RT Journal Article
SR Electronic
T1 Tuberculosis in UK prisoners: a challenge for control
JF Journal of Epidemiology and Community Health
JO J Epidemiol Community Health
FD BMJ Publishing Group Ltd
SP 373
OP 376
DO 10.1136/jech.2009.094375
VO 64
IS 4
A1 Anderson, Charlotte
A1 Story, Alistair
A1 Brown, Tim
A1 Drobniewski, Francis
A1 Abubakar, Ibrahim
YR 2010
UL http://jech.bmj.com/content/64/4/373.abstract
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.