X ray screening at entry and systematic screening for the control of tuberculosis in a highly endemic prison

Autor: A. B. Espinola, Alexandra Sánchez, Germano Gerhardt, Luiz Antonio Bastos Camacho, Mahinda Siriwardana, Bernard Larouzé, Véronique Massari
Přispěvatelé: Programa de Controle de Tuberculose e, Coordenação de Gestão em Saúde Penitenciária, Epidémiologie des maladies infectieuses et modélisation (ESIM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Fundação Athaulfo de Paiva, Departamento de Epidemiologia e Metodos Quantitativos [Rio de Janeiro] (DEMQS), Escola Nacional de Saude Publica Sergio Arouca / Sergio Arouca National School of Public Health [Rio de Janeiro] (ENSP), Fundação Oswaldo Cruz (FIOCRUZ), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Fundação Oswaldo Cruz (FIOCRUZ), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), This study was supported by funds from the Coordenação de Gestão em Saúde Penitenciária da Secretaria de Estado de Administração Penitenciária do Rio de Janeiro and the International Cooperation Program FIOCRUZ - Institut National de la Santé et de la Recherche Médicale, France, BMC, Ed., Fundação Oswaldo Cruz / Oswaldo Cruz Foundation (FIOCRUZ), Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Fundação Oswaldo Cruz / Oswaldo Cruz Foundation (FIOCRUZ)
Jazyk: angličtina
Rok vydání: 2013
Předmět:
Adult
Male
Pediatrics
medicine.medical_specialty
Tuberculosis
Adolescent
Endemic Diseases
Cross-sectional study
media_common.quotation_subject
030231 tropical medicine
Population
Prison
Ambulatory Care Facilities
Young Adult
03 medical and health sciences
0302 clinical medicine
Epidemiology
Prevalence
medicine
Humans
Mass Screening
030212 general & internal medicine
Young adult
education
Mass screening
Aged
media_common
X-ray screening
education.field_of_study
Tuberculosis control
business.industry
Prisoners
X-Rays
Incidence (epidemiology)
Incidence
Public Health
Environmental and Occupational Health
Middle Aged
medicine.disease
3. Good health
Surgery
Cross-Sectional Studies
[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie
Prisons
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
business
Brazil
Research Article
Zdroj: BMC Public Health
BMC Public Health, BioMed Central, 2013, 13 (1), pp.983. ⟨10.1186/1471-2458-13-983⟩
BMC Public Health, 2013, 13 (1), pp.983. ⟨10.1186/1471-2458-13-983⟩
ISSN: 1471-2458
DOI: 10.1186/1471-2458-13-983⟩
Popis: International audience; BACKGROUND: Tuberculosis (TB) is a major issue in prisons of low and middle income countries where TB incidence rates are much higher in prison populations as compared with the general population. In the Rio de Janeiro (RJ) state prison system, the TB control program is limited to passive case-finding and supervised short duration treatment. The aim of this study was to measure the impact of X-ray screening at entry associated with systematic screening on the prevalence and incidence of active TB. METHODS: We followed up for 2 years a RJ State prison for adult males (1429 inmates at the beginning of the study) and performed, in addition to passive case-finding, 1) two "cross-sectional" X-ray systematic screenings: the first at the beginning of the study period and the second 13 months later; 2) X-ray screening of inmates entering the prison during the 2 year study period. Bacteriological examinations were performed in inmates presenting any pulmonary, pleural or mediastinal X-ray abnormality or spontaneously attending the prison clinic for symptoms suggestive of TB. RESULTS: Overall, 4326 X-rays were performed and 246 TB cases were identified. Prevalence among entering inmates remained similar during 1st and the 2nd year of the study: 2.8% (21/754) and 2.9% (28/954) respectively, whereas prevalence decreased from 6.0% (83/1374) to 2.8% (35/1244) between 1st and 2nd systematic screenings (p < 0.0001). Incidence rates of cases identified by passive case-finding decreased from 42 to 19 per 1000 person-years between the 1st and the 2nd year (p < 0.0001). Cases identified by screenings were less likely to be bacteriologically confirmed as compared with cases identified by passive-case finding. CONCLUSIONS: The strategy investigated, which seems highly effective, should be considered in highly endemic confined settings such as prisons.
Databáze: OpenAIRE
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