Universidad de Antioquia, Medellín, Antioquia, Colombia.
Department of Medical Microbiology and Infectious Diseases, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, Manitoba, Canada.
Am J Trop Med Hyg. 2021 Dec 6;106(1):66-74. doi: 10.4269/ajtmh.20-0307.
People deprived of liberty (PDL) are at high risk of acquiring Mycobacterium tuberculosis infection (latent tuberculosis infection [LTBI]) and progressing to active tuberculosis (TB). We sought to determine the incidence rates and factors associated with LTBI and active TB in Colombian prisons. Using information of four cohort studies, we included 240 PDL with two-step tuberculin skin test (TST) negative and followed them to evaluate TST conversion, as well as, 2,134 PDL that were investigated to rule out active TB (1,305 among people with lower respiratory symptoms of any duration, and 829 among people without respiratory symptoms and screened for LTBI). Latent tuberculosis infection incidence rate was 2,402.88 cases per 100,000 person-months (95% CI 1,364.62-4,231.10) in PDL with short incarceration at baseline, and 419.66 cases per 100,000 person-months (95% CI 225.80-779.95) in individuals with long incarceration at baseline (who were enrolled for the follow after at least 1 year of incarceration). The TB incidence rate among PDL with lower respiratory symptoms was 146.53 cases/100,000 person-months, and among PDL without respiratory symptoms screened for LTBI the incidence rate was 19.49 cases/100,000 person-months. History of Bacillus Calmette-Guerin vaccination decreased the risk of acquiring LTBI among PDL who were recently incarcerated. Female sex, smoked drugs, and current cigarette smoking were associated with an increased risk of developing active TB. This study shows that PDL have high risk for LTBI and active TB. It is important to perform LTBI testing at admission to prison, as well as regular follow-up to control TB in prisons.
被剥夺自由的人(PDL)感染结核分枝杆菌(潜伏性结核感染[LTBI])并进展为活动性结核病(TB)的风险很高。我们旨在确定哥伦比亚监狱中 LTBI 和活动性 TB 的发病率及相关因素。利用四项队列研究的信息,我们纳入了 240 名 TST 双阴性的 PDL,并对其进行了随访以评估 TST 转化情况,还纳入了 2134 名 PDL 以排除活动性 TB(1305 名有任何持续时间的下呼吸道症状,829 名无呼吸道症状且筛查 LTBI)。在基线监禁时间较短的 PDL 中,LTBI 的发病率为 2402.88 例/100000 人月(95%CI 1364.62-4231.10),而在基线监禁时间较长的个体中,LTBI 的发病率为 419.66 例/100000 人月(95%CI 225.80-779.95)(这些个体在至少监禁 1 年后才被纳入随访)。有下呼吸道症状的 PDL 的 TB 发病率为 146.53 例/100000 人月,筛查 LTBI 的无呼吸道症状的 PDL 的发病率为 19.49 例/100000 人月。最近被监禁的 PDL 中,卡介苗接种史降低了获得 LTBI 的风险。女性、吸毒和当前吸烟与发生活动性 TB 的风险增加相关。本研究表明,PDL 存在 LTBI 和活动性 TB 的高风险。在入狱时进行 LTBI 检测以及定期随访以控制监狱中的 TB 非常重要。