Predictive factors of Mycobacterium tuberculosis infection and pulmonary tuberculosis in prisoners.
BACKGROUND
Tuberculosis currently represents a serious problem in prison populations.


METHODS
With the aim of studying the predictive factors for, and the prevalence of, Mycobacterium tuberculosis infection and pulmonary tuberculosis in a Spanish prison, all those admitted during 1991 and 1992 were included (N = 1314). The tuberculin skin test, HIV serology, chest X-ray and bacteriological examination of sputum were carried out. Statistical analysis was done by univariant tests, stratified analysis and logistic regression.


RESULTS
The prevalence of M. tuberculosis infection was 55.5% (95% confidence interval [CI] 52.5-58.5). An association was found with sex, imprisonment more than once, HIV infection and age. The co-infection rate (tuberculosis plus HIV) was 9.2%. Logistic regression showed a greater risk with age (4.4% per year), time spent in prison and for males. The prevalence of pulmonary tuberculosis was 1.26% and an association was found with M. tuberculosis infection, HIV infection (odds ratio [OR] = 13.7), intravenous drug users (OR = 17.2) and imprisonment more than once (OR = 7.3). Logistic regression showed an association with HIV co-infection (OR = 20.2).


CONCLUSIONS
The prevalence of M. tuberculosis infection and pulmonary tuberculosis is high when compared with similar studies. The influence of age, time spent in prison and co-infection with HIV is relevant to recommendations for specific tuberculosis prevention programmes in correctional facilities.
Martín Sánchez
V
V
Centro Penitenciario de León, Spain.
Alvarez-Guisasola
F
F
Caylá
J A
JA
Alvarez
J L
JL
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011329:Prisoners; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D015819:Substance Abuse, Intravenous; D014374:Tuberculin Test; D014376:Tuberculosis / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*