Tuberculosis in a southern Brazilian prison

Kuhleis, Daniele; Ribeiro, Alexandre Moretto; Costa, Elis Regina Dalla; Cafrune, Patrícia Izquierdo; Schmid, Karen Barros; Costa, Luciana Scarlazzari; Ribeiro, Marta Osório; Zaha, Arnaldo; Rossetti, Maria Lúcia Rosa

doi:10.1590/s0074-02762012000700012

Cited by 35 publications

(43 citation statements)

References 33 publications

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“…The prison had typical conditions in terms of layout, crowding, and diagnostic resources. However, other studies have found that TB incidence and transmission rates are even higher in other prisons in Brazil ( 3 , 14 , 15 ). Thus, the contribution of spillover infections to the general community may be even greater.…”

Section: Discussionmentioning

confidence: 79%

Prisons as Reservoir for Community Transmission of Tuberculosis, Brazil

Sacchi¹,

Praça²,

Tatara³

et al. 2015

Emerg. Infect. Dis.

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Section: Discussionmentioning

confidence: 79%

Prisons as Reservoir for Community Transmission of Tuberculosis, Brazil

Sacchi¹,

Praça²,

Tatara³

et al. 2015

Emerg. Infect. Dis.

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“…16 Multiple studies in prisons throughout Brazil have documented active TB prevalence in excess of 2,000 cases per 100,000 inmates. 14,[17][18][19][20] The central west state of Mato Grosso do Sul has the highest incarceration rate in the country. In this setting, we obtained empirical data on architecture, ventilation, and occupancy and projected the impact of diagnostic and environmental interventions on TB transmission.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Ventilation and Early Diagnosis on Tuberculosis Transmission in Brazilian Prisons

Urrego¹,

Ko²,

Carbone³

et al. 2015

The American Journal of Tropical Medicine and Hygiene

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Abstract. Prisoners have among the highest incidence of tuberculosis (TB) globally. However, the contribution of the prison environment on transmission is not well understood and structural characteristics have received little attention as effective epidemiological interventions in TB control. We evaluated architectural characteristics and estimated ventilation rates in 141 cells in three prisons in central west Brazil using steady-state exhaled carbon dioxide (CO 2 ) levels. We used a modified Wells-Riley equation to estimate the probability of infection for inmates sharing a cell with an infectious case and projected the impact of interventions, including early diagnosis and improved ventilation. Overall, prison cells were densely populated (mean 2.1 m 2 per occupant) and poorly ventilated, with only three cells meeting World Health Organization (WHO) standards for per-person ventilation (60 L/s) applied in infection control settings. In the absence of interventions, projected mean risk of infection was 78.0% during a 6-month period. Decreasing timeto-diagnosis by 25% reduced transmission risk by 8.3%. Improving ventilation to WHO standards decreased transmission by 38.2%, whereas optimizing cross-ventilation reduced transmission by 64.4%. Prison environments promote high infection risk over short-time intervals. In this context, enhanced diagnostics have a limited impact on reducing transmission. Improving natural ventilation may be required to effectively control TB in prisons.

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“…, 30 , 34 As discussed, this population consists predominantly of young adults from socioeconomically disadvantaged communities with high rates of active tuberculosis. Among other elements posing an increased risk for the development of tuberculosis, the rate of alcoholism (24.8%) was lower than that reported in other studies (39.2-44.1%), 30 whereas the rate of smoking (61.1%) was similar 30 .…”

Section: Discussionmentioning

confidence: 99%

“… 18 , 27 , 34 , 36 Therefore, it is important to detect LTBI in the HIV-infected population so that preventive measures can be taken, because HIV-infected individuals with LTBI have an 8.0-10.0% annual risk of developing active tuberculosis, as do users of inhaled illicit drugs with LTBI. In contrast, HIV-uninfected individuals with LTBI have a 10.0% lifetime risk of developing tuberculosis 18 …”

Section: Discussionmentioning

confidence: 99%

“…Chief among the conditions of the prison environment that can favor the spread of the disease are limited exposure to sunlight, 5 , 6 overpopulation, 5 , 6 , 8 , 18 , 30 , 34 and inadequate ventilation 5 6 , 30 To this context, we can add lack of training in tuberculosis control activities among prison health teams 5 and limited access to health care in prisons 30 …”

Section: Discussionmentioning

confidence: 99%

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Prevalence of latent Mycobacterium tuberculosis infection in prisoners

et al. 2016

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Objective:To determine the prevalence of and the factors associated with latent Mycobacterium tuberculosis infection (LTBI) in prisoners in the state of Minas Gerais, Brazil. Methods:This was a cross-sectional cohort study conducted in two prisons in Minas Gerais. Tuberculin skin tests were performed in the individuals who agreed to participate in the study. Results:A total of 1,120 individuals were selected for inclusion in this study. The prevalence of LTBI was 25.2%. In the multivariate analysis, LTBI was associated with self-reported contact with active tuberculosis patients within prisons (adjusted OR = 1.51; 95% CI: 1.05-2.18) and use of inhaled drugs (adjusted OR = 1.48; 95% CI: 1.03-2.13). Respiratory symptoms were identified in 131 (11.7%) of the participants. Serological testing for HIV was performed in 940 (83.9%) of the participants, and the result was positive in 5 (0.5%). Two cases of active tuberculosis were identified during the study period. Conclusions:Within the prisons under study, the prevalence of LTBI was high. In addition, LTBI was associated with self-reported contact with active tuberculosis patients and with the use of inhaled drugs. Our findings demonstrate that it is necessary to improve the conditions in prisons, as well as to introduce strategies, such as chest X-ray screening, in order to detect tuberculosis cases and, consequently, reduce M. tuberculosis infection within the prison system.

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Tuberculosis in a southern Brazilian prison

Abstract: The occurrence of tuberculosis (TB)

Cited by 35 publications

References 33 publications

Prisons as Reservoir for Community Transmission of Tuberculosis, Brazil

Prisons as Reservoir for Community Transmission of Tuberculosis, Brazil

The Impact of Ventilation and Early Diagnosis on Tuberculosis Transmission in Brazilian Prisons

Prevalence of latent Mycobacterium tuberculosis infection in prisoners

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