Tuberculosis in Lebanese jails: prevalence and risk factors

A survey was conducted in 1995 to assess the prevalence of TB infection using the PPD skin test infection among 3931 inmates in all 21 jails in Lebanon. Forty-five percent of participants had a positive PPD skin test. The likelihood of testing positive was higher among men versus women, and among those who had been incarcerated for more than 3 years versus less than that. Compared to prisoners whose usual residence was Central Lebanon, those from North Lebanon and those from outside Lebanon (mostly Syria and Egypt) had a higher risk for PPD positivity, those from Bekaa a lower risk, and those from South Lebanon about the same risk. Among those with positive PPD tests, 7% had abnormal chest X-rays suggestive of active infection. Results suggest that TB infection is an important health problem in correctional facilities in Lebanon and that special control programs should target North Lebanon. The importance of screening the incarcerated population with chest X-rays rather than PPD skin tests is discussed.