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Free Content Contact screening and latent TB infection treatment in Singapore correctional facilities

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SETTING: Singapore, a city-state with a tuberculosis (TB) incidence rate of 47 per 100000 population in 2000.

OBJECTIVES: 1) To report our experience with contact investigation and latent TB infection (LTBI) treatment in high-risk contacts with unknown human immunodeficiency virus (HIV) status in correctional facilities (CFs) (prisons/drug rehabilitation centres); and 2) to compare the yield of contact screening in this setting with that in the community (household/family) setting.

METHODS: The tuberculin skin test (TST) readings of 704 CF contacts screened from 1999 to 2001 were compared with those of 2729 household/family contacts who underwent screening in 2000.

RESULTS: Respectively eight (1.1%) and 20 (0.7%) active TB cases were detected among the CF and community contacts. A significantly higher proportion of CF contacts had first (non-conversion) TST readings ≥15 mm (39% vs. 22%, OR 2.3; 95%Cl 1.9–2.7; P < 0.001), and 10–14 mm (26% vs. 18%, OR 1.6; 95%Cl 1.3–2.0; P < 0.001) and TST conversion (43% vs. 20%, OR 2.9; 95%Cl 1.7–4.9; P < 0.001). LTBI treatment was started in 65% of the CF contacts screened; 87% completed treatment.

CONCLUSION: We found a high LTBI rate among CF contacts, presenting an opportunity for intervention.
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Keywords: contact screening; drug rehabilitation centres; latent TB infection; prisons; tuberculin skin testing; tuberculosis

Document Type: Regular Paper

Affiliations: 1: TB Control Unit, Department of Respiratory Medicine, Tan Tock Seng Hospital, Singapore, Singapore 2: Department of Clinical Epidemiology, Tan Tock Seng Hospital, Singapore, Singapore

Publication date: 2005-11-01

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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.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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