Moyo Nompilo, Tay Ee Laine, Denholm Justin
The Victorian Tuberculosis Program at the Peter Doherty Institute, Melbourne, Victoria 3000, Australia.
Health Protection Branch, Department of Health and Human Services, Melbourne, Victoria 3000, Australia.
Trop Med Infect Dis. 2018 Aug 31;3(3):93. doi: 10.3390/tropicalmed3030093.
Globally, rates of tuberculosis (TB) cases in prisons are substantially higher than in the general population. The goal of this study was to review TB notifications in Victorian correctional facilities, and consider whether additional interventions towards TB elimination may be useful in this setting. All patients who were notified with or treated for TB in the Australian state of Victoria from 1 January 2003 to 1 December 2017 were included in this study. Descriptive analysis was performed. Demographic and treatment outcome data for individuals with and without a history of incarceration were reviewed and compared. Of the 5645 TB cases notified during the study period, 26 (0.5%) had a history of being incarcerated in correctional facilities while receiving treatment for TB. There were 73,238 inmates in Victorian correctional facilities over the same study period, meaning that approximately 0.04% of inmates were diagnosed or treated with TB disease in correctional facilities. Incarcerated individuals were more likely to have positive sputum smears and cavitation compared with nonincarcerated people with TB. There was no significant difference in treatment outcomes between the general TB population and those who had a history of incarceration during their treatment. There is a low apparent rate of TB in Victorian prisoners, and prisons do not contribute significantly to TB incidence in Victoria. Overall, TB outcomes do not differ between prisoners and nonprisoners. Ongoing efforts to sustain these lower rates and comparable outcomes in this vulnerable cohort are important for continued progress towards TB elimination.
在全球范围内，监狱中的结核病发病率远高于普通人群。本研究的目的是回顾维多利亚州惩教机构的结核病通报情况，并考虑在这种情况下，采取额外的结核病消除干预措施是否有用。本研究纳入了2003年1月1日至2017年12月31日期间在澳大利亚维多利亚州被通报患有结核病或接受结核病治疗的所有患者。进行了描述性分析。对有监禁史和无监禁史个体的人口统计学和治疗结果数据进行了回顾和比较。在研究期间通报的5645例结核病病例中，有26例（0.5%）在接受结核病治疗时有在惩教机构被监禁的历史。在同一研究期间，维多利亚州惩教机构有73238名囚犯，这意味着约0.04%的囚犯在惩教机构被诊断患有结核病或接受结核病治疗。与未被监禁的结核病患者相比，被监禁者痰涂片阳性和有空洞的可能性更大。普通结核病患者群体与治疗期间有监禁史的患者在治疗结果上没有显著差异。维多利亚州囚犯的结核病发病率明显较低，监狱对维多利亚州的结核病发病率贡献不大。总体而言，囚犯和非囚犯的结核病治疗结果没有差异。持续努力维持这一弱势群体的较低发病率和可比结果，对于在结核病消除方面持续取得进展至关重要。
