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PLoS Med. Tuberculosis Incidence in Prisons: A Systematic Review
Tuberculosis Incidence in Prisons: A Systematic Review (PLoS Med., abstract, edited)
[Source: PLoS Medicine, full text: <cite cite="http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000381?utm_so urce=feedburner&utm_medium=feed&utm_campaign=Feed% 3A+plosmedicine%2FNewArticles+%28Ambra+-+Medicine+New+Articles%29">PLoS Medicine: Tuberculosis Incidence in Prisons: A Systematic Review</cite>. Abstract, edited.]
Tuberculosis Incidence in Prisons: A Systematic Review
Iacopo Baussano 1,2*, Brian G. Williams 3, Paul Nunn 3, Marta Beggiato 1, Ugo Fedeli 4, Fabio Scano 3
1 Cancer Epidemiology Unit, UPO ?A.Avogadro? and CPO-Piemonte, Novara, Italy,
2 Division of Epidemiology, Public Health and Primary Care, Faculty of Medicine, Imperial College of Science, Technology and Medicine, London, United Kingdom,
3 Stop TB Department, World Health Organization, Geneva, Switzerland,
4 SER, Epidemiological Department, Veneto Region, Castelfranco Veneto, Italy
Abstract
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.
Citation: Baussano I, Williams BG, Nunn P, Beggiato M, Fedeli U, et al. (2010) Tuberculosis Incidence in Prisons: A Systematic Review. PLoS Med 7(12): e1000381. doi:10.1371/journal.pmed.1000381
Academic Editor: Dick Menzies, McGill University, Canada
Received: May 7, 2010; Accepted: November 5, 2010; Published: December 21, 2010
Copyright: ? 2010 World Health Organization; licensee Public Library of Science (PLoS).
This is an Open Access article in the spirit of the Public Library of Science (PLoS) principles for Open Access http://www.plos.org/oa/, without any waiver of WHO's privileges and immunities under international law, convention, or agreement.
This article should not be reproduced for use in association with the promotion of commercial products, services or any legal entity.
There should be no suggestion that WHO endorses any specific organisation or products.
The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.
Funding: This work was financially supported by WHO to inform the policy on tuberculosis infection control. WHO supported study design; collection, analysis, and interpretation of data; the writing of the report; and the decision to submit the paper for publication. IB was supported by the ?Regione Piemonte? Italy, Assessorato Sanit?, Progetti di Ricerca Sanitaria Finalizzata, 2008. The Regione Piemonte had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors alone are responsible for the views expressed in this publication and they do not necessarily represent the decisions or policies of WHO.
Competing interests: The authors have declared that no competing interests exist.
Abbreviations: IQR, interquartile range; IRR, incidence rate ratio; LTBI, latent tuberculosis infection; PAF, population attributable fraction; TB, tuberculosis; TST, tuberculin skin test
* E-mail: i.baussano06@imperial.ac.uk
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[Source: PLoS Medicine, full text: <cite cite="http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000381?utm_so urce=feedburner&utm_medium=feed&utm_campaign=Feed% 3A+plosmedicine%2FNewArticles+%28Ambra+-+Medicine+New+Articles%29">PLoS Medicine: Tuberculosis Incidence in Prisons: A Systematic Review</cite>. Abstract, edited.]
Tuberculosis Incidence in Prisons: A Systematic Review
Iacopo Baussano 1,2*, Brian G. Williams 3, Paul Nunn 3, Marta Beggiato 1, Ugo Fedeli 4, Fabio Scano 3
1 Cancer Epidemiology Unit, UPO ?A.Avogadro? and CPO-Piemonte, Novara, Italy,
2 Division of Epidemiology, Public Health and Primary Care, Faculty of Medicine, Imperial College of Science, Technology and Medicine, London, United Kingdom,
3 Stop TB Department, World Health Organization, Geneva, Switzerland,
4 SER, Epidemiological Department, Veneto Region, Castelfranco Veneto, Italy
Abstract
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.
Citation: Baussano I, Williams BG, Nunn P, Beggiato M, Fedeli U, et al. (2010) Tuberculosis Incidence in Prisons: A Systematic Review. PLoS Med 7(12): e1000381. doi:10.1371/journal.pmed.1000381
Academic Editor: Dick Menzies, McGill University, Canada
Received: May 7, 2010; Accepted: November 5, 2010; Published: December 21, 2010
Copyright: ? 2010 World Health Organization; licensee Public Library of Science (PLoS).
This is an Open Access article in the spirit of the Public Library of Science (PLoS) principles for Open Access http://www.plos.org/oa/, without any waiver of WHO's privileges and immunities under international law, convention, or agreement.
This article should not be reproduced for use in association with the promotion of commercial products, services or any legal entity.
There should be no suggestion that WHO endorses any specific organisation or products.
The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.
Funding: This work was financially supported by WHO to inform the policy on tuberculosis infection control. WHO supported study design; collection, analysis, and interpretation of data; the writing of the report; and the decision to submit the paper for publication. IB was supported by the ?Regione Piemonte? Italy, Assessorato Sanit?, Progetti di Ricerca Sanitaria Finalizzata, 2008. The Regione Piemonte had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors alone are responsible for the views expressed in this publication and they do not necessarily represent the decisions or policies of WHO.
Competing interests: The authors have declared that no competing interests exist.
Abbreviations: IQR, interquartile range; IRR, incidence rate ratio; LTBI, latent tuberculosis infection; PAF, population attributable fraction; TB, tuberculosis; TST, tuberculin skin test
* E-mail: i.baussano06@imperial.ac.uk
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