Results of a 29-state survey of tuberculosis in nursing homes and correctional facilities

A survey of the 15,379 cases of tuberculosis reported to the Centers for Disease Control and Prevention by 29 State health departments in 1984 and 1985 revealed that 7.7 percent of the victims older than age 64 were living in a nursing home at the time of diagnosis and 1.8 percent between the ages of 15 and 64 were living in a correctional institution at the time of diagnosis. Incidence rates of tuberculosis for residents of nursing homes and for inmates of Federal and State prisons and local jails were estimated using denominators derived from institutional population counts provided by the National Center for Health Statistics and by the Department of Justice, Bureau of Justice Statistics, and Bureau of Prisons. The aggregate tuberculosis incidence rate for nursing home residents in the 29 States was 1.8 times higher than the rate seen in elderly persons who were living in the community (95 percent confidence interval on the relative risk 1.64, 2.02). The aggregate tuberculosis incidence rate for inmates in correctional facilities was 3.9 times higher than the rate for persons of a similar age who were not incarcerated (95 percent confidence interval on the relative risk 3.35, 4.49). Strengths and limitations of the design and implications of the first survey of tuberculosis incidence, in a large number of States, among residents of nursing homes and correctional facilities are discussed.