Centre Hospitalier Cayenne, Unité Sanitaire en Milieu Pénitentiaire, Guyane française, France.
Department of General Medicine, University of the French West Indies, Pointe-à-Pitre, Guadeloupe.
Glob Public Health. 2024 Jan;19(1):2332969. doi: 10.1080/17441692.2024.2332969. Epub 2024 Mar 26.
Tuberculosis is a major cause of mortality worldwide. Prisoners in Guiana have multiple risk factors. The primary objective of this study was to describe tuberculosis occurring in prison and after release in French Guiana between 2008 and 2020. Secondary objectives were to identify tuberculosis risk factors and determine annual incidences.
A retrospective cohort study of tuberculosis cases was carried out at the Guiana prison between 2008 and 2020. Data were collected from prison registers and cross-referenced with the list of tuberculosis notifications in French Guiana.
A total of 36 cases of tuberculosis were studied. Incidence was high, at 263/100,000 per year, higher than elsewhere in France and comparable to that in Brazil. Despite visibly effective screening on entry, with little evidence of intra-prison circulation of tuberculosis, 39% of patients were diagnosed within two years of leaving prison (76% were symptomatic). This could be explained by the high prevalence of latent forms (LTI).
Continued screening on entry, in combination with annual radiological and clinical screening, and reinforced follow-up on release seem indicated to improve patient management and the search for possible LTI.
结核病是全球主要的死亡原因之一。圭亚那的囚犯存在多种风险因素。本研究的主要目的是描述 2008 年至 2020 年间在法属圭亚那监狱内和释放后的结核病发生情况。次要目标是确定结核病的危险因素并确定年发病率。
对 2008 年至 2020 年期间圭亚那监狱的结核病病例进行了回顾性队列研究。从监狱登记处收集数据，并与法属圭亚那的结核病报告清单进行交叉核对。
共研究了 36 例结核病病例。发病率很高，为 263/100,000 人/年，高于法国其他地区，与巴西相当。尽管在进入监狱时进行了明显有效的筛查，且监狱内结核病的传播情况很少，但 39%的患者在离开监狱两年内被诊断（76%有症状）。这可能是由于潜伏性结核感染（LTBI）的高患病率所致。
持续的入境筛查，结合每年的影像学和临床筛查，并在释放后加强随访，似乎可以改善患者的管理和对可能的 LTBI 的寻找。
