Universal radiographic screening for tuberculosis among inmates upon admission to jail.

Abstract

OBJECTIVES: This study evaluated the efficacy of radiographic screening for tuberculosis in correctional facilities. METHODS: Inmates at an admission facility in New York, NY, were screened for tuberculosis by registry cross-match, symptom interviews, tuberculin testing, and chest radiography. RESULTS: Thirty-two cases of tuberculosis were detected among 4172 inmate admissions (767 cases per 100,000). Twenty-five inmates (78%) were previously diagnosed but incompletely treated; all were identified by registry cross-match. Seven inmates (22%) were newly diagnosed, of whom four (57%) were asymptomatic, had negative skin tests, and were detected only by their abnormal radiographs. CONCLUSIONS: Screening strategies that limit radiographic testing to inmates with either positive skin tests or symptoms may result in missed opportunities for diagnosing active tuberculosis.

High Tuberculosis Prevalence in a South African Prison: The Need for Routine Tuberculosis Screening

“…This is in line with recommendations for sputum microscopy [37]. Mass miniature radiography for new entrants has been implemented in US detention centres at a cost of only $3 per prisoner screened and found to increase case finding and speed up isolation of tuberculosis cases [38], [39]. However, the logistics of conducting chest radiographic screening within prisons, including the staffing and expertise required, maintenance of equipment and movement of prisoners, also needs to be considered if implementation is planned.…”

Pulmonary tuberculosis incidence in Turkish prisons: importance of screening and case finding strategies

“…In addition to the universal World Health Organization (WHO) Directly Observed Treatment Short-course strategy, several measures have been proposed by WHO and the Red Cross to control tuberculosis in prisons including mass screening of prisoners based on symptoms and the systematic detection of tuberculosis at entry point (2,(8)(9)(10)(11). In Turkey the administration of prisons is under the responsibility of three different authorities having different bureaucratic rules: Ministry of Health (MoH), Ministry of Justice (MoJ) and Ministry of Internal Affairs (MoIA).…”

Constrangimentos ao controlo da tuberculose no sistema prisional

“…Provindo a maioria dos reclusos de segmentos populacionais com estilos de vida desajustados e que oferecem maiores dificuldades de identificação e tratamento da TB na comunidade exterior, o encarceramento permite circunscrever e visar terapeuticamente este grupo de alto risco, sob um regime terapêutico supervisionado adjuvado, programas de desintoxicação e de educação para a saúde 6,34,37,38,69 . Mais do que uma ameaça de contrair doença, o tempo de reclusão deverá proporcionar a oportunidade de diagnosticar e tratar estes indivíduos com benefício repartido para o sujeito e comunidade em geral 37,70 .…”

“…A presença de um destes deve conduzir à alocação do recluso numa unidade de isolamento respirató-rio até posterior investigação com intradermorreação (IDR) ou QuantiFERON ® , microscopia da expetoração e radiografia de tórax 40 . Por seu lado, em prisões de risco «não-mínimo», todos os reclusos assintomáticos devem, além do inquérito clínico--anamnésico, efetuar IDR, QuantiFERON ® ou radiografia de tórax 24,70 . Em infetados VIH deve ser sempre salvaguardada a realização de radiografia 71 .…”