Primary Prophylaxis to Prevent Tuberculosis Infection in Prison Inmates: A Randomized, Double-Blind, Placebo-Controlled Trial

Oliveira, de; Santos, Andréa da Silva; Reis, Cássia Barbosa; Leite, Alessandra de Cássia; Sacchi, Flávia Patussi Correia; Araujo, Rafaele Carla Pivetta de; Santos, Paulo César Pereira dos; Rolla, Valéria Cavalcanti; Martínez, Leonardo; Andrews, Jason R; Croda, Júlio

doi:10.4269/ajtmh.20-0110

Cited by 5 publications

(7 citation statements)

References 38 publications

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“…In four studies in Brazil, the annual risk was greater than 25%, among the highest rates of M tuberculosis infection recorded in any population globally. 20 , 21 , 27 , 30 These rates are orders of magnitude higher than those reported in the general population 32 - 34 and in a previous meta-analysis of prisoners. 6 BCG boosting of tuberculin skin tests in these studies is unlikely as these are conversion studies in which participants must have a baseline negative test.…”

Section: Discussionmentioning

confidence: 57%

“…globally. 20,21,27,30 These rates are orders of magnitude higher than those reported in the general population [32][33][34] and in a previous metaanalysis of prisoners. 6 BCG boosting of tuberculin skin tests in these studies is unlikely as these are conversion studies in which participants must have a baseline negative test.…”

Section: Global Region †mentioning

confidence: 59%

“…The incidence of M tuberculosis infection ranged from one to 144 infections per 100 personyears (figure 2). [20][21][22][23][24][25][26][27][28][29][30] Infection rates were highest in Brazil and Nigeria (23-144 incident infections per 100 personyears) and lowest in Australia, Spain, and the USA (0-6 infections per 100 personyears), but these low rates were still higher than infection rates among the general population. The overall pooled rate of incident M tuberculosis infection among all studies was 15•0 (95% CrI 3•8-41•6) per 100 personyears, based on results from the metaregression model (figure 2).…”

Section: Resultsmentioning

confidence: 99%

“…Incidence differed markedly across regions. The annual incidence per 100 000 personyears was lowest in North America ( Niero (1982) 20 Ferreira et al (1996) 21 MacIntyre et al (1997) 22 Martín et al (2000) 23 Hung (2003) 24 Levy et al (2007) 25 Chigbu and Iroegbu (2010) 26 Paião et al (2016) 27 Mamani et al (2016) 28 Arroyave et al (2017) 29 Dias de Oliveira et al (2020) 30 Overall pooled rate per 100 000 personyears in settings with a national tuber culosis incidence of 250 or more cases per 100 000 person years (table 2). The incidence of tuberculosis per 100 000 personyears was also much higher in prisons (450 [95% CrI 270-690] cases) than in jails (260 [140-460] cases) or detention centres (60 cases; table 2).…”

Section: Resultsmentioning

confidence: 99%

“…6 Among 11 studies measuring inci dence of M tuberculosis infection by use of tuberculin or QuantiFERON tests among prisoners, rates were strikingly high. Among studies done in Iran, Colombia, Nigeria, and Brazil, 20,21,26,27,29,30 the annual risk of M tuberculosis infection was greater than 15%. In four studies in Brazil, the annual risk was greater than 25%, among the highest rates of M tuberculosis infection recorded in any population CrI=credible interval.…”

Section: Global Region †mentioning

confidence: 91%

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Incidence and prevalence of tuberculosis in incarcerated populations: a systematic review and meta-analysis

