[Prevalence of tuberculosis infection prevalence in a provincial prison]

Tuberculosis in prisons is a serious public health problem. In those penitentiaries with a high prevalence of co-infection by M. tuberculosis and HIV infection, the treatment of the tubercular infection can be an important tool for prevention and control. Ascertaining the prevalence of tubercular infection, the access and adherence to the treatment of tubercular infection in a prison population without a history of treatment of tubercular disease or infection could be of great interest in order to assess the efficacy of this measure.

A cross study was made of the population confined at 28 June 1999 in a Penitentiary with a programme of prevention and control of tuberculosis, based on the directly observed therapy (DOT) of the patients, on early diagnosis and the treatment of the tubercular infection. The treatment of the tubercular infection was prescribed following individualised counselling, reaching an agreement with the patient as to the modality of treatment (DOT, daily or twice-weekly check-up). The clinical histories of the patients were reviewed in order to determine the prevalence of patients infected by M. tuberculosis, of those who had completed treatment and of those who were still undergoing treatment of tubercular infection. The Eidus-Hamilton test was performed in the case of patients under treatment for tubercular infection in order to evaluate compliance.

Of the 219 inmates, 127 (58%) presented criteria of tubercular infection. Treatment of the tubercular infection was indicated in 113 people of whom 29 refused (25.7%). Of the 84 patients who initiated treatment for their tubercular infection, 22 (26.2%) abandoned it, 39 (46.4%) had finalized the treatment, and 23 (27.4%) were still undergoing treatment. Of the latter, 95.7% showed positive to the Eidus-Hamilton test. 48% of those infected by M. tuberculosis, either had finalized or were undergoing the treatment against tubercular infection correctly.

The prevalence of tubercular infection observed in this group is very high. Acceptable levels of access and adherence to the treatment of tubercular infection have been observed, which translates into a high level of treatment coverage of this infection in the population studied.