Departments of Epidemiology and Global Health, Rollins School of Public Health, Emory University, Atlanta, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
Departments of Epidemiology and Global Health, Rollins School of Public Health, Emory University, Atlanta.
Int J Tuberc Lung Dis. 2019 Nov 1;23(11):1198-1204. doi: 10.5588/ijtld.18.0782.
Sixteen South African correctional facilities. To determine the prevalence of and risk factors for tuberculosis (TB) in South African correctional facilities using data collected during a TB screening program in South African correctional facilities in 2015. Inmates in 16 South African correctional facilities were screened for TB from January to December 2015. Inmates reporting ≥1 TB symptom or having an abnormal computer-assisted digital chest X-ray (CXR) provided sputum. Abnormal CXRs were interpreted by a radiologist. Sputum was tested for using Xpert MTB/RIF. Data from 16 South African correctional facilities were used in regression analysis, and prevalence estimates calculated for 12 South African correctional facilities with >30% screening coverage. In 12 South African correctional facilities included in the prevalence estimates, 837 inmates had TB disease (2653/100 000) as indicated by current TB treatment or screening-identified TB by radiologist or Xpert. Previous TB was associated with increased odds of screening-identified TB in HIV-positive inmates (OR 4.3, 95%CI 2.5-7.3). For HIV-negative inmates, previous TB (adjusted OR [aOR] 4.9, 95%CI 1.7-14.1) and self-reported symptoms vs. none (1 symptom, aOR 8.8, 95%CI 1.2-67.7; >2 symptoms, aOR 21.7, 95%CI 3.0-158.8) were independently associated with increased odds of screening-identified TB. Routine TB screening, including CXR, is needed in South African correctional facilities to identify and refer inmates with active TB.
十六家南非惩教设施。目的是利用 2015 年南非惩教设施结核筛查项目期间收集的数据，确定南非惩教设施中结核的流行率和危险因素。2015 年 1 月至 12 月期间，对 16 家南非惩教设施中的囚犯进行了结核筛查。报告≥1 项结核症状或计算机辅助数字胸部 X 线（CXR）异常的囚犯提供痰液。异常 CXR 由放射科医生解读。痰液用 Xpert MTB/RIF 检测。对来自 16 家南非惩教设施的数据进行了回归分析，并对 12 家筛查覆盖率超过 30%的南非惩教设施进行了患病率估计。在纳入患病率估计的 12 家南非惩教设施中，有 837 名囚犯患有结核病（2653/100000），表明目前正在接受结核病治疗或放射科医生或 Xpert 筛查发现结核病。既往结核病与 HIV 阳性囚犯的筛查发现结核病的几率增加有关（OR 4.3，95%CI 2.5-7.3）。对于 HIV 阴性的囚犯，既往结核病（调整后的 OR [aOR] 4.9，95%CI 1.7-14.1）和自我报告的症状与无症状（1 个症状，aOR 8.8，95%CI 1.2-67.7；>2 个症状，aOR 21.7，95%CI 3.0-158.8）与筛查发现结核病的几率增加独立相关。南非惩教设施需要进行常规结核筛查，包括 CXR，以发现和转介活动性结核的囚犯。
