Lobacheva Tatiana, Asikainen Tommi, Giesecke Johan
Department of Medical Epidemiology and Biostatistics, Karolinska Institute, SE-171 77, Stockholm, Sweden.
Eur J Epidemiol. 2007;22(2):121-7. doi: 10.1007/s10654-006-9068-z. Epub 2007 Mar 3.
Detainees have a substantial risk to develop tuberculosis (TB) due to a higher incidence of TB in remand prison compared to the civil community. They develop TB during incarceration not only due to poor living conditions in remand prison, but also due to some factors affecting their life before imprisonment. Prevention measures against TB spread from penitentiary institutions to society include study of factors, which contribute to TB development. Current study aims at identification of important risk factors of TB development in remand prison in St. Petersburg, Russia.
A retrospective matched case-control study was performed from May 2002 to May 2003 in two remand prisons in St. Petersburg. One hundred and fourteen prisoners (57 cases, 57 controls) were interviewed by using standardised questionnaire. Logistic regression analysis was performed to identify risk factors.
Six factors were significantly linked to the risk of developing TB: narcotic drug use (odds ratio (OR): 2.6, 95% confidence interval (CI): 1.0-6.9), low income (OR: 3.2, CI: 1.2-8.6), high ratio of prisoners per available bed (OR: 4.0, CI: 1.1-15.0), not having own bed clothes (OR: 13.0, CI: 2.7-61.6), and little time outdoors (OR: 3.3, CI: 1.3-8.5). However, good housing before imprisonment (OR: 4.2, CI: 1.1-15.7) was a separate risk factor for TB.
Three of the risk factors (high number of prisoners per bed, not having own bed clothes, and little time outdoors) are certainly possible to approach by improvement of conditions in remand prisons. The remaining three factors (narcotic drug use, good housing before imprisonment, and low income) provide knowledge about study population, but cannot be intervened by prison's medical staff.
由于还押监狱中结核病（TB）的发病率高于普通社区，被拘留者感染结核病的风险很大。他们在监禁期间感染结核病不仅是因为还押监狱的生活条件差，还由于一些入狱前影响其生活的因素。防止结核病从惩教机构传播到社会的预防措施包括研究导致结核病发生的因素。当前的研究旨在确定俄罗斯圣彼得堡还押监狱中结核病发生的重要风险因素。
2002年5月至2003年5月在圣彼得堡的两所还押监狱进行了一项回顾性匹配病例对照研究。使用标准化问卷对114名囚犯（57例病例，57例对照）进行了访谈。进行逻辑回归分析以确定风险因素。
六个因素与患结核病的风险显著相关：使用麻醉药品（比值比（OR）：2.6，95%置信区间（CI）：1.0 - 6.9）、低收入（OR：3.2，CI：1.2 - 8.6）、每可用床位的囚犯比例高（OR：4.0，CI：1.1 - 15.0）、没有自己的床上用品（OR：13.0，CI：2.7 - 61.6）以及户外活动时间少（OR：3.3，CI：1.3 - 8.5）。然而，入狱前居住条件好（OR：4.2，CI：1.1 - 15.7）是结核病的一个独立风险因素。
其中三个风险因素（每张床位的囚犯数量多、没有自己的床上用品以及户外活动时间少）肯定可以通过改善还押监狱的条件来解决。其余三个因素（使用麻醉药品、入狱前居住条件好和低收入）提供了关于研究人群的信息，但监狱医务人员无法对其进行干预。
