Detecting Tuberculosis in Prisons: Switching Off the Disease at Its Source.

Marc Woodman,Louis Grandjean

doi:10.1093/cid/ciaa139

Abstract

Detecting Tuberculosis in Prisons: Switching Off the Disease at Its Source.

Highlights

There are few sources of tuberculosis worthier of intervention than tuberculosis disease arising in prisons
Unless tuberculosis disease is diagnosed and treated within the prison, on release, prisoners are more likely to return to high risk transmission networks and fuel the epidemic further (5)
The authors intensively and prospectively screened consenting prisoners in three Brazilian prisons for tuberculosis using symptom screening, GeneXpert, sputum culture and chest radiography with Computer-Aided Detection for Tuberculosis (CAD4TB). They retrospectively applied four alternative less comprehensive screening algorithms to the data to determine which was most cost effective per case detected. They found that 84% of tuberculosis cases were detectable by a single sputum sample for Xpert MTB/RIF, and that systematic screening with this method had a cost per case of US$234

Summary

Introduction

There are few sources of tuberculosis worthier of intervention than tuberculosis disease arising in prisons. Unless tuberculosis disease is diagnosed and treated within the prison, on release, prisoners are more likely to return to high risk transmission networks and fuel the epidemic further (5). Prison settings often compound the problem by facilitating transmission through overcrowding, inadequate ventilation, incomplete treatment, late case detection and high prisoner turnover (6).

Results

Conclusion