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Effectiveness of tuberculosis control programmes in prisons, Barcelona 1987-2000
T Rodrigo1, J A Caylà, P García de Olalla
1Municipal Institute of Health, Epidemiology Service, Barcelona, Spain.
Summary
Prisons can effectively control tuberculosis (TB) by implementing targeted prevention and control programs (TPCP). Evaluating these programs, particularly focusing on reducing diagnostic delays and ensuring treatment adherence through directly observed treatment (DOT), is key to success.
Area of Science:
- Public Health
- Infectious Disease Control
- Prison Health
Background:
- Prisons require robust tuberculosis prevention and control programs (TPCP).
- Evaluating existing TPCPs is crucial for enhancing their effectiveness in correctional facilities.
Purpose of the Study:
- To evaluate the effectiveness of tuberculosis prevention and control programmes (TPCP) in Barcelona prisons.
- To identify necessary modifications for improving TPCP effectiveness.
Main Methods:
- Utilized an exhaustive retrospective assessment from 1987-2000.
- Employed quantitative indicators aligned with the Barcelona TPCP (gold standard).
- Analyzed indicator trends and impact by comparing results against the gold standard.
Main Results:
- Significant trends observed in incidence rates, infection prevalence, treatment adherence, and directly observed treatment (DOT) (P < 0.0001).
- Achieved objectives included a 25.2% decline in average annual incidence rate.
- Attained desired adherence rates (>95%) among smear-positive cases since 1993 through DOT.
Conclusions:
- Tuberculosis control in prisons is effective when TPCPs prioritize reducing diagnostic delays.
- Directly observed treatment (DOT) and contact tracing are vital components for successful TB control in correctional settings.