title: Prevalence of tuberculosis in prisons: risk factors and molecular epidemiology.
abstract: METHODS
  Tuberculosis (TB) in prisons is a challenge for the public health system. Active and passive case screening are important tools for TB case detection.
  
  
  OBJECTIVE
  To characterise TB in a southern Brazil prison in terms of epidemiological variables, diagnostic approaches and clinical isolate genotypes.
  
  
  METHODS
  Inmates of a southern Brazilian prison were assessed using active and passive TB case screening. Sputum microscopy, culture, drug susceptibility testing and genotyping were performed. Data were analysed using descriptive statistics and multivariable logistic regression.
  
  
  RESULTS
  TB prevalence was 4712 per 100 000 inmates, and was associated with low educational level, time incarcerated, productive cough, previous TB history, smoking and human immunodeficiency virus (HIV) infection. Overall, 27.8% of TB cases were detected by culture only; the prevalence of drug-resistant strains was 7.8%; 58.3% of clinical isolates had an identical genotypic profile.
  
  
  CONCLUSIONS
  The study showed extensive circulation of Mycobacterium tuberculosis strains in a highly endemic prison. It is recommended that priority be given to the evaluation of prison inmates with longer jail times, those who are HIV-positive, those with symptoms and those with a previous history of tuberculosis. We observed that active case finding induced passive case detection.
authors.affiliation: Escola de Enfermagem, Universidade Federal do Rio Grande, Rio Grande, Centro de Ciências da Vida e da Saúde, Universidade Católica de Pelotas, Pelotas, Brazil.
authors.forename: M S
authors.initials: MS
authors.lastname: Valença
authors.affiliation: Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil.
authors.forename: J L R
authors.initials: JL
authors.lastname: Scaini
authors.affiliation: Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil.
authors.forename: F S
authors.initials: FS
authors.lastname: Abileira
authors.affiliation: Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil.
authors.forename: C V
authors.initials: CV
authors.lastname: Gonçalves
authors.affiliation: Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil.
authors.forename: A
authors.initials: A
authors.lastname: von Groll
authors.affiliation: Faculdade de Medicina, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil.
authors.forename: P E A
authors.initials: PE
authors.lastname: Silva
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods; D017720:Molecular Epidemiology; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification*; D015995:Prevalence; D011329:Prisoners / Q000706:statistics & numerical data*; D011330:Prisons; D012307:Risk Factors; D014376:Tuberculosis / Q000175:diagnosis / Q000453:epidemiology*; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology; D055815:Young Adult