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Free Content Pulmonary tuberculosis in prisons of the ex-USSR state Georgia: results of a nation-wide prevalence survey among sentenced inmates

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SETTING: The penitentiary system of the ex-USSR state of Georgia.

OBJECTIVES: To measure the prevalence of active pulmonary tuberculosis and drug-resistant disease among prisoners. To identify factors associated with active tuberculosis and multidrug resistance (MDR).

DESIGN: A comprehensive multiphasic screening survey for tuberculosis.

RESULTS: The prevalence of smear- or culture-positive tuberculosis was 5995 per 100000 prisoners (n = 448 cases among 7473 inmates). Of all the strains, 215 (77.9%) were resistant to at least one drug and 37 (13.0%) were MDR. Independent risk markers associated with smear- or culture-positive tuberculosis included prison stay of 2 years or more, body mass index <20 kg/m2, accommodation in a large size prison, previous anti-tuberculosis treatment, cough of 2 weeks or more and loss of appetite. Risk markers associated with MDR were a prison stay of less than 2 years and being over 25 years of age.

CONCLUSIONS: In Georgia, the excess risk for tuberculosis among prisoners is unprecedented, suggesting that prisons represent a significant reservoir of tuberculosis. Only a comprehensive strategy for tuberculosis control in prisons, including prison reform, control of anti-tuberculosis drugs, and prompt and efficient diagnosis and treatment of patients can have an impact on the tuberculosis burden in the prison system.
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Keywords: drug resistance; ex-USSR; prisons; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Health Services Unit, International Committee of the Red Cross (ICRC), Geneva, Switzerland 2: Tuberculosis Control Programme, ICRC, Georgia 3: National Tuberculosis Reference Laboratory, National Tuberculosis Control Programme, Ministry of Health, Georgia 4: Health Services of the Execution of Sentences Department, Ministry of Internal Affairs, Georgia 5: Unit of Mycobacteriology, Department of Microbiology, Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium 6: Centre Hospitalier Universitaire Vaudois, Switzerland

Publication date: 01 December 2000

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

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