Contact screening and latent TB infection treatment in Singapore correctional facilities.
METHODS
Singapore, a city-state with a tuberculosis (TB) incidence rate of 47 per 100000 population in 2000.


OBJECTIVE
1) To report our experience with contact investigation and latent TB infection (LTBI) treatment in high-risk contacts with unknown human immunodeficiency virus (HIV) status in correctional facilities (CFs) (prisons/drug rehabilitation centres); and 2) to compare the yield of contact screening in this setting with that in the community (household/family) setting.


METHODS
The tuberculin skin test (TST) readings of 704 CF contacts screened from 1999 to 2001 were compared with those of 2729 household/family contacts who underwent screening in 2000.


RESULTS
Respectively eight (1.1%) and 20 (0.7%) active TB cases were detected among the CF and community contacts. A significantly higher proportion of CF contacts had first (non-conversion) TST readings > or =15 mm (39% vs. 22%, OR 2.3; 95%CI 1.9-2.7; P < 0.001), and 10-14 mm (26% vs. 18%, OR 1.6; 95%CI 1.3-2.0; P < 0.001) and TST conversion (43% vs. 20%, OR 2.9; 95%CI 1.7-4.9; P < 0.001). LTBI treatment was started in 65% of the CF contacts screened; 87% completed treatment.


CONCLUSIONS
We found a high LTBI rate among CF contacts, presenting an opportunity for intervention.
Chee
C B E
CB
Department of Respiratory Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore. cynthia_chee@ttsh.com.sg
Teleman
M D
MD
Boudville
I C
IC
Wang
Y T
YT
D000328:Adult; D016358:Contact Tracing; D005192:Family Health; D006801:Humans; D008875:Middle Aged; D011330:Prisons; D012846:Singapore; D014374:Tuberculin Test; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy / Q000635:transmission*