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Compliance with isoniazid prophylaxis in jail.
P Alcabes1, P Vossenas, R Cohen
1Montefiore-Rikers Island Health Services, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx 10467.
The American Review of Respiratory Disease
|November 1, 1989
Summary
Tuberculosis (TB) is rising in New York City, including Rikers Island jail. Isoniazid prophylaxis compliance was low (37.5%) and affected by housing and inmate knowledge of TB treatment.
Area of Science:
- Public Health
- Infectious Diseases
- Epidemiology
Background:
- Tuberculosis (TB) incidence has significantly increased in New York City over the past decade.
- This rise is also observed within the incarcerated population at Rikers Island jail.
- Effective TB control requires understanding treatment compliance in vulnerable populations.
Purpose of the Study:
- To investigate the establishment and maintenance of isoniazid prophylaxis compliance among incarcerated individuals.
- To identify factors influencing compliance with TB preventive therapy in a jail setting.
- To assess the impact of jail environment on public health interventions.
Main Methods:
- Studied compliance in young men reactive to tuberculin at incarceration.
- Quantified compliance by the ratio of doses taken to doses available.
- Analyzed factors affecting compliance in a sample of 74 inmates.
Main Results:
- Mean compliance with isoniazid prophylaxis was 37.5%.
- Key determinants of compliance included the specific housing unit and inmate's knowledge of tuberculosis and the isoniazid regimen.
- Inmate knowledge of tuberculosis and the isoniazid regimen significantly impacted compliance.
Conclusions:
- Low isoniazid compliance rates pose a challenge for TB control in the incarcerated population.
- Housing unit assignment and patient education are critical factors for improving TB prophylaxis adherence.
- Prison overcrowding and associated administrative responses may negatively impact medical care and public health outcomes.