Tuberculosis in prison and aspects associated with the diagnosis site.

Melisane Rl Ferreira,Rubia L De P Andrade,Nathalia H Orfão,Tatiane C Siqueira,Tereza Cs Villa,Rafaele O Bonfim,Aline A Monroe

doi:10.3855/jidc.11522

Abstract

Tuberculosis (TB) is highly endemic in prison environments, and requires special attention in the population deprived of liberty (PDL). Thus, we aimed to describe the epidemiological situation of TB among PDL in a large municipality of the Brazilian Legal Amazon, from 2012 to 2016, and to identify the factors associated with the site of TB cases notification. Both descriptive and cross-sectional studies were conducted. Sociodemographic, clinical, diagnostic and treatment data of PDL with TB were collected from the National Disease Notification System - SINAN. Data analysis included frequency distribution, Chi-square test, Fisher exact test and residue analysis, with a significance level of 95%. 256 cases of TB have been notified among PDL in the penitentiary complex situated in the municipality and 100 cases in local health services, such as Primary Health Care units or referral services. Notification in the penitentiary complex was associated with non-X-ray and more than ten contacts identified. An association was found between diagnosis in local health services and female sex, AIDS, alcoholism, illicit drug use, extrapulmonary clinical form, extrapulmonary pulmonary disease, suspected X-ray, sputum smear-negative for diagnosis, HIV positive, culture of sputum not performed/ in progress, DOT ignored/ blank, less than five contacts identified, transfer and others as closure situation. The results show that intricate TB cases were notified by the local health services. Strategies of surveillance and articulation with these health services seem to contribute to the identification of TB cases among PDL.

Highlights

Tuberculosis (TB) is highly endemic in prison environments, and requires special attention in the population deprived of liberty (PDL)
Tuberculosis (TB) is considered the main cause of death among infectious diseases in the world and is highly endemic in prison environments. It requires a special attention in the Population Deprived of Liberty (PDL), since this population belongs to one of the groups most likely to develop TB, with a relative risk 28 times higher of acquiring the disease compared to the general population [1,2]
In the period from 2012 to 2016, 2,400 TB cases were notified in the municipality, of which 361 (15.0%) were PDL in the penitentiary complex of the municipality

Summary

Introduction

Tuberculosis (TB) is highly endemic in prison environments, and requires special attention in the population deprived of liberty (PDL). In Brazil, in 2017, over 69,500 new cases of TB were reported, of which 10.5% concerned PDL Having this in mind, in the same year, the Ministry of Health (MH) presented the National Plan for the End of Tuberculosis as a Public Health Problem, whose 2nd pillar refers to the policies and support system for facing TB in prisons [6]. In the same year, the Ministry of Health (MH) presented the National Plan for the End of Tuberculosis as a Public Health Problem, whose 2nd pillar refers to the policies and support system for facing TB in prisons [6] In this context, notification of cases represents as a tool for surveillance and follow-up of cases, since the reports contain information identifying the patient, the service, clinical and epidemiological data, influencing disease control. This background shows the importance of studying TB case notification among PDL as a vulnerable population, to identify barriers in detecting cases onsite and to propose interventional measures for the proper diagnosis of the disease

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Conclusion