Centre of Excellence for Research in AIDS, University of Malaya, Kuala Lumpur, Malaysia.
Int J Tuberc Lung Dis. 2012 Jul;16(7):871-9. doi: 10.5588/ijtld.11.0447. Epub 2012 Mar 7.
Tuberculosis (TB) remains a major cause of morbidity and mortality worldwide and the main cause of death in correctional facilities in middle- and low-income countries. Due to the closed environment and the concentration of individuals with TB-related risk factors, effective measures are required to control TB in such settings. Isoniazid preventive therapy (IPT) represents an effective and cost-effective measure. Despite international recommendations that IPT be integral to TB control, it is seldom deployed. A systematic review of interventions used to assess IPT initiation and completion in correctional facilities was conducted using published studies from two biomedical databases and relevant keywords. Additional references were reviewed, resulting in 18 eligible studies. Most (72%) studies were conducted in the United States and in jail settings (60%), with the main objective of improving completion rates inside the facility or after release. Studies that provided data about initiation and completion rates showed poor success in correctional facilities. Adverse consequences and treatment interruption ranged from 1% to 55% (median 5%) in reported studies; hepatotoxicity was the most prevalent adverse reaction. Despite its accelerating effect on the development of active TB, information on human immunodeficiency virus (HIV) status was provided in only half of the studies. Among the four studies where IPT effectiveness was assessed, the results mirror those described in community settings. Future studies require thorough assessments of IPT initiation and completion rates and adverse effects, particularly in low- and middle-income countries and where comorbid viral hepatitis may contribute significantly to outcomes, and in settings where TB and HIV are more endemic.
结核病（TB）仍然是全球发病率和死亡率的主要原因，也是中低收入国家惩教设施中主要的死亡原因。由于封闭的环境和聚集了具有与结核病相关的风险因素的个体，因此需要采取有效的措施来控制这些环境中的结核病。异烟肼预防治疗（IPT）是一种有效且具有成本效益的措施。尽管国际建议将 IPT 作为结核病控制的重要组成部分，但很少在实践中采用。使用发表在两个生物医学数据库和相关关键词中的研究，对评估惩教设施中 IPT 起始和完成情况的干预措施进行了系统综述。对额外的参考文献进行了审查，最终有 18 项符合条件的研究。大多数（72%）研究在美国和监狱环境中进行（60%），主要目的是提高设施内或释放后的完成率。提供了起始和完成率数据的研究表明，在惩教设施中成功率较低。不良后果和治疗中断率在报告的研究中从 1%到 55%（中位数为 5%）不等；肝毒性是最常见的不良反应。尽管 IPT 对活动性结核病的发展有加速作用，但只有一半的研究提供了关于人类免疫缺陷病毒（HIV）状况的信息。在评估 IPT 有效性的四项研究中，结果与社区环境中描述的结果相似。未来的研究需要对 IPT 的起始和完成率以及不良反应进行全面评估，特别是在中低收入国家以及病毒性肝炎可能对结果有重大影响的国家，以及结核病和 HIV 更为流行的国家。
