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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Tuberculosis incidence in prisons: A systematic review
PLoS Medicine, Volume 7, No. 12, Article e1000381, Year 2010
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Description
Background: Transmission of tuberculosis (TB) in prisons has been reported worldwide to be much higher than that reported for the corresponding general population. Methods and Findings: A systematic review has been performed to assess the risk of incident latent tuberculosis infection (LTBI) and TB disease in prisons, as compared to the incidence in the corresponding local general population, and to estimate the fraction of TB in the general population attributable (PAF%) to transmission within prisons. Primary peer-reviewed studies have been searched to assess the incidence of LTBI and/or TB within prisons published until June 2010; both inmates and prison staff were considered. Studies, which were independently screened by two reviewers, were eligible for inclusion if they reported the incidence of LTBI and TB disease in prisons. Available data were collected from 23 studies out of 582 potentially relevant unique citations. Five studies from the US and one from Brazil were available to assess the incidence of LTBI in prisons, while 19 studies were available to assess the incidence of TB. The median estimated annual incidence rate ratio (IRR) for LTBI and TB were 26.4 (interquartile range [IQR]: 13.0-61.8) and 23.0 (IQR: 11.7-36.1), respectively. The median estimated fraction (PAF%) of tuberculosis in the general population attributable to the exposure in prisons for TB was 8.5% (IQR: 1.9%-17.9%) and 6.3% (IQR: 2.7%-17.2%) in high- and middle/low-income countries, respectively. Conclusions: The very high IRR and the substantial population attributable fraction show that much better TB control in prisons could potentially protect prisoners and staff from within-prison spread of TB and would significantly reduce the national burden of TB. Future studies should measure the impact of the conditions in prisons on TB transmission and assess the population attributable risk of prison-to-community spread. © 2010 World Health Organization.
Authors & Co-Authors
Baussano, Iacopo
Italy, Vercelli
Università Degli Studi Del Piemonte Orientale Amedeo Avogadro
United Kingdom, London
Imperial College London
Williams, Brian Gerard
Switzerland, Geneva
Organisation Mondiale de la Santé
Nunn, Paul P.
Switzerland, Geneva
Organisation Mondiale de la Santé
Fedeli, U.
Unknown Affiliation
Scano, Fabio
Switzerland, Geneva
Organisation Mondiale de la Santé
Statistics
Citations: 319
Authors: 5
Affiliations: 3
Identifiers
Doi:
10.1371/journal.pmed.1000381
ISSN:
15491676
Research Areas
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Systematic review