Z V Rueda1, L Arroyave2, D Marin3, L López4, Y Keynan5, M R Giraldo6, H Pulido7, M P Arbeláez8. 1. Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia. 2. Facultad Nacional de Salud Pública, Medellín, Colombia. 3. Grupo de Demografía y Salud, Facultad Nacional de Salud Pública, Medellín, Colombia. 4. Grupo MICROBA, Escuela de Microbiología, Universidad de Antioquia, Medellín, Colombia. 5. Laboratory of Viral Immunology, Department of Internal Medicine, Medical Microbiology and Community Health Sciences, University of Manitoba, Winnipeg, Canada. 6. Secretaría Seccional de Salud y Protección Social de Antioquia, Gobernación de Antioquia, Medellín, Medellín, Colombia. 7. Secretaría de Salud de Bello, Alcaldía de Bello, Bello, Colombia. 8. Grupo de Epidemiología, Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia.
Abstract
SETTING: Two prisons in Medellín and Itagüí, Colombia. OBJECTIVE: To determine the prevalence of tuberculin skin test (TST) positivity in prisoners and the annual risk of tuberculous infection (ARTI), to identify risk factors associated with a positive result, and to describe progression to active disease. DESIGN: Cross-sectional study. Inmates were included if time of incarceration was ⩾1 year and excluded if subjects had had previous or active tuberculosis (TB), or conditions that could hamper TST administration or interpretation. RESULTS: We screened 1014 inmates. The overall prevalence of TST positivity was 77.6%. The first TST administration resulted in 66% positivity, and the second TST an additional 11.6%. In Prison One, the ARTI was 5.09% in high TB incidence cell blocks and 2.72% in low TB incidence blocks. In Prison Two, the ARTI was 2.77%. Risk factors associated with TST positivity were history of previous incarceration and length of incarceration. Among all those included in the study, four individuals developed active pulmonary TB. CONCLUSION: Prevalence of TST positivity in prisoners and the ARTI were higher than in the general population, but differed between prisons; it is important to apply a second TST to avoid an overestimation of converters during follow-up.
SETTING: Two prisons in Medellín and Itagüí, Colombia. OBJECTIVE: To determine the prevalence of tuberculin skin test (TST) positivity in prisoners and the annual risk of tuberculous infection (ARTI), to identify risk factors associated with a positive result, and to describe progression to active disease. DESIGN: Cross-sectional study. Inmates were included if time of incarceration was ⩾1 year and excluded if subjects had had previous or active tuberculosis (TB), or conditions that could hamper TST administration or interpretation. RESULTS: We screened 1014 inmates. The overall prevalence of TST positivity was 77.6%. The first TST administration resulted in 66% positivity, and the second TST an additional 11.6%. In Prison One, the ARTI was 5.09% in high TB incidence cell blocks and 2.72% in low TB incidence blocks. In Prison Two, the ARTI was 2.77%. Risk factors associated with TST positivity were history of previous incarceration and length of incarceration. Among all those included in the study, four individuals developed active pulmonary TB. CONCLUSION: Prevalence of TST positivity in prisoners and the ARTI were higher than in the general population, but differed between prisons; it is important to apply a second TST to avoid an overestimation of converters during follow-up.
Authors: Javier Leonardo Galindo; Adriana Catalina Galeano; David Alfonso Suarez-Zamora; Ana Milena Callejas; Mónica Patricia Caicedo-Verástegui; Darío Londoño; Luis Gerardo García-Herreros; Aylen Vanessa Ospina-Serrano; Alfredo Saavedra; Plutarco Garcíaherreros; Diana María Palacios; Margarita Baldión Journal: ERJ Open Res Date: 2019-10-15