High incidence of tuberculosis in prison officers in Zomba, Malawi.

We conducted a study in four prisons in Zomba district, Malawi, to determine the tuberculosis case notification rate in prison officers during the year 2000. Of 201 prison staff, 9 (4.5%) were diagnosed with TB: 2 with smear-positive pulmonary tuberculosis (PTB), 4 with smear-negative PTB and 3 with extrapulmonary TB (EPTB). This incidence in prison officers (9/201) was significantly greater than the incidence in primary school teachers in a separate (unpublished) study in Malawi the previous year (78/4,289) (OR 2.58,[95% CI, 2.44 - 2.73], p <0.015). Expressed as annual TB case notification rates, the data for prison officers in these 4 prisons was 4,478 per 100,000, compared to 1,786 per 100,000 in teachers. There may be a high incidence of TB in prison officers. Further research needs to be carried out in this group to confirm these findings and to develop an occupational health service to reduce the risk of TB for these workers.