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Tuberculosis prevalence in an urban jail: 1994 and 1998
M C White1, J P Tulsky, C J Portillo
1Department of Community Health Systems, University of California, School of Nursing, San Francisco 94143-0608, USA. mcwhite@itsa.ucsf.edu
Setting:
Despite a continuing decline in tuberculosis (TB) in the US, jails remain a high-risk setting for the identification of active and latent TB infection (LTBI).
Objective:
The purpose of this study was to document the change in TB prevalence in the San Francisco City and County Jail.
Design:
Two period prevalence analyses were done, for 1994 and 1998. The sample included all persons booked into jail during the two years. The rates of inmates screened and the prevalence of active TB and LTBI by sex and ethnicity were compared using computerized records.
Results:
Prevalence of active TB was 72.1 per 100000 jail population for 1998, and did not change significantly from 1994. In 1998 one third of active TB cases were found through jail screening. Latinos represented respectively 20.1% and 17.7% of those booked in 1994 and 1998, but 43.0% and 41.7% of inmates with LTBI. In 1998, being Latino (odds ratio 2.9) and male (odds ratio 1.6) were most strongly associated with LTBI.
Conclusion:
Screening for TB among jail inmates is an increasingly valuable clinical and epidemiological tool for case-finding and for identifying persons who would benefit from preventive therapy.