High prevalence and risk factors associated with latent tuberculous infection in two Colombian prisons
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.
Document Type: Original Article
Affiliations: 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
Publication date: October 1, 2014
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