people (370%). Several indicators of the national TB program performance have deteriorated including TB case detection, HIV co-infection study and contact tracing activities. Overall results indicate a higher than expected case-fatality ratio (> 3%), high rates of loss from follow-up (> 5%), and low percentage of cohort healing rate (< 90%). This decline is associated with a Control Program with scarce human resources whose central budget decreased by 90% from 2008 to 2014. New molecular diagnostic tools and liquid media culture were only recently implemented. Conclusions: TB trends and overall program performance indicators have deteriorated in recent years in Chile and several factors appear to be involved. Multiple strategies will be required to rectify this situation.

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Tuberculosis in prisoners and their contacts in Chile: estimating incidence and latent infection

Abstract: Our results confirm that incarceration increases the risk of tuberculous infection and TB disease, and that it was associated not only with origin from vulnerable groups, but also with the prison environment. Reinforcing TB control is essential to prevent TB transmission in prisons.

Cited by 18 publications

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Prevalence of tuberculosis and associated risk factors in the Central Prison of Mbuji-Mayi, Democratic Republic of Congo

Prevalence of tuberculosis and associated risk factors in the Central Prison of Mbuji-Mayi, Democratic Republic of Congo

High Prevalence of and Risk Factors for Latent Tuberculosis Infection among Prisoners, Tianjin, China

El deterioro de la tuberculosis en Chile

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