Our aim was to determine the incidence of tuberculin skin test (TST) conversion in the Maryland state correctional system.
We conducted a historical longitudinal cohort study.
A sample of 1,289 inmates, incarcerated in 16 of 23 prisons, who had a negative TST and a second test within 24 months was selected.
The incidence of recent conversion was 6.3 per 100 person-years.
Risk factors for conversion included high prison-population density (relative risk [RR]=2.4 ; 95% confidence interval [CI], 1.5-3.8) and incarceration in a higher-security institution (RR=2.4 ; 95% CI, 1.4-4.3).
Incarceration in an institution with higher levels of isoniazid prophylaxis (>65% of TST positives) reduced the risk of infection by 50% (RR=0.5 ; 95% CI, 0.3-0.7).
Crowding was strongly correlated with risk of conversion (r=0.83 ; P<. 001), while rates of isoniazid prophylaxis initiation were inversely correlated with risk of infection (r=-0.82 ; P<. 001).
In stepwise regression, higher prison-population density was the strongest predictor of increased infection.
In a final model, inclusion of the rate of isoniazid prophylaxis initiation reduced the risk associated with crowding (RR=1.4 ; P=4).
Annual screening programs for prisons can identify recent conversions that may not otherwise be detected.
Mots-clés Pascal : Tuberculose, Mycobactériose, Bactériose, Infection, Programme sanitaire, Facteur risque, Epidémiologie, Méthode, Prévention, Incidence, Maryland, Etats Unis, Amérique du Nord, Amérique, Milieu carcéral, Homme
Mots-clés Pascal anglais : Tuberculosis, Mycobacterial infection, Bacteriosis, Infection, Sanitary program, Risk factor, Epidemiology, Method, Prevention, Incidence, Maryland, United States, North America, America, Carceral environment, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0337420
Code Inist : 002B05B02O. Création : 12/09/1997.