Prevalence of Tuberculin Skin Test Reactions Among Prison Workers

Jochem, K; Tannenbaum, Terry; Menzies, Dick

doi:10.1007/bf03403888

Cited by 14 publications

(11 citation statements)

References 17 publications

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“…20 Our data refine their conclusions by demonstrating a temporal effect between BCG vaccination and TST. The RR of a positive TST result was 3.56 (95% CI 3.05 to 4.15) when the skin test was performed within 15 years of BCG vaccination but only 1.46 (95% CI 1.40 to 1.53) after 15 years.…”

Section: Discussionsupporting

confidence: 85%

A meta-analysis of the effect of Bacille Calmette Guerin vaccination on tuberculin skin test measurements

Wang

Turner²,

Elwood³

et al. 2002

Thorax

426

257

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Background: The accurate diagnosis of latent tuberculosis infection (LTBI) is an important component of any tuberculosis control programme and depends largely on tuberculin skin testing. The appropriate interpretation of skin test results requires knowledge of the possible confounding factors such as previous BCG vaccination. Uncertainty about the effect of BCG vaccination on tuberculin skin testing and the strength with which recommendations are made to individual patients regarding treatment of LTBI have identified a need to analyse the available data on the effect of BCG on skin testing. A meta-analysis of the evidence for the effect of BCG vaccination on tuberculin skin testing in subjects without active tuberculosis was therefore performed. Methods: Medline was searched for English language articles published from 1966 to 1999 using the key words "BCG vaccine", "tuberculin test/PPD", and "skin testing". Bibliographies of relevant articles were reviewed for additional studies that may have been missed in the Medline search. Articles were considered for inclusion in the meta-analysis if they had recorded tuberculin skin test results in subjects who had received BCG vaccination more than 5 years previously and had a concurrent control group. Only prospective studies were considered. The geographical location, number of participants, type of BCG vaccine used, type of tuberculin skin test performed, and the results of the tuberculin skin test were extracted. Results: The abstracts and titles of 980 articles were identified, 370 full text articles were reviewed, and 26 articles were included in the final analysis. Patients who had received BCG vaccination were more likely to have a positive skin test (5 TU PPD: relative risk (RR) 2.12 (95% confidence interval (CI)1.50 to 3.00); 2 TU RT23: 26.50 (95% CI 1.83 to 3.85). The effect of BCG vaccination on PPD skin test results was less after 15 years. Positive skin tests with indurations of >15 mm are more likely to be the result of tuberculous infection than of BCG vaccination. Conclusions: In subjects without active tuberculosis, immunisation with BCG significantly increases the likelihood of a positive tuberculin skin test. The interpretation of the skin test therefore needs to be made in the individual clinical context and with evaluation of other risk factors for infection. The size of the induration should also be considered when making recommendations for treatment of latent infection.

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Section: Discussionsupporting

confidence: 85%

A meta-analysis of the effect of Bacille Calmette Guerin vaccination on tuberculin skin test measurements

Wang

Turner²,

Elwood³

et al. 2002

Thorax

426

257

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“…A tuberculin survey among full-time employees of a Canadian prison revealed a high (32%) prevalence of TST positivity that was independently associated with longer duration of prison service, travelling to a TB endemic area and BCG vaccination 25. Of note, the majority (46%) of those prison workers with a positive TST had no other recognised TB risk factor; highlighting the possibility of unrecognised TB transmission from inmates with undiagnosed active TB disease.…”

Section: Discussionmentioning

confidence: 99%

“…Correctional settings with limited implementation of evidence-based TB control programmes render these settings as reservoirs augmenting transmission of TB among inmates and staff members alike 30. This was largely attributed to the missed diagnosis of active TB cases among prisoners and hence the facilitation of on-going TB transmission 25 31. Our recent study of an intensified TB case finding revealed a very high (12.0%) prevalence of undiagnosed active TB among HIV-infected inmates in the same Malaysian prison,11 which may have contributed to the extraordinarily high reported prevalence of TST positivity among prisoners (88.8%) and prison officers (81.0%) in this prison 21…”

Section: Discussionmentioning

confidence: 99%

Prevalence and correlates of latent tuberculosis infection among employees of a high security prison in Malaysia

et al. 2015

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Objectives Although prison employees share the same tuberculosis (TB) risk environment with prisoners, the magnitude of TB problems among prison employees is unknown in most resource-limited prisons. This survey was conducted to investigate the prevalence and correlates of tuberculin skin test (TST) positivity among employees in Malaysia’s largest prison. Methods Consented, full-time prison employees were interviewed using a structured questionnaire that included sociodemographic data, history of working in the correctional system and TB-related risk. TST was placed intradermally and read after 48–72 h. Induration size of ≥10 mm was considered positive. Logistic regression analyses were conducted to explore associations with TST positivity. Results Of the 445 recruited prison employees, 420 (94.4%) had complete data. Most were young (median=30.0 years) men (88.8%) who had only worked at this prison (76.4%) for a median total employment period of 60 months (IQR 34.5–132.0). The majority were correctional officers, while civilian employees represented only 7.6% of the sample. Only 26 (6.2%) reported having ever been screened for TB since employment. Prevalence of TST positivity was 81% and was independently associated with longer (≥12 months) prison employment (AOR 4.9; 95% CI 1.5 to 15.9) and current tobacco smoking (AOR=1.9, 95% CI 1.2 to 3.2). Conclusions Latent TB prevalence was high in this sample, approximating that of prisoners in this setting, perhaps suggesting within prison TB transmission in this facility. Formal TB control programmes for personnel and prisoners alike are urgently needed within the Malaysian correctional system.

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“…Jochem et al 17 determined the prevalence of latent tuberculosis among the professional staff of a penitentiary for women in Montreal, Canada, as being of 32%. The authors found a positive association between working in a penitentiary and latent tuberculosis.…”

Section: Discussionmentioning

confidence: 99%

Infecção tuberculosa latente em profissionais contatos e não contatos de detentos de duas penitenciárias do estado de São Paulo, Brasil, 2008

Nogueira

Abrahão

Galesi

2011

Rev. bras. epidemiol.

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Prevalence of Tuberculin Skin Test Reactions Among Prison Workers

Cited by 14 publications

References 17 publications

A meta-analysis of the effect of Bacille Calmette Guerin vaccination on tuberculin skin test measurements

A meta-analysis of the effect of Bacille Calmette Guerin vaccination on tuberculin skin test measurements

Prevalence and correlates of latent tuberculosis infection among employees of a high security prison in Malaysia

Infecção tuberculosa latente em profissionais contatos e não contatos de detentos de duas penitenciárias do estado de São Paulo, Brasil, 2008

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