title: Pulmonary and latent tuberculosis screening in opiate drug users: an essential and neglected approach for harm-reduction facilities.
abstract: OBJECTIVE
  Opiates drug users are at much higher risk of developing tuberculosis (TB) infection than general population. We conducted this study to determine the susceptibility for pulmonary and latent TB infection in opiates drug users.
  
  
  METHODS
  In this cross-sectional study, all opiates drug users referred to drop-in centers, methadone maintenance clinics, and harm-reduction facilities affiliated with Shiraz University of Medical Sciences in southern Iran were screened for pulmonary and latent TB infection.
  
  
  RESULTS
  The participation rate of opiate drug users was 87.66% (263 of 300). Mean age was 37.37 ± 8.33 (range, 20-65) years. Two hundred twenty-six (85.93%) were male and 197 (74.90%) were injection drug users (IDUs). One hundred sixty-three (61.97%) had TB-related symptoms. Culture for TB was positive in 3 patients (1.14%) (2 non-IDUs and 1 IDU). Two patients (0.76%) showed acid-fast bacilli in the direct sputum smear. Eighty-five of 244 patients (34.83%) had a 5- to 10-mm induration in the skin TB test. Twenty-nine of 223 patients (13%) had abnormal findings from chest x-ray films.
  
  
  CONCLUSIONS
  The prevalence of smear-positive pulmonary TB in opiate drug users is more than 100 times in the general population in Iran. Therefore, active and appropriate screening to detect pulmonary TB infection should be integrated into routine activities at all harm-reduction facilities for drug users, irrespective of their route of drug use or human immunodeficiency virus status, in this country.
authors.affiliation: From the Health Policy Research Center (BH, KBL), Health Department (NO), and HIV/AIDS Research Center (AR, MM, PAK, HAA), Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Behnam
authors.initials: B
authors.lastname: Honarvar
authors.forename: Kamran Bagheri
authors.initials: KB
authors.lastname: Lankarani
authors.forename: Neda
authors.initials: N
authors.lastname: Odoomi
authors.forename: Amir
authors.initials: A
authors.lastname: Roudgari
authors.forename: Mohsen
authors.initials: M
authors.lastname: Moghadami
authors.forename: Parvin Afsar
authors.initials: PA
authors.lastname: Kazerooni
authors.forename: Alireza Hassan
authors.initials: AH
authors.lastname: Abadi
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D055985:Latent Tuberculosis / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000453:epidemiology* / Q000382:microbiology*; D011795:Surveys and Questionnaires; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000453:epidemiology*