PREDICTIVE FACTORS OF MYCOBACTERIUM-TUBERCULOSIS INFECTION AND PULMONARY TUBERCULOSIS IN PRISONERS

Background. Tuberculosis currently represents a serious problem in pri son populations. Methods. With the aim of studying the predictive fact ors for, and the prevalence of, Mycobacterium tuberculosis infection a nd pulmonary tuberculosis in a Spanish prison, all those admitted duri ng 1991 and 1992 were included (N = 1314). The tuberculin skin test, H IV serology, chest X-ray and bacteriological examination of sputum wer e carried out. Statistical analysis was done by univariant tests, stra tified analysis and logistic regression. Results. The prevalence of M. tuberculosis infection was 55.5% (95% confidence interval [CI] 52.5-5 8.5). An association was found with sex, imprisonment more than once, HIV infection and age. The co-infection rate (tuberculosis plus HIV) w as 9.2%. Logistic regression showed a greater risk with age (4.4% per year), time spent in prison and for males. The prevalence of pulmonary tuberculosis was 1.26% and an association was found with M. tuberculo sis infection, HIV infection (odds ratio [OR] = 13.7), intravenous dru g users (OR = 17.2) and imprisonment more than once (OR = 7.3). Logist ic regression showed an association with HIV co-infection (OR = 20.2). Conclusions. The prevalence of M. tuberculosis infection and pulmonar y tuberculosis is high when compared with similar studies. The influen ce of age, time spent in prison and co-infection with HIV is relevant to recommendations for specific tuberculosis prevention programmes in correctional facilities.