Negative latent tuberculosis at time of incarceration: identifying a very high-risk group for infection

ABSTRACT: The main aim was to measure the incidence of latent tuberculosis infection (LTBI) and identify risk factors associated with infection. In addition, we determined the number needed to screen (NNS) to identify LTBI and active tuberculosis. We followed 129 prisoners for 2 years following a negative two-step tuberculin skin test (TST). The cumulative incidence of TST conversion over 2 years was 29·5% (38/129), among the new TST converters, nine developed active TB. Among persons with no evidence of LTBI, the NNS to identify a LTBI case was 3·4 and an active TB case was 14·3. The adjusted risk factors for LTBI conversion were incarceration in prison number 1, being formerly incarcerated, and overweight. In conclusion, prisoners have higher risk of LTBI acquisition compared with high-risk groups, such as HIV-infected individuals and children for whom LTBI testing should be performed according to World Health Organization guidance. The high conversion rate is associated with high incidence of active TB disease, and therefore we recommend mandatory LTBI screening at the time of prison entry. Individuals with a negative TST at the time of entry to prison are at high risk of acquiring infection, and should therefore be followed in order to detect convertors and offer LTBI treatment. This approach has a very low NNS for each identified case, and it can be utilized to decrease development of active TB disease and transmission.

• Autores: Arroyave Echeverri, Luisa Fernanda; Arbeláez Montoya, María Patricia; Marín Pineda, Diana Marcela; Keynan, Yoav; López López, Lucelly; Rueda Vallejo, Zulma Vanessa
• Tipo de recurso: Article of investigation
• Fecha de publicación: 2017
• Institución: Universidad de Antioquia
• Repositorio: Repositorio UdeA
• Idioma: eng
• OAI Identifier: oai:bibliotecadigital.udea.edu.co:10495/38383
• Acceso en línea: https://hdl.handle.net/10495/38383
• Palabra clave: Tuberculosis Latente; Latent Tuberculosis; Incidencia; Incidence; Prisiones; Prisons; Factores de Riesgo; Risk Factors; Prueba de Tuberculina; Tuberculin Test; Colombia - epidemiología; Colombia - epidemiology; https://id.nlm.nih.gov/mesh/D055985; https://id.nlm.nih.gov/mesh/D015994; https://id.nlm.nih.gov/mesh/D011330; https://id.nlm.nih.gov/mesh/D012307; https://id.nlm.nih.gov/mesh/D003105
• Rights: openAccess
• License: https://creativecommons.org/licenses/by-nc-nd/4.0/