Guards in Prisons: A Risk Group for Latent Tuberculosis Infection

Area of Science:

• Occupational Health
• Infectious Diseases
• Epidemiology

Background:

• Prison environments pose unique challenges for infectious disease control.
• Latent tuberculosis infection (LTBI) is a significant public health concern globally.
• Understanding LTBI prevalence and incidence in occupational settings like prisons is crucial for targeted interventions.

Purpose of the Study:

• To determine the prevalence and incidence of latent tuberculosis infection (LTBI) among prison guards in Colombia.
• To identify risk factors associated with LTBI among this occupational group.
• To assess the occupational risk of TB transmission in correctional facilities.

Main Methods:

• A cohort study was conducted involving adult prison guards in two male prisons in Medellín and Itaguí, Colombia.
• Participants underwent tuberculin skin testing (TST) after exclusion criteria were applied.
• Data on risk factors, including lifetime drug use and sex, were collected and analyzed.

Main Results:

• LTBI prevalence varied significantly between prisons: 55.8% in Prison 1 and 39.1% in Prison 2.
• Lifetime drug use (Prevalence Ratio [PR]: 1.75) and male sex (PR: 2.16) were identified as significant risk factors for LTBI.
• The cumulative incidence of TST conversion over 6 months was 3.2%, with all conversions occurring in Prison 1.

Conclusions:

• Prison guards exhibit a notable occupational risk for LTBI, with prevalence differing by facility.
• Targeted screening and prevention strategies are warranted for prison guards, particularly in high-prevalence settings.
• Further research into the specific transmission dynamics within different prison environments is recommended.