title: Pulmonary tuberculosis in prisons of the ex-USSR state Georgia: results of a nation-wide prevalence survey among sentenced inmates.
abstract: METHODS
  The penitentiary system of the ex-USSR state of Georgia.
  
  
  OBJECTIVE
  To measure the prevalence of active pulmonary tuberculosis and drug-resistant disease among prisoners. To identify factors associated with active tuberculosis and multidrug resistance (MDR).
  
  
  METHODS
  A comprehensive multiphasic screening survey for tuberculosis.
  
  
  RESULTS
  The prevalence of smear- or culture-positive tuberculosis was 5995 per 100,000 prisoners (n = 448 cases among 7473 inmates). Of all the strains, 215 (77.9%) were resistant to at least one drug and 37 (13.0%) were MDR. Independent risk markers associated smear- or culture-positive tuberculosis with included prison stay of 2 years or more, body mass index <20 kg/m2, accommodation in a large size prison, previous anti-tuberculosis treatment, cough of 2 weeks or more and loss of appetite. Risk markers associated with MDR were a prison stay of less than 2 years and being over 25 years of age.
  
  
  CONCLUSIONS
  In Georgia, the excess risk for tuberculosis among prisoners is unprecedented, suggesting that prisons represent a significant reservoir of tuberculosis. Only a comprehensive strategy for tuberculosis control in prisons, including prison reform, control of anti-tuberculosis drugs, and prompt and efficient diagnosis and treatment of patients can have an impact on the tuberculosis burden in the prison system.
authors.affiliation: Health Services Unit, International Committee of the Red Cross, Geneva, Switzerland. aaerts@icrc.org
authors.forename: A
authors.initials: A
authors.lastname: Aerts
authors.forename: M
authors.initials: M
authors.lastname: Habouzit
authors.forename: L
authors.initials: L
authors.lastname: Mschiladze
authors.forename: N
authors.initials: N
authors.lastname: Malakmadze
authors.forename: N
authors.initials: N
authors.lastname: Sadradze
authors.forename: O
authors.initials: O
authors.lastname: Menteshashvili
authors.forename: F
authors.initials: F
authors.lastname: Portaels
authors.forename: P
authors.initials: P
authors.lastname: Sudre
mesh_terms: D000328:Adult; D018432:Drug Resistance, Multiple; D005260:Female; D005846:Georgia (Republic) / Q000453:epidemiology; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D015995:Prevalence; D011329:Prisoners / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012307:Risk Factors; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology*