Wong M Y, Leung C C, Tam C M, Kam K M, Ma C H, Au K F
Tuberculosis and Chest Service, Department of Health, Hong Kong, China.
Int J Tuberc Lung Dis. 2008 Jan;12(1):93-8.
To understand the epidemiology of tuberculosis (TB) inside the prison system of Hong Kong.
Prospective territory-wide TB surveillance was conducted among prisoners in 24 correctional institutions.
From 1999 to 2005, 622 prevalent TB cases diagnosed before or within 3 months of incarceration and 214 incident cases diagnosed after 3 months were reported by prison staff to a paper-based central prison TB registry. Both crude prevalence and incidence were falling (chi(2) for trend, both P < 0.001), despite a higher sex- and age-adjusted prison TB incidence as compared to the general population (indirectly standardised rate [ISR] 280.6 vs. 108.0/100000, P < 0.001). Illegal immigrants (odds ratio [OR] 3.6, 95% confidence interval [CI] 1.8-7.4) and drug addicts (OR 2.04, 95%CI 1.13-3.7) were two major risk groups. The TB incident risk disappeared after their exclusion (ISR 117.1 vs. 108.0/100000, P = 0.52). No significant difference in the multidrug-resistant rate was found when comparing the group with the general population (3.5% vs. 1.0%, OR 3.6, 95%CI 0.5-28.4). No extensively drug-resistant (XDR) cases were identified.
TB remains a significant disease in local prisons. Further strengthening of TB control programmes in prisons, especially targeting the higher risk groups, is recommended.
了解香港监狱系统内结核病（TB）的流行病学情况。
对24所惩教机构的囚犯进行全港前瞻性结核病监测。
1999年至2005年，监狱工作人员向基于纸质的中央监狱结核病登记处报告了622例在监禁前或监禁3个月内确诊的现患结核病病例以及214例在3个月后确诊的新发病例。尽管与普通人群相比，经性别和年龄调整后的监狱结核病发病率更高（间接标准化率[ISR]为280.6 vs. 108.0/100000，P<0.001），但粗患病率和发病率均呈下降趋势（趋势χ²检验，P均<0.001）。非法移民（优势比[OR] 3.6，95%置信区间[CI] 1.8 - 7.4）和吸毒者（OR 2.04，95%CI 1.13 - 3.7）是两个主要风险群体。排除这两个群体后，结核病发病风险消失（ISR为117.1 vs. 108.0/100000，P = 0.52）。与普通人群相比，耐多药率无显著差异（3.5% vs. 1.0%，OR 3.6，95%CI 0.5 - 28.4）。未发现广泛耐药（XDR）病例。
结核病在当地监狱中仍然是一种重要疾病。建议进一步加强监狱内的结核病控制项目，尤其是针对高风险群体。
