Determinants of tuberculosis in the prison population in Catalonia

Describe the characteristics of inmates who have or have had tuberculosis (TB) and identify associated factors.

An observational, prospective, multicenter, population-based study was carried out on patients admitted to the nine prisons in Catalonia between March 1 and June 30, 2023. The patient's history of TB was assessed, and the presence of current TB was confirmed/ruled out. In TB cases, predictor variables were studied using bivariate and multivariate logistic regression analysis, calculating the risk ratio (RR) and its 95% confidence interval (CI).

There were 1,679 admissions, 2.3% with previous TB and 1 with TB detected at screening. TB cases were older (45.1 vs. 33.7 years) and more frequently intravenous drug users (6.9% vs. 1.7% in non-users), Asian (9.1% vs. 1.4% in non-Asian), HIV-infected (10.3% vs. 1.9% in non-infected) and homeless (3.4% vs. 1.9% in those with a home). Multivariate analysis confirmed the association with: a) be older (RR: 2.9 in >30 years of age and RR=5.8 in >60 years of age, p =0.001); b) Asian origin (RR: 8.81; p <0.001); and c) not having a home (RR: 3.07; p = 0.005).

2.3% had or had previously had tuberculosis. Therefore, it is essential to carry out tuberculosis screening upon admission to detect new cases or exacerbations and prevent TB transmission in an enclosed environment. Previous tuberculosis was more common in older adults, Asians, and those without shelter or housing; such groups require special follow-up.