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Screening for tuberculosis in jail and clinic follow-up after release
J P Tulsky1, M C White, C Dawson
1Department of Medicine, University of California, San Francisco, USA.
Objectives:
The purpose of this study was to describe tuberculosis (TB) screening and preventive therapy in the San Francisco County Jail and to measure the follow-up rate at the public health department TB clinic.
Methods:
The records of male inmates screened for 6 months in 1994 were reviewed. Those prescribed isoniazid and released before therapy ended were matched with TB clinic records. Inmates were considered to have followed up if they came to the TB clinic within 1 month of release.
Results:
Of 3352 inmates screened, 553 (16.5%) reported a prior positive skin test, and 330 (26.9%) of 1229 tests placed and read were positive. Of those with positive tests, 151 (45.8%) began isoniazid. Most of the inmates were foreign-born Hispanics (80.8%). Ninety-three (61.6%) inmates were released before completion, after an average of 68.5 days. Three (3.2%) went to the TB clinic within a month.
Conclusions:
Jail represents an important screening site for TB, but care is not continued after release. Strategies are needed to enhance the continuity of isoniazid preventive care.