Effectiveness of tuberculosis control programmes in prisons, Barcelona 1987-2000.
METHODS
Different bodies have emphasised the need for prisons to implement and evaluate their own tuberculosis prevention and control programmes (TPCP), with the aims of evaluating TPCP in Barcelona prisons and obtaining conclusions that would allow any necessary modifications to be introduced to improve their effectiveness.


METHODS
An assessment was carried out for the period 1987-2000, using the exhaustive retrospective method. The quantitative indicators used were defined in the same way as those employed by the Barcelona TPCP, which were taken as the gold standard. The assessment studied trends in the indicators and evaluated the impact by comparing the results with the gold standard.


RESULTS
Statistically significant trends (P < 0.0001) were found for incidence rates, infection prevalence, treatment adherence rates among smear-positive cases and percentage of cases on directly observed treatment (DOT). When impact was assessed, only the decline in the average annual incidence rate (25.2%) and desired rates of adherence among smear-positives (> or = 95% since 1993) achieved the proposed objectives.


CONCLUSIONS
The observed decline in incidence shows that when programmes are based on reducing diagnostic delay, controlling adherence using DOT and tracing contacts, tuberculosis control among the prisons is effective.
Rodrigo
T
T
Municipal Institute of Health, Epidemiology Service, Barcelona, Spain.
Caylà
J A
JA
García de Olalla
P
P
Brugal
M T
MT
Jansà
J M
JM
Guerrero
R
R
Marco
A
A
Martín
V
V
D000995:Antitubercular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D023801:Directly Observed Therapy; D006801:Humans; D015994:Incidence; D017053:Infection Control; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D011330:Prisons; D015397:Program Evaluation; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D013997:Time Factors; D014376:Tuberculosis / Q000453:epidemiology / Q000517:prevention & control*
D000995:Antitubercular Agents