Weant Tyler E, Turner Abigail Norris, Murphy-Weiss Maureen, Murray David M, Wang Shu-Hua
Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH 43210, USA.
Tuberc Res Treat. 2012;2012:132406. doi: 10.1155/2012/132406. Epub 2012 Dec 23.
Improved screening and treatment of latent tuberculosis infection (LTBI) in correctional facilities may improve TB control. The Ohio Department of Rehabilitation and Correction (ODRC) consists of 32 prisons. Inmates are screened upon entry to ODRC and yearly thereafter. The objective of the study was to determine if social history factors such as tobacco, alcohol, and drug use are significant predictors of LTBI and treatment outcomes. We reviewed the medical charts of inmates and randomly selected age-matched controls at one ODRC facility for 2009. We used a conditional logistic regression to assess associations between selected social history variables and LTBI diagnosis. Eighty-nine inmates with a history of LTBI and 88 controls were identified. No social history variable was a significant predictor of LTBI. Medical comorbidities such as asthma, rheumatoid arthritis, and hepatitis C were significantly higher in inmates with LTBI. 84% of inmates diagnosed with LTBI had either completed or were on treatment. Annual TB screening may not be cost-effective in all inmate populations. Identification of factors to help target screening populations at risk for TB is critical. Social history variables did not predict LTBI in our inmate population. Additional studies are needed to identify inmates for the targeted TB testing.
改善惩教设施中潜伏性结核感染（LTBI）的筛查和治疗可能会改善结核病控制。俄亥俄州康复与惩教部（ODRC）由32所监狱组成。囚犯在进入ODRC时接受筛查，此后每年筛查一次。该研究的目的是确定烟草、酒精和药物使用等社会历史因素是否是LTBI和治疗结果的重要预测因素。我们回顾了2009年在一个ODRC设施中囚犯的病历，并随机选择了年龄匹配的对照。我们使用条件逻辑回归来评估选定的社会历史变量与LTBI诊断之间的关联。确定了89名有LTBI病史的囚犯和88名对照。没有社会历史变量是LTBI的重要预测因素。LTBI囚犯中哮喘、类风湿性关节炎和丙型肝炎等医学合并症明显更高。84%被诊断为LTBI的囚犯已经完成治疗或正在接受治疗。年度结核病筛查在所有囚犯群体中可能不具有成本效益。确定有助于针对结核病高危筛查人群的因素至关重要。社会历史变量在我们的囚犯群体中不能预测LTBI。需要进一步研究以确定适合进行针对性结核病检测的囚犯。
