TB surveillance in correctional institutions in Hong Kong, 1999-2005.
OBJECTIVE
To understand the epidemiology of tuberculosis (TB) inside the prison system of Hong Kong.


METHODS
Prospective territory-wide TB surveillance was conducted among prisoners in 24 correctional institutions.


RESULTS
From 1999 to 2005, 622 prevalent TB cases diagnosed before or within 3 months of incarceration and 214 incident cases diagnosed after 3 months were reported by prison staff to a paper-based central prison TB registry. Both crude prevalence and incidence were falling (chi(2) for trend, both P < 0.001), despite a higher sex- and age-adjusted prison TB incidence as compared to the general population (indirectly standardised rate [ISR] 280.6 vs. 108.0/100000, P < 0.001). Illegal immigrants (odds ratio [OR] 3.6, 95% confidence interval [CI] 1.8-7.4) and drug addicts (OR 2.04, 95%CI 1.13-3.7) were two major risk groups. The TB incident risk disappeared after their exclusion (ISR 117.1 vs. 108.0/100000, P = 0.52). No significant difference in the multidrug-resistant rate was found when comparing the group with the general population (3.5% vs. 1.0%, OR 3.6, 95%CI 0.5-28.4). No extensively drug-resistant (XDR) cases were identified.


CONCLUSIONS
TB remains a significant disease in local prisons. Further strengthening of TB control programmes in prisons, especially targeting the higher risk groups, is recommended.
Wong
M Y
MY
Tuberculosis and Chest Service, Department of Health, Hong Kong, China.
Leung
C C
CC
Tam
C M
CM
Kam
K M
KM
Ma
C H
CH
Au
K F
KF
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D003140:Communicable Disease Control; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011159:Population Surveillance; D015995:Prevalence; D011330:Prisons / Q000706:statistics & numerical data*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology; D013997:Time Factors; D014171:Transients and Migrants / Q000706:statistics & numerical data; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology
D000995:Antitubercular Agents