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

Authors: Chee, C.B.E.1; Teleman, M.D.2; Boudville, I.C.2; Wang, Y.T.1

Source: The International Journal of Tuberculosis and Lung Disease, Volume 9, Number 11, November 2005 , pp. 1248-1252(5)

Publisher: International Union Against Tuberculosis and Lung Disease

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Abstract:

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.

Keywords: tuberculosis; prisons; drug rehabilitation centres; contact screening; tuberculin skin testing; latent TB infection

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

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