Tuberculosis screening in Washington state male correctional facilities

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Correctional Healthcare

Background:

• Tuberculosis (TB) remains a significant global health concern, particularly in congregate settings like correctional facilities.
• Effective screening protocols are crucial for early detection and prevention of TB transmission in prisons.
• Washington state's penal institutions implemented TB screening to assess prevalence and identify transmission risks.

Purpose of the Study:

• To evaluate the quality of tuberculosis screening in Washington state men's penal institutions.
• To determine the proportion of inmates who were tuberculosis reactors in 1983.
• To investigate the characteristics of reactors and nonreactors and identify potential transmission within facilities.

Main Methods:

• A retrospective review of 4,744 medical charts of current male inmates in four Washington state prisons in June 1983.
• Analysis of recorded skin test results, with 90.0% of charts containing this data.
• Detailed data abstraction for 1,176 inmates newly admitted in 1982 to characterize reactors and nonreactors.

Main Results:

• 12.5% of the 4,744 surveyed inmates were identified as tuberculosis reactors.
• Among inmates newly admitted in 1982, 14.2% of the 1,176 individuals were reactors.
• No evidence of tuberculosis transmission within the institutions was found; three conversions were linked to inmate releases.

Conclusions:

• The study supports the recommendation for tuberculosis skin testing upon inmate entry or reentry.
• Initial hiring screening for employees is deemed sufficient, without routine retesting.
• Continued implementation of entry/reentry skin testing for residents is advised for the Washington State Department of Corrections.