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Trop. Med. Infect. Dis. 2018, 3(3), 93; https://doi.org/10.3390/tropicalmed3030093

‘Know Your Epidemic’: Are Prisons a Potential Barrier to TB Elimination in an Australian Context?

1
The Victorian Tuberculosis Program at the Peter Doherty Institute, Melbourne, Victoria 3000, Australia
2
Health Protection Branch, Department of Health and Human Services, Melbourne, Victoria 3000, Australia
3
Department of Microbiology and Immunology, University of Melbourne, Melbourne, Victoria 3000, Australia
*
Author to whom correspondence should be addressed.
Received: 12 August 2018 / Revised: 27 August 2018 / Accepted: 27 August 2018 / Published: 31 August 2018
(This article belongs to the Special Issue Tuberculosis Elimination in the Asia-Pacific)
Full-Text   |   PDF [551 KB, uploaded 31 August 2018]   |  

Abstract

Globally, rates of tuberculosis (TB) cases in prisons are substantially higher than in the general population. The goal of this study was to review TB notifications in Victorian correctional facilities, and consider whether additional interventions towards TB elimination may be useful in this setting. All patients who were notified with or treated for TB in the Australian state of Victoria from 1 January 2003 to 1 December 2017 were included in this study. Descriptive analysis was performed. Demographic and treatment outcome data for individuals with and without a history of incarceration were reviewed and compared. Of the 5645 TB cases notified during the study period, 26 (0.5%) had a history of being incarcerated in correctional facilities while receiving treatment for TB. There were 73,238 inmates in Victorian correctional facilities over the same study period, meaning that approximately 0.04% of inmates were diagnosed or treated with TB disease in correctional facilities. Incarcerated individuals were more likely to have positive sputum smears and cavitation compared with nonincarcerated people with TB. There was no significant difference in treatment outcomes between the general TB population and those who had a history of incarceration during their treatment. There is a low apparent rate of TB in Victorian prisoners, and prisons do not contribute significantly to TB incidence in Victoria. Overall, TB outcomes do not differ between prisoners and nonprisoners. Ongoing efforts to sustain these lower rates and comparable outcomes in this vulnerable cohort are important for continued progress towards TB elimination. View Full-Text
Keywords: correctional facilities; tuberculosis; treatment; incarceration correctional facilities; tuberculosis; treatment; incarceration
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Moyo, N.; Tay, E.L.; Denholm, J. ‘Know Your Epidemic’: Are Prisons a Potential Barrier to TB Elimination in an Australian Context? Trop. Med. Infect. Dis. 2018, 3, 93.

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