PT  - JOURNAL ARTICLE
AU  - Anderson, Charlotte
AU  - Story, Alistair
AU  - Brown, Tim
AU  - Drobniewski, Francis
AU  - Abubakar, Ibrahim
TI  - Tuberculosis in UK prisoners: a challenge for control
AID  - 10.1136/jech.2009.094375
DP  - 2010 Apr 01
TA  - Journal of Epidemiology and Community Health
PG  - 373--376
VI  - 64
IP  - 4
4099  - http://jech.bmj.com/content/64/4/373.short
4100  - http://jech.bmj.com/content/64/4/373.full
SO  - J Epidemiol Community Health2010 Apr 01; 64
AB  - Aims Prisoners include a disproportionate number of those with social and clinical risk factors for tuberculosis and pose a challenge for control. The aim of this study was to investigate the characteristics of prisoners with tuberculosis in order to inform clinical management and control policy.Methods Between 2004 and 2007, 205 patients newly diagnosed as having tuberculosis in prison in the UK identified in national surveillance reports were studied. Isolates from prisoners were tested for susceptibility to first-line antituberculosis drugs and strain typed where possible.Results Prisoners were significantly more likely to be UK-born (47 vs 25%), to be white (33 vs 22%) and to have pulmonary disease (75 vs 56%) than other tuberculosis patients. Pulmonary cases were also more likely to be sputum-smear-positive (69 vs 57%). Over one-third of culture confirmed cases among prisoners were resistant to isoniazid. Less than half (48%) of patients diagnosed as having tuberculosis in prison completed treatment, with a fifth lost to follow-up.Discussion In the UK, imprisonment is an important risk factor for tuberculosis, especially drug-resistant and infectious forms of the disease. The management of tuberculosis among UK prisoners is further complicated by high rates of loss to follow-up care and poor treatment outcomes.