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BMC Public Health

, 13:983

Health behavior, health promotion and society

Abstract

BackgroundTuberculosis TB is a major issue in prisons of low and middle income countries where TB incidence rates are much higher in prison populations as compared with the general population. In the Rio de Janeiro RJ State prison system, the TB control program is limited to passive case-finding and supervised short duration treatment. The aim of this study was to measure the impact of X-ray screening at entry associated with systematic screening on the prevalence and incidence of active TB.

MethodsWe followed up for 2 years a RJ State prison for adult males 1429 inmates at the beginning of the study and performed, in addition to passive case-finding, 1 two -cross-sectional- X-ray systematic screenings: the first at the beginning of the study period and the second 13 months later; 2 X-ray screening of inmates entering the prison during the 2 year study period. Bacteriological examinations were performed in inmates presenting any pulmonary, pleural or mediastinal X-ray abnormality or spontaneously attending the prison clinic for symptoms suggestive of TB.

ResultsOverall, 4326 X-rays were performed and 246 TB cases were identified. Prevalence among entering inmates remained similar during 1 and the 2 year of the study: 2.8% 21-754 and 2.9% 28-954 respectively, whereas prevalence decreased from 6.0% 83-1374 to 2.8% 35-1244 between 1 and 2 systematic screenings p < 0.0001. Incidence rates of cases identified by passive case-finding decreased from 42 to 19 per 1000 person-years between the 1 and the 2 year p < 0.0001. Cases identified by screenings were less likely to be bacteriologically confirmed as compared with cases identified by passive-case finding.

ConclusionsThe strategy investigated, which seems highly effective, should be considered in highly endemic confined settings such as prisons.

KeywordsTuberculosis control X-ray screening Prisons Brazil Incidence  Download fulltext PDF



Autor: Alexandra Sanchez - Veronique Massari - Germano Gerhardt - Ana Beatriz Espinola - Mahinda Siriwardana - Luiz Antonio B Ca

Fuente: https://link.springer.com/



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