Compliance of antituberculosis therapy among ex-inmates in the Madrid Area

BACKGROUND. The inmate population is not a tight compartment without commun ication with the community but there is a flow of persons and thus of healt h problems. The high incidence of tuberculosis among inmates is therefore o f concern for the Public Health System. METHODS. The outcomes of antituberculosis treatment among ex-inmates releas ed from prison in 1987 in the Madrid Area were evaluated and compared with those who reamained in jail on treatment. Individuals who met the case defi nition of tuberculosis were included in the study. The outcome was defined as the individual status one year after the beginning of therapy. To determ ine the association between the study variables with outcome, odds ratios ( OR) with their 95% confidence intervals were used. The Chi(2) test was used to determine the statistical significance. RESULTS. Differences between outcomes of individuals in the two groups were observed: 69.7% of inmates had completed their therapy compared with 20.5% of ex-inmates. Treatment had to be prolonged in 15.2% of inmates compared with 46.2% in ex-inmates. The only predictor associated with therapy comple tion one year after the beginning was imprisonment, as OR for not having co mpleted therapy for ex-inmates was almost 13 times higher (OR=12.94; 95% IC , 3.38-13.10) than those in jail. CONCLUSIONS. Special strategies should be developed that assure clinical cu re of persons with factors related to noncompliance.