Cords

Martínez

Warren

et al. 2021

The Lancet Public Health

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Summary Background Prisons are recognised as high-risk environments for tuberculosis, but there has been little systematic investigation of the global and regional incidence and prevalence of tuberculosis, and its determinants, in prisons. We did a systematic review and meta-analysis to assess the incidence and prevalence of tuberculosis in incarcerated populations by geographical region. Methods In this systematic review and meta-analysis, we searched MEDLINE, Embase, Web of Knowledge, and the LILACS electronic database from Jan 1, 1980, to Nov 15, 2020, for cross-sectional and cohort studies reporting the incidence of Mycobacterium tuberculosis infection, incidence of tuberculosis, or prevalence of tuberculosis among incarcerated individuals in all geographical regions. We extracted data from individual studies, and calculated pooled estimates of incidence and prevalence through hierarchical Bayesian meta-regression modelling. We also did subgroup analyses by region. Incidence rate ratios between prisons and the general population were calculated by dividing the incidence of tuberculosis in prisons by WHO estimates of the national population-level incidence. Findings We identified 159 relevant studies; 11 investigated the incidence of M tuberculosis infection (n=16 318), 51 investigated the incidence of tuberculosis (n=1 858 323), and 106 investigated the prevalence of tuberculosis (n=6 727 513) in incarcerated populations. The overall pooled incidence of M tuberculosis infection among prisoners was 15·0 (95% credible interval [CrI] 3·8–41·6) per 100 person-years. The incidence of tuberculosis (per 100 000 person-years) among prisoners was highest in studies from the WHO African (2190 [95% CrI 810–4840] cases) and South-East Asia (1550 [240–5300] cases) regions and in South America (970 [460–1860] cases), and lowest in North America (30 [20–50] cases) and the WHO Eastern Mediterranean region (270 [50–880] cases). The prevalence of tuberculosis was greater than 1000 per 100 000 prisoners in all global regions except for North America and the Western Pacific, and highest in the WHO South-East Asia region (1810 [95% CrI 670–4000] cases per 100 000 prisoners). The incidence rate ratio between prisons and the general population was much higher in South America (26·9; 95% CrI 17·1–40·1) than in other regions, but was nevertheless higher than ten in the WHO African (12·6; 6·2–22·3), Eastern Mediterranean (15·6; 6·5–32·5), and South-East Asia (11·7; 4·1–27·1) regions. Interpretation Globally, people in prison are at high risk of contracting M tuberculosis infection and developing tuberculosis, with consistent disparities between prisons and the general population across regions. Tuberculosis control programmes should prioritise preventive interventions among incarcerated populations. ...

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Section: Discussionmentioning

confidence: 57%

Section: Global Region †mentioning

confidence: 59%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Global Region †mentioning

confidence: 91%

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Incidence and prevalence of tuberculosis in incarcerated populations: a systematic review and meta-analysis

Cords

Martínez

Warren

et al. 2021

The Lancet Public Health

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Reimbursing incarcerated individuals for participation in research: A scoping review

Mambro,

Afshar,

Leone

et al. 2024

International Journal of Drug Policy

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Serial Mass Screening for Tuberculosis Among Incarcerated Persons in Brazil

Pivetta de Araujo,

Martinez,

da Silva Santos

et al. 2024

Clinical Infectious Diseases

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Background Active search for tuberculosis cases through mass screening is widely described as a tool to improve case detection in hyperendemic settings. However, its effectiveness in high-risk populations, such as incarcerated people, is debated. Methods Between 2017 and 2021, three rounds of mass screening were carried out in three Brazilian prisons. Social and health questionnaires, chest X-rays and Xpert MTB/RIF were performed. Results Over 80% of the prison population was screened. Overall, 684 cases of pulmonary tuberculosis were diagnosed. Prevalence across screening rounds was not statistically different. Among incarcerated persons with symptoms, the overall prevalence of tuberculosis per 100,000 persons was 8,497 (95% CI, 7,346–9,811), 11,115 (95% CI, 9,471–13,082), and 7,957 (95% CI, 6,380–9,882) in screening rounds one, two and three, respectively. Similar to our overall results, there were no statistical differences between screening rounds and within individual prisons. We found no statistical differences in CAD4TB scores across screening rounds among people with tuberculosis – the median scores in rounds 1, 2, and 3 were 82 (IQR, 63–97), 77 (IQR, 60–94), and 81 (IQR, 67–92), respectively. Conclusions In this environment with hyperendemic rates of tuberculosis, three rounds of mass screening did not reduce the overall tuberculosis burden. In prisons, where a substantial amount of TB is undiagnosed annually, a range of complementary interventions and more frequent TB screening may be required.

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Primary Prophylaxis to Prevent Tuberculosis Infection in Prison Inmates: A Randomized, Double-Blind, Placebo-Controlled Trial

Cited by 5 publications

References 38 publications

Incidence and prevalence of tuberculosis in incarcerated populations: a systematic review and meta-analysis

Incidence and prevalence of tuberculosis in incarcerated populations: a systematic review and meta-analysis

Reimbursing incarcerated individuals for participation in research: A scoping review

Serial Mass Screening for Tuberculosis Among Incarcerated Persons in Brazil

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