Tuberculosis In Prisons Research Articles

Undetected tuberculosis in prison. Source of infection for community at large.

Discovery of two cases of infectious tuberculosis in a state prison in 1976 prompted a careful study of the entire population of 1,500. Eight more cases were found, giving a morbidity of 670/100,000 (arkansas rate, 21.1). The epidemic was aborted by the use of isoniazid and the establishment of a program for screening and periodic retesting. Clear evidence was found for intramural spread of the infection, and eight of 16 persons with clinical tuberculosis from 1975 to 1977 had entered the prison uninfected. Nine percent of 800 men with tuberculosis in Arkansas from 1972 through 1977 had "done time" in this particular prison. In January 1978 a child died of tuberculosis transmitted from a former inmate who had been infected while incarcerated in 1976 but released without therapy. Tuberculosis morbidity was 6.5 times greater in state prisons than in the general population.

Medical Care in Prisons

Improved medical care for prisoners in American jails not only would be a humane course of action, but also would serve the best interests of society as a whole. This is clearly demonstrated by the report entitled Undetected Tuberculosis in Prison: Source of Infection for Community at Large by William W. Stead, MD (p 2544). The lack of an adequate tuberculosis control program in one prison resulted in a high incidence of tuberculin skin test conversions and active cases of disease among its inmates. Society punished these prisoners twice, once by incarceration and a second time by illness. The second punishment was also inflicted on the family of one prisoner, for his undetected tuberculosis was ultimately transmitted to his wife and two children, one of whom died. Delay in reforming the prison's medical care program apparently was due to bureaucratic inertia, indifference, and perhaps incompetence. Medical direction and advice were

Studies on Calorie Requirement in Patients of Pulmonary Tuberculosis

The basal metabolism of 20 patients of pulmonary tuberculosis in prison was studied in September and October 1953.Results obtained were as follows:1) The averages of their basal metabolism were 32.1-35.1 Cal. per sq. m. per hr., which was lower than the standard value of Japanese 36.7 Calories by 4.3-12.5%.2) Their caloric consumption was 1580 Calories per day.

Tuberculosis in Prisons

Inmates have a right to reasonable medical care and sanitation. Ninety-five per cent of all inmates in Illinois are eventually released. Tuberculosis is a major health problem in many state penal institutions. There is a national trend toward its recognition and correction. Few states, however, have adequate control programs. There is a need for separate sections or hospitals to treat this disease. The eradication and treatment should be relatively easy and simple with administrative and medical cooperation. All personnel (guards, attendants, inmates, etc.) of the Tuberculosis Hospital should be immediately responsible to the executive physician, and indirectly to the lay administrators. The retention and removal of all hospital employees should be at the discretion of the executive physician. At times, it is necessary to have sputum collections, temperatures, etc., certified. At least one registered nurse should be on duty during each shift. Inmate personnel need supervision but give good service and are deserving of extra good time. The planning, preparation and serving of food should be under the guidance of qualified personnel. More efficient guards would lessen breaches of discipline; therefore, higher ratings for hospital guards should be considered. Humane methods of enforcing discipline are indicated and successful. Treatment and public health measures should be the same as in modern non-penal sanatoria. Special psychotics should be treated in the mental division. Forty-three per cent of our patients had collapse therapy, and in 38 per cent of these sputa were converted. Ultra-violet light has been very beneficial in tuberculous adenitis and peritonitis. Employees and inmates of the penal institutions should be tuberculin tested and positive reactors x-rayed. Thereafter, at least yearly examinations (tuberculin and/or x-ray) should be made. Parole board decisions are important. If adequate care is provided, [See Figure in the PDF File] inmates should be treated in prison. If treatment is inadequate, sick parole should be considered. Non-penal hospitalization and/or follow-up care should be a condition of parole. At the Pontiac Branch, 76 per cent of the inmates and 81 per cent of the officers are positive reactors and the morbidity rate of inmates for tuberculosis is 899 per 100,000. More deaths occurred in referrals from, the sick lines than from the tuberculin x-ray group. In the Illinois State Penitentiaries, the known mortality rate of inmates from tuberculosis is 137 per 100,000; the estimated mortality rate is 200 per 100,000. Out-patients should be under central medical supervision regardless of the locale of their incarceration. The Department should use a mobile photo-roentgenographic unit (See Fig. 10 ), central interpretation of x-rays, and standardize treatments and methods of transferring patients. There is need for a national committee of physicians to study the problem of tuberculosis in prisons.

Tuberculosis in prisons

Tuberculosis in prisons

Tuberculosis in Prisons.

Tuberculosis in Prisons.

Tuberculosis in Prisons.

St. Paul, Jan. 14, 1904. To the Editor: —In an editorial, January 2 (p. 36), you draw attention to the fact that New York State has led the way in providing the first isolation wards for the treatment of tuberculous prisoners. You do not mention the date of such action, but I presume it was recent. If so, New York is not the first state to make such provision for prisoners. Dr. B. J. Merrill, physician in charge of the prison at Stillwater, Minn., established the system of isolation, special diet, etc., at that institution in the summer of 1894. He set aside a group of cells that came to be known, in prison parlance, as Tuberculous Row. With any symptoms of tuberculosis showing, a prisoner was subjected to a careful examination, physical and bacteriologic, and if the presence of the disease was established he was at once placed in