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Janota AD, Hibbard PF, Meadows ME, Cocco JP, Carr AL, Nichols D, Chapman E, Maupomé G, Duwve JM. Peer Education as a Tool to Improve Health Knowledge for People Who Are Incarcerated: A Secondary Analysis of Data From the Indiana Peer Education Program ECHO. JOURNAL OF CORRECTIONAL HEALTH CARE 2024. [PMID: 38990210 DOI: 10.1089/jchc.23.10.0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
Considerable health inequities occur among people who are incarcerated, with ripple effects into broader community health. The Indiana Peer Education Program uses the Extension for Community Health Outcomes Extension for Community Healthcare Outcomes (ECHO) model to train people who are incarcerated as peer health educators. This analysis sought to evaluate the effectiveness of this program and explore emergent themes not covered in survey instruments. Survey data for both peer educators and their students were assessed using multivariate regression. Qualitative data were used to triangulate survey findings and explore additional themes via thematic analysis. Students showed improvements in knowledge scores and postrelease behavior intentions; peer educators improved in knowledge, health attitudes, and self-efficacy. Qualitative data affirmed survey findings and pointed toward peer educators acquiring expertise in the content they teach, and how to teach it, and that positive results likely expand beyond participants to others in prison, their families, and the communities to which they return. Though preliminary, the results confirm an earlier analysis of the New Mexico Peer Education Program ECHO, adding to the evidence that training individuals who are incarcerated as peer educators on relevant public health topics increases health knowledge and behavior intentions and likely results in improvements in personal and public health outcomes.
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Affiliation(s)
- Andrea D Janota
- Richard M. Fairbanks School of Public Health, Indiana University-Indianapolis, Indianapolis, Indiana, USA
| | | | | | | | | | | | - Erika Chapman
- Indiana Department of Health, Indianapolis, Indiana, USA
| | - Gerardo Maupomé
- Richard M. Fairbanks School of Public Health, Indiana University-Indianapolis, Indianapolis, Indiana, USA
| | - Joan M Duwve
- Richard M. Fairbanks School of Public Health, Indiana University-Indianapolis, Indianapolis, Indiana, USA
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Lukoye D, Kalamya JN, Awor AC, Gustavson G, Kabanda J, Ferroussier-Davis O, Kajoba C, Kanyamibwa A, Marungu L, Turyahabwe S, Muchuro S, Mills L, Dirlikov E, Nelson LJ. Treatment Outcomes for Tuberculosis Infection and Disease Among Persons Deprived of Liberty, Uganda, 2020. Emerg Infect Dis 2024; 30:1402-1405. [PMID: 38916570 PMCID: PMC11210659 DOI: 10.3201/eid3007.230611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024] Open
Abstract
We report that unsuccessful treatment outcomes were 11.8% for tuberculosis (TB) disease and 21.8% for TB infection among persons deprived of liberty in Uganda Prisons Service facilities. Remedial efforts should include enhancing referral networks to ensure treatment continuity, strengthening data systems for complete outcome documentation, and prioritizing short-course treatment regimens.
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Sequera G, Estigarribia-Sanabria G, Aguirre S, Piñanez C, Martinez L, Lopez-Olarte R, Andrews JR, Walter KS, Croda J, Garcia-Basteiro AL. Excess tuberculosis risk during and following incarceration in Paraguay: a retrospective cohort study. LANCET REGIONAL HEALTH. AMERICAS 2024; 31:100668. [PMID: 38500958 PMCID: PMC10945421 DOI: 10.1016/j.lana.2023.100668] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 12/22/2023] [Accepted: 12/26/2023] [Indexed: 03/20/2024]
Abstract
Background The increased risk of tuberculosis (TB) among people deprived of liberty (PDL) is due to individual and institution-level factors. We followed a cohort of PDL from 5 prisons in Paraguay to describe the risk of TB during incarceration and after they were released. Methods We linked a 2013 national census of prisons with TB records from the TB Program from 2010 to 2021 to identify TB notifications among incarcerated and formerly incarcerated individuals. We used multivariable Cox regression models to quantify the risk of TB during and following incarceration and to identify risk factors associated with TB. Findings Among 2996 individuals incarcerated, 451 (15.1%) were diagnosed with TB. Of these, 262 (58.1%) cases occurred during incarceration and 189 (41.9%) occurred in the community after release. In prison, the hazard ratio of developing TB was 1.97 (95% CI: 1.52-2.61) after six months of incarceration and increased to 2.78 (95% CI: 1.82-4.24) after 36 months compared with the first six months. The overall TB notification rate was 2940 per 100,000 person-years. This rate increased with the duration of incarceration from 1335 per 100,000 person-years in the first year to 8455 per 100,000 person-years after 8 years. Among former prisoners, the rate of TB decreased from 1717 in the first year after release to 593 per 100 000 person-years after 8 years of follow up. Interpretation Our study shows the alarming risk of TB associated with prison environments in Paraguay, and how this risk persists for years following incarceration. Effective TB control measures to protect the health of people during and following incarceration are urgently needed. Funding Paraguay National Commission of Science and Technology grant CONACYT PIN 15-705 (GS, GES, SA).
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Affiliation(s)
- Guillermo Sequera
- Cátedra de Salud Pública, Universidad Nacional de Asunción (UNA), Paraguay
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Gladys Estigarribia-Sanabria
- Instituto Regional de Investigación en Salud, Universidad Nacional de Caaguazú- (UNCA), Coronel Oviedo, Paraguay
- School of Medicine, Federal University of Mato Grosso do Sul - UFMS, Campo Grande, MS, Brazil
| | - Sarita Aguirre
- Programa Nacional de Control de la Tuberculosis, Asunción, Paraguay
| | - Claudia Piñanez
- Departamento de Sanidad Penitenciaria, Ministerio de Justicia, Paraguay
| | - Leonardo Martinez
- Department of Epidemiology, School of Public Health, Boston University, Boston, MA, USA
| | - Rafael Lopez-Olarte
- Former Regional Tuberculosis Adviser, Pan American Health Organization, Washington, DC, USA
| | - Jason R. Andrews
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Julio Croda
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
- School of Medicine, Federal University of Mato Grosso do Sul - UFMS, Campo Grande, MS, Brazil
- Oswaldo Cruz Foundation Mato Grosso do Sul, Mato Grosso do Sul, Brazil
| | - Alberto L. Garcia-Basteiro
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saude de Manhiça (CISM), Maputo, Mozambique
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Barcelona, Spain
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Ghosh A, Pillai RR, Vij J, Nain R, Shetty D, Maulik PK, Basu D. Substance use in the correctional settings: A qualitative exploration of individual and contextual characteristics and intervention strategies using the behavior change wheel framework. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 158:209257. [PMID: 38072380 DOI: 10.1016/j.josat.2023.209257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/02/2023] [Accepted: 12/04/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND AND OBJECTIVES Planning and implementing prison-based substance use disorder (SUD) interventions are challenging. We wanted to understand why and how people in correctional settings (CS) use drugs and to explore what policies, environmental, and interpersonal factors influence substance use among incarcerated people. Using the Behavior Change Wheel (BCW) framework, we proposed a thematic map with intervention functions to reduce substance use in CS. METHODS We used the Framework Method of qualitative analysis. We did snowball sampling for the incarcerated people with drug use (PWD) and convenience sampling for the staff. The in-depth interview sample comprised 17 adult PWD, three prison administrative, and two healthcare staff. We determined the sample size by thematic data saturation. We followed a mixed coding approach for generating categories, i.e., deductive (based on the BCW framework) and inductive. The study constructed the final theoretical framework by determining the properties of the categories and relationships among the categories. RESULTS We identified eleven categories aligned with the BCW framework. The themes were prison routine, interpersonal dynamics of the incarcerated population, exposure to substance use, attitude of staff towards PWD, experience with prison healthcare, willingness (to reduce drug use) and coping, compassion, drug use harms, conflict between staff and residents, stigma, and family/peer support. The BCW framework aided the identification of potential intervention functions and their interactions with the organizational policies that could influence PWD's capability-opportunity-motivation (COM) and drug use behavior (B). CONCLUSION There is a need to raise awareness of SUD prevention and intervention among decision-makers and revisit the prison policies.
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Affiliation(s)
- Abhishek Ghosh
- Drug Deaddiction and Treatment Centre, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
| | - Renjith R Pillai
- Drug Deaddiction and Treatment Centre, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Jatina Vij
- Drug Deaddiction and Treatment Centre, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Reina Nain
- Drug Deaddiction and Treatment Centre, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Deepa Shetty
- Drug Deaddiction and Treatment Centre, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pallab K Maulik
- George Institute India, India; Faculty of Medicine, University of New South Wales, Sydney, Australia; Mental Health, Imperial College London, United Kingdom; Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Debasish Basu
- Drug Deaddiction and Treatment Centre, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Dekhil N, Mardassi H. On the onset and dispersal of a major MDR TB clone among HIV-negative patients, Tunisia. Antimicrob Resist Infect Control 2024; 13:18. [PMID: 38355557 PMCID: PMC10865554 DOI: 10.1186/s13756-023-01360-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/28/2023] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND To carry out a whole genome sequencing (WGS)-based investigation on the emergence and spread of the largest multidrug-resistant tuberculosis (MDR TB) outbreak that has been thriving among HIV-negative patients, Tunisia, since the early 2000s. METHODS We performed phylogeographic analyses and molecular dating based on a WGS dataset representing 68 unique Mycobacterium tuberculosis isolates, covering almost the entire MDR TB outbreak for the time period 2001-2016. RESULTS The data indicate that the ancestor of the MDR TB outbreak emerged in the region of Bizerte, as early as 1974 (95% CI 1951-1985), from where it spread to other regions by 1992 (95% CI 1980-1996). Analysis of a minimum spanning tree based on core genome Multilocus Sequence Typing (cgMLST) uncovered the early spill-over of the fitness-compensated MDR TB strain from the prison into the general population. Indeed, cases with history of incarceration were found to be directly or indirectly linked to up to 22 new outbreak cases (32.35%) among the non-imprisoned population. By around 2008, the MDR TB outbreak strain had acquired additional resistance, leading to an XDR phenotype. CONCLUSIONS WGS allowed refining our understanding of the emergence and evolution of the largest MDR TB outbreak in Tunisia, whose causative strain has been circulating silently for almost 26 years before. Our study lends further support to the critical role of prisons-related cases in the early spread of the outbreak among the general population. The shift to an XDR phenotype of such an epidemic clone prompts an urgent need to undertake drastic control measures.
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Affiliation(s)
- Naira Dekhil
- Unit of Typing and Genetics of Mycobacteria, Laboratory of Molecular Microbiology, Vaccinology, and Biotechnology Development, Pasteur Institute, Tunis, University of Tunis El Manar, Tunis, Tunisia.
| | - Helmi Mardassi
- Unit of Typing and Genetics of Mycobacteria, Laboratory of Molecular Microbiology, Vaccinology, and Biotechnology Development, Pasteur Institute, Tunis, University of Tunis El Manar, Tunis, Tunisia.
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McDougal AN, DeMaet MA, Garcia B, York T, Iverson T, Ojo O, Patel J. A cluster investigation of Candida auris among hospitalized incarcerated patients. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2023; 3:e244. [PMID: 38156225 PMCID: PMC10753478 DOI: 10.1017/ash.2023.520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/15/2023] [Accepted: 11/15/2023] [Indexed: 12/30/2023]
Abstract
Objective Investigate and mitigate a cluster of Candida auris cases among incarcerated patients in a maximum-security prison hospital utilizing contact tracing, screening, whole genome sequencing, and environmental sampling and decontamination. Design Outbreak investigation. Setting Inpatient prison hospital affiliated with an academic tertiary referral center. Patients Inmates of the Texas Department of Criminal Justice. Methods Epidemiologic and environmental investigations were conducted including contact tracing, point prevalence surveys, and environmental sampling. Whole genome sequencing was performed on positive patient isolates. Results Following a clinical case of C. auris fungemia, 344 patients underwent C. auris surveillance screening. Eight (2.3%) patients were identified with C. auris colonization. All patients were male. Our index patient was the only clinical case and death. Whole genome sequencing was performed on the nine patient isolates. All isolates were clade III (Africa) and clustered together with the largest SNP difference being 21. Environmental cultures from 7 of 61 rooms (11.5%) were positive following terminal disinfection with bleach. Sites nearest to the patient were most often positive including the hospital bed rails and bedside table. The transmission cluster was successfully mitigated within 60 days of identification. Conclusions Implementation of an aggressive surveillance and decontamination program resulted in mitigation of a C. auris transmission cluster among our incarcerated patients. This investigation provides valuable insight into C. auris transmission in the incarcerated population, which is not considered a classic high-risk population as well as the challenges faced to stop transmission in a facility that requires the use of shared patient environments.
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Affiliation(s)
- April N. McDougal
- Department of Infection Control and Healthcare Epidemiology, University of Texas Medical Branch, Galveston, TX, USA
- Division of Infectious Disease, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Mary Ann DeMaet
- Department of Infection Control and Healthcare Epidemiology, University of Texas Medical Branch, Galveston, TX, USA
| | - Bobbiejean Garcia
- Healthcare Safety Unit, Texas Department of State Health Services, Austin, TX, USA
| | - Teresa York
- Department of Infection Control and Healthcare Epidemiology, University of Texas Medical Branch, Galveston, TX, USA
| | - Thomas Iverson
- Utah Department of Health and Human Services, Salt Lake City, UT, USA
| | - Olugbenga Ojo
- Division of General Internal Medicine, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
- Texas Department of Criminal Justice Hospital & Clinics, Galveston, TX, USA
| | - Janak Patel
- Department of Infection Control and Healthcare Epidemiology, University of Texas Medical Branch, Galveston, TX, USA
- Division of Infectious Disease, Department of Pediatrics, University of Texas Medical Branch, Galveston, TX, USA
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7
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Litvinjenko S, Magwood O, Wu S, Wei X. Burden of tuberculosis among vulnerable populations worldwide: an overview of systematic reviews. THE LANCET. INFECTIOUS DISEASES 2023; 23:1395-1407. [PMID: 37696278 PMCID: PMC10665202 DOI: 10.1016/s1473-3099(23)00372-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 06/02/2023] [Accepted: 06/07/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND Tuberculosis is a communicable disease of public health concern that inequitably impacts the most vulnerable populations worldwide. Vulnerable populations are those with a high risk for tuberculosis disease and whose disadvantaged or marginalised socioeconomic position limits their access to the health system. We conducted an overview of reviews that aimed to assess the burden (ie, prevalence and incidence) of tuberculosis disease among 12 vulnerable populations globally. METHODS We did an overview of reviews using a systematic search in MEDLINE, Embase, and the Cochrane Database for Systematic Reviews for articles published in English, French, and Chinese, from Jan 1, 2010 to March 8, 2023. We did an initial search on Oct 28, 2021, and updated our search on March 8, 2023. We included systematic and scoping reviews reporting on the prevalence or incidence of active tuberculosis among 12 vulnerable populations. Evidence gaps were supplemented with primary or secondary database studies. Study characteristics and outcome data related to tuberculosis burden were tabulated, including prevalence ratios and incidence rate ratios, and evidence was synthesised narratively. This trial is registered with PROSPERO (CRD42022324421). FINDINGS We screened 13 169 citations and included 44 publications (23 reviews and 21 primary or database studies) in the final synthesis. The comprehensiveness and methodological quality of the evidence differed across population groups. Prevalence of more than 1000 cases per 100 000 were reported in all vulnerable populations. On the basis of pooled estimates, prevalence ratios were often more than 25 among people experiencing homelessness, incarcerated populations, refugees, asylum seekers, and people living with HIV compared with the general population. Incidence was infrequently reported, with the best-available incidence rate ratios documented for people who were incarcerated. There was scarce evidence specific to miners, nomadic populations, sex workers, men who have sex with men, and transgender individuals. INTERPRETATION The burden of tuberculosis is substantially higher among vulnerable populations than general populations, suggesting a need for improved integration of these groups, including dedicated efforts for their identification, targeted screening and prevention measures, as well as treatment support. FUNDING WHO.
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Affiliation(s)
- Stefan Litvinjenko
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Olivia Magwood
- Bruyère Research Institute, Ottawa, ON, Canada; Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Shishi Wu
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Xiaolin Wei
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
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Sklar R, Noth E, Kwan A, Sear D, Bertozzi S. Ventilation conditions during COVID-19 outbreaks in six California state carceral institutions. PLoS One 2023; 18:e0293533. [PMID: 37934737 PMCID: PMC10629643 DOI: 10.1371/journal.pone.0293533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 09/23/2023] [Indexed: 11/09/2023] Open
Abstract
Residents of carceral facilities are exposed to poor ventilation conditions which leads to the spread of communicable diseases such as COVID-19. Indoor ventilation conditions are rarely studied within carceral settings and there remains limited capacity to develop solutions to address the impact of poor ventilation on the health of people who are incarcerated. In this study, we empirically measured ventilation rates within housing units of six adult prisons in the California Department of Corrections and Rehabilitation (CDCR) and compare the measured ventilation rates to recommended standards issued by the World Health Organization (WHO). Findings from the empirical assessment include lower ventilation rates than the recommended ventilation standards with particularly low ventilation during winter months when heating systems were in use. Inadvertent airflows from spaces housing potentially infected individuals to shared common spaces was also observed. The methodology used for this work can be leveraged for routine ventilation monitoring, pandemic preparedness, and disaster response.
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Affiliation(s)
- Rachel Sklar
- Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, California, United States of America
| | - Elizabeth Noth
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, United States of America
| | - Ada Kwan
- Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, San Francisco, CA, United States of America
| | - David Sear
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA, United States of America
| | - Stefano Bertozzi
- Division of Health Policy and Management, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
- School of Public Health, University of Washington, Seattle, Washington, USA and Instituto Nacional de Salud Pública, Cuernavaca, Mexico
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Havumaki J, Warren JL, Zelner J, Menzies NA, Calderon R, Contreras C, Lecca L, Becerra MC, Murray M, Cohen T. Spatially-targeted tuberculosis screening has limited impact beyond household contact tracing in Lima, Peru: A model-based analysis. PLoS One 2023; 18:e0293519. [PMID: 37903091 PMCID: PMC10615320 DOI: 10.1371/journal.pone.0293519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 10/15/2023] [Indexed: 11/01/2023] Open
Abstract
Mathematical models have suggested that spatially-targeted screening interventions for tuberculosis may efficiently accelerate disease control, but empirical data supporting these findings are limited. Previous models demonstrating substantial impacts of these interventions have typically simulated large-scale screening efforts and have not attempted to capture the spatial distribution of tuberculosis in households and communities at a high resolution. Here, we calibrate an individual-based model to the locations of case notifications in one district of Lima, Peru. We estimate the incremental efficiency and impact of a spatially-targeted interventions used in combination with household contact tracing (HHCT). Our analysis reveals that HHCT is relatively efficient with a median of 40 (Interquartile Range: 31.7 to 49.9) household contacts required to be screened to detect a single case of active tuberculosis. However, HHCT has limited population impact, producing a median incidence reduction of only 3.7% (Interquartile Range: 5.8% to 1.9%) over 5 years. In comparison, spatially targeted screening (which we modeled as active case finding within high tuberculosis prevalence areas 100 m2 grid cell) is far less efficient, requiring evaluation of ≈12 times the number of individuals as HHCT to find a single individual with active tuberculosis. Furthermore, the addition of the spatially targeted screening effort produced only modest additional reductions in tuberculosis incidence over the 5 year period (≈1.3%) in tuberculosis incidence. In summary, we found that HHCT is an efficient approach for tuberculosis case finding, but has limited population impact. Other screening approaches which target areas of high tuberculosis prevalence are less efficient, and may have limited impact unless very large numbers of individuals can be screened.
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Affiliation(s)
- Joshua Havumaki
- Department of Epidemiology of Microbial Diseases, Yale University, New Haven, CT, United States of America
| | - Joshua L. Warren
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, United States of America
| | - Jon Zelner
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, United States of America
- Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, MI, United States of America
| | - Nicolas A. Menzies
- Department of Global Health and Population, Harvard T. H. Chan, School of Public Health, Boston, MA, United States of America
| | - Roger Calderon
- Socios en Salud Sucursal Peru, Lima, Peru
- Programa Acadêmico de Tuberculose, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Leonid Lecca
- Department of Global Health and Population, Harvard T. H. Chan, School of Public Health, Boston, MA, United States of America
- Socios en Salud Sucursal Peru, Lima, Peru
| | - Mercedes C. Becerra
- Department of Global Health and Population, Harvard T. H. Chan, School of Public Health, Boston, MA, United States of America
| | - Megan Murray
- Department of Global Health and Population, Harvard T. H. Chan, School of Public Health, Boston, MA, United States of America
| | - Ted Cohen
- Department of Epidemiology of Microbial Diseases, Yale University, New Haven, CT, United States of America
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Mendoza-Hisey EC, Dier A, Marquez NV, Bumanglag LV, Cadiao SBA, Guirgis SF. Gender-related factors affecting access to TB services and treatment outcomes in the Philippines. Public Health Action 2023; 13:107-111. [PMID: 37736580 PMCID: PMC10446658 DOI: 10.5588/pha.23.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/04/2023] [Indexed: 09/23/2023] Open
Abstract
SETTING The Philippines is one of the countries with the highest TB burdens. While TB affects men and women differently, studies also show that gender affects people's experience of and access to healthcare. Men and women have usually assigned roles and responsibilities that affect their decisions and health-seeking behaviour. OBJECTIVE The gender analysis aimed to examine the relationship between gender and access to TB services and treatment outcomes according to five domains: cultural norms and beliefs; patterns of power and decision-making; gender roles and responsibilities; access to resources; laws and policies. DESIGN The team conducted 19 in-depth interviews and five focus group discussions with project staff, TB coordinators from healthcare facilities, representatives from the private and informal business sector and representatives from the Philippine Department of Health from August to November 2019. RESULTS Study findings indicated that men faced greater limitations than women in terms of accessing TB resources and services, which highlight the differences between genders in relation to health-seeking behaviours and ability to access healthcare. CONCLUSION This demonstrates the importance of integrating a gender lens into the service provision set up, from screening to treating and monitoring, to ensure equitable health benefits for men, women, transgender and gender-diverse persons.
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Affiliation(s)
| | - A Dier
- FHI 360 Philippine Country Office, Makati, The Philippines
| | - N V Marquez
- FHI 360 Philippine Country Office, Makati, The Philippines
| | - L V Bumanglag
- FHI 360 Philippine Country Office, Makati, The Philippines
| | - S B A Cadiao
- FHI 360 Philippine Country Office, Makati, The Philippines
| | - S F Guirgis
- FHI 360 Philippine Country Office, Makati, The Philippines
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11
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Feasi M, Pontali E. Meeting of two pandemics in prison: a challenging event in a challenging environment. Int J Tuberc Lung Dis 2023; 27:653-654. [PMID: 37608486 PMCID: PMC10443787 DOI: 10.5588/ijtld.23.0253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 08/24/2023] Open
Affiliation(s)
- M Feasi
- Department of Infectious Diseases, Ente Ospedaliero Ospedali Galliera, Genoa, Italy
| | - E Pontali
- Department of Infectious Diseases, Ente Ospedaliero Ospedali Galliera, Genoa, Italy
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12
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Ribeiro CC, Santos ADS, Tshua DH, Oliveira RDD, Lemos EF, Bourdillon P, Laranjeira A, Gonçalves CCM, Andrews J, Ko A, Croda J. Delay in the diagnosis and treatment of tuberculosis in prisons in Mato Grosso do Sul, Brazil. Rev Soc Bras Med Trop 2023; 56:e00152023. [PMID: 37493729 PMCID: PMC10367220 DOI: 10.1590/0037-8682-0015-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/26/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND The number of tuberculosis (TB) cases in prisons is higher than that in the general population and has been reported as the most common cause of death in prisons. This study evaluated the delay in the diagnosis and treatment of TB in Brazilian prisons. METHODS A retrospective cohort study was conducted between 2007 and 2015 using data from the five largest male prisons in Mato Grosso do Sul, Brazil. TB case data was collected from the National Database of Notifiable Diseases (SINAN), GAL-LACEN, and prison medical records. The following variables were recorded: prison, year of diagnosis, age, race, education, HIV status, smoking status, comorbidities, number of symptoms, percentage of cures, delay in diagnosis, patient delay, provider delay, laboratory delay, and delay in treatment. Descriptive statistics were used for the variables of interest. RESULTS A total of 362 pulmonary TB cases were identified. The average time between the first symptom and reporting of data was 94 days. The mean time between symptom onset and laboratory diagnosis was 91 days. The average time from symptom onset to first consultation was 80 days. The time between diagnosis and treatment initiation was 5 days. CONCLUSIONS Delays were significant between reporting of the first symptoms and diagnosis and significantly smaller from the time between notification and start of treatment. Control strategies should be implemented to diagnose cases through active screening, to avoid delays in diagnosis and treatment, and to reduce TB transmission.
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Affiliation(s)
- Carla Celina Ribeiro
- Universidade Federal da Grande Dourados, Faculdade de Ciências da Saúde, Dourados, MS, Brasil
| | - Andrea da Silva Santos
- Universidade Federal da Grande Dourados, Faculdade de Ciências da Saúde, Dourados, MS, Brasil
| | | | - Roberto Dias de Oliveira
- Universidade Federal da Grande Dourados, Faculdade de Ciências da Saúde, Dourados, MS, Brasil
- Universidade Estadual de Mato Grosso do Sul, Curso de Enfermagem, Dourados, MS, Brasil
| | - Everton Ferreira Lemos
- Universidade Estadual de Mato Grosso do Sul, Faculdade de Medicina, Campo Grande, MS, Brasil
| | - Paul Bourdillon
- Yale University School of Public Health, Department of Epidemiology of Microbial Diseases, New Haven, United States of America
| | - Alexandre Laranjeira