Guards in Prisons: A Risk Group for Latent Tuberculosis Infection
To determine the prevalence and incidence of LTBI among prison guards and to the risk factors associated with infection. Two male prisons in Medellín and Itaguí, Colombia. A cohort study was conducted in adult prison guards that consented to participate. Exclusion criteria included: previous or current active TB, or conditions that preclude TST administration. We screened 194 guards and completed 155 TST administrations. The prevalence of LTBI was 55.8% in prison one, and 39.1% in prison two. The risk factors associated with LTBI diagnosis included drug use at least once in a lifetime (PR: 1.75; 95% CI 1.42–2.15) and male sex (PR: 2.16; 95% CI 1.01–4.62). The cumulative incidence of TST conversion over 6 months was 3.2%. All conversions occurred in prison 1. Our findings suggest an occupational risk for LTBI prevalence and incidence among guards (different prevalence and incidence according to the prison they work).
KeywordsTuberculosis Infection Prison guards Prevalence Incidence
The authors are grateful to all participants of this study; to INPEC (Instituto Nacional Penitenciario y Carcelario de Colombia), the prisons directors and everyone working there for their support in the study. Thanks to Grupo de Epidemiología, Universidad de Antioquia and Facultad de Medicina, Universidad Pontificia Bolivariana, for supported one author in travel expenses to share the results in a scientific event. Thanks to those who funded this research: Colciencias (Colombian Administrative Department of Science, Technology and Innovation) and Universidad Pontificia Bolivariana (Grant No. 121071249878). The study sponsors were not involved in study design, data collection, interpretation and analysis or in writing the manuscript.
Compliance with Ethical Standards
Conflict of interest
All authors have no conflict of interest to report.
This research was approved by the Human Research Ethics Committee of the Facultad Nacional de Salud Pública, Universidad de Antioquia, the Instituto Nacional Penitenciario y Carcelario (INPEC), and the director of each prison.
Written informed consent was explained and signed in the presence of two witnesses, which under no circumstance were a superior. For those guards with respiratory symptoms at the time of evaluation, a referral for further assessment by a physician to rule out the presence of active TB, was carried out. To date no cases of active TB were identified during the study.
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