DIRECTLY OBSERVED ISONIAZID PREVENTIVE THERAPY FOR RELEASED JAIL INMATES

This study was designed to determine whether an integrated screening p rogram could be Implemented that identified persons with latent tuberc ulosis infection among jail inmates and produced a high rate of comple tion of isoniazid preventive therapy (IPT) in those persons after thei r discharge from shortterm detention, by means of community-based dire ctly observed preventive therapy (DOPT). From June 1, 1992 through Dec ember 31, 1994 inmates in the King County Jail who were from populatio ns at high risk of tuberculosis were screened by means of the tubercul in skin test and those with latent tuberculosis infection were offered IPT. Among 262 inmates receiving lm upon release from jail, 105 (40%) could not be located after release. Among another 105 enrolled on DOP T, 63 (60%) completed therapy. Among 52 who chose self-supervised ison iazid therapy after release, 15 (29%) completed therapy (chi-square = 13.50, p = 0.0002). Among persons with latent tuberculosis infection d etected during screening at a county jail, a postrelease DOPT program resulted in a high rate of immediate loss to follow-up and a low rate of completion of therapy. Based on these results, we suggest that fund s for TB control, if limited, should not be diverted to jail-based scr eening and postrelease DOPT.