McDaniel C J, Chitnis A S, Barry P M, Shah N
Office of State, Trial, Local and Territorial Support, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA; Tuberculosis Control Branch, Division of Communicable Disease Control, Center for Infectious Diseases California Department of Public Health, Richmond, California, USA.
Tuberculosis Control Branch, Division of Communicable Disease Control, Center for Infectious Diseases California Department of Public Health, Richmond, California, USA.
Int J Tuberc Lung Dis. 2017 Aug 1;21(8):922-929. doi: 10.5588/ijtld.16.0855.
Incarcerated persons are disproportionately diagnosed with tuberculosis (TB). California has the second highest inmate population in the United States, but reports the highest number of cases.
To describe the TB epidemiology among incarcerated patients in California.
Trends in incidence were assessed using Poisson regression, and trends in percentage were assessed using weighted linear regression. Demographic and clinical characteristics were compared using χ2 or Mann-Whitney U tests.
During 1993-2013, of the 64 090 TB cases reported, 2323 (4%) were correctional facility residents. Incidence in correctional facilities decreased until 2006 (annual per cent change [APC] -12.3%, 95%CI -14.4 to -10.1), but has since stabilized (APC 4.4%, 95%CI -2.1 to 11.4). Compared with state prisoners, federal prisoners were more likely to be male (98%, P = 0.03), persons arriving in the United States within 5 years of diagnosis (62%, P < 0.001), and born in Mexico (88%, P = 0.02), whereas local jail inmates were more likely to have a history of substance use (75%, P < 0.001) and homelessness (35%, P < 0.001).
TB incidence in correctional facilities had steadily declined over the last two decades, but has recently leveled out. To promote further reduction in incidence among diverse incarcerated populations, health departments and correctional facilities should strengthen collaboration by conducting TB risk-based assessments.
被监禁者患结核病（TB）的比例过高。加利福尼亚州的囚犯人数在美国排名第二，但报告的病例数却是最多的。
描述加利福尼亚州被监禁患者中的结核病流行病学情况。
使用泊松回归评估发病率趋势，使用加权线性回归评估百分比趋势。使用χ2检验或曼-惠特尼U检验比较人口统计学和临床特征。
在1993 - 2013年期间，报告的64090例结核病病例中，有2323例（4%）是惩教设施中的居民。惩教设施中的发病率在2006年之前一直下降（年变化百分比[APC] -12.3%，95%CI -14.4至-10.1），但此后趋于稳定（APC 4.4%，95%CI -2.1至11.4）。与州囚犯相比，联邦囚犯更可能为男性（98%，P = 0.03）、在诊断前5年内抵达美国的人（62%，P < 0.001）以及出生在墨西哥的人（88%，P = 0.02），而当地监狱囚犯更可能有药物使用史（75%，P < 0.001）和无家可归史（35%，P < 0.001）。
在过去二十年中，惩教设施中的结核病发病率稳步下降，但最近趋于平稳。为促进不同被监禁人群中发病率的进一步降低，卫生部门和惩教设施应通过开展基于结核病风险的评估来加强合作。
