García-Guerrero J, Marco Mouriño A, Sáiz de la Hoya Zamácola P, Vera-Remartínez E J
Centro Penitenciario de Castellón I, Castellón, España.
Rev Esp Sanid Penit. 2010 Feb;12(3):79-85. doi: 10.4321/S1575-06202010000300003.
To study the prevalence of latent tuberculosis infection (LTBI) amongst inmates in Spanish prisons.
Multi-centre, cross-sectional study; two stage sampling. Socio-demographic, prison and clinical variables were gathered. A univariate, bivariate and multivariate analysis was carried out using logistic regression with the variables that showed statistical significance. The odds ratio was calculated with a confidence interval of 95%.
378 patients. The Mantoux test (PPD) assessable in 90.2% was available. 91.2% men, 37.8% foreigners with average age of 35.9±10.3 years. Average stay in prison: 2 years, 28.7% had been > 5 years in prison. 49.6% entered prison in 2006 or before. 24.5% had a history of intravenous drug use (IDU). 50.4% presented LTBI that was associated with: age > 40 years (63.2 vs 43.8%; CI: 1.39-3.49; OR: 2.20; p=0.001); stay of > 5 years in prison (71.2 vs 41.3%; CI: 2.13-5.75; OR: 3.50; p<0.001); in prison since 2006 or before (58.1 vs 42.6%; CI: 1.22-2.88; OR:1.87; p=0.004); infected with HCV+ (66.3 vs 45.3%; CI:1.40-4.0; OR: 2.37; p=0.001). The logistic regression model confirmed the independent association of LTBI with: a) age > 40 years (OR: 1.76; CI: 1.08-2.87; p=0.024); and length of prison stay > 5 years (OR: 2.50; CI: 1.41-4.43; p=0.002).
The prevalence of LTBI in prison is very high, especially amongst inmates over 40 and those who have been in prison for more than five years. To prevent the risk of progression to tuberculosis, treatment is recommended for those who require it along with the maintenance of control programmes for this pathology.
研究西班牙监狱中囚犯潜伏性结核感染(LTBI)的患病率。
多中心横断面研究;两阶段抽样。收集社会人口统计学、监狱和临床变量。对具有统计学意义的变量进行单因素、双因素和多因素分析,采用逻辑回归。计算比值比,置信区间为95%。
378例患者。90.2%的患者可进行结核菌素试验(PPD)。男性占91.2%,外国人占37.8%,平均年龄为35.9±10.3岁。平均监禁时间:2年,28.7%的人监禁时间>5年。49.6%的人于2006年或之前入狱。24.5%有静脉吸毒史(IDU)。50.4%的人存在LTBI,与以下因素相关:年龄>40岁(63.2%对43.8%;CI:1.39 - 3.49;OR:2.20;p = 0.001);监禁时间>5年(71.2%对41.3%;CI:2.13 - 5.75;OR:3.50;p < 0.001);2006年或之前入狱(58.1%对42.6%;CI:1.22 - 2.88;OR:1.87;p = 0.004);感染丙型肝炎病毒阳性(66.3%对45.3%;CI:1.40 - 4.0;OR:2.37;p = 0.001)。逻辑回归模型证实LTBI与以下因素独立相关:a)年龄>40岁(OR:1.76;CI:1.08 - 2.87;p = 0.024);监禁时间>5年(OR:2.50;CI:1.41 - 4.43;p = 0.002)。
监狱中LTBI的患病率非常高,尤其是在40岁以上以及监禁超过五年的囚犯中。为预防进展为结核病的风险,建议对有需要的人进行治疗,并维持针对该疾病的控制项目。