Tuberculosis among correctional facility workers: A systematic review and meta-analysis

Area of Science:

• Public Health
• Infectious Diseases
• Occupational Health

Background:

• Prison inmates can transmit tuberculosis (TB), including drug-resistant strains, to correctional staff and the community.
• Correctional facility workers are a vulnerable population at risk of TB exposure.

Purpose of the Study:

• To investigate the prevalence and incidence of active and latent tuberculosis infection (LTBI) among correctional facility workers.
• To identify risk factors associated with LTBI in this population.

Main Methods:

• A systematic literature review was conducted searching multiple databases (MEDLINE, EMBASE, etc.) from 1989 to 2017.
• Studies included data on correctional facility workers and tuberculosis, with stratified analyses based on TB burden.
• 15 studies encompassing 110,393 workers were included.

Main Results:

• Pooled prevalence of LTBI was 26% (95% CI: 12-42%), reaching 44% in high-burden countries.
• LTBI incidence was 2% (95% CI: 1-3%).
• Risk factors for LTBI included longer job duration, older age, non-native country of birth, smoking, inmate contact, and BCG vaccination.

Conclusions:

• Latent tuberculosis infection is prevalent in correctional facility workers, particularly in high-burden settings.
• Risk factors suggest both occupational and community TB exposure.
• Systematic surveillance and infection control are crucial to protect this high-risk group.