Incidence of tuberculosis and the importance of treatment of latent tuberculosis infection in a Spanish prison population.
OBJECTIVE
To establish the incidence of tuberculosis (TB) in a prison population and its link with latent tuberculosis infection treatment (LTIT).


METHODS
From 1991 to 1999 a TB programme was run in a Spanish prison. A cohort study was conducted to know TB incidence and the associated variables.


RESULTS
Of 1,050 people studied, 10% were co-infected by the human immunodeficiency virus (HIV) and Mycobacterium tuberculosis. Twenty-three cases of TB were detected, an incidence rate of 6.39 per 1,000 person-years of follow-up. Multivariate analysis showed HIV-infected patients (RR 4.07, 95%CI 2.61-6.35), and those infected by M. tuberculosis who did not undergo LTIT (RR 10.15, 95%CI 0.90-50.59) to be at greater risk of developing TB. In TST reactors, those co-infected with HIV (RR 10.15, 95%CI 3.80-27.07) and those who had not undergone LTIT (RR 8.53, 95%CI 1.12-64.86) were shown to be at the greatest risk of developing TB.


CONCLUSIONS
The observed incidence of TB is much higher in prisons than in the community at large. HIV-M. tuberculosis co-infection appears as the main risk factor for developing TB, while LTIT significantly reduces incidence.
Martin
V
V
Medical Service, Penitentiary Centre, Léon, Spain. dfivms@unilcon.es
Guerra
J M
JM
Cayla
J A
JA
Rodriguez
J C
JC
Blanco
M D
MD
Alcoba
M
M
D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications / Q000628:therapy; D006801:Humans; D015994:Incidence; D008297:Male; D015999:Multivariate Analysis; D009169:Mycobacterium tuberculosis / Q000145:classification; D011330:Prisons; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D014376:Tuberculosis / Q000150:complications / Q000453:epidemiology* / Q000628:therapy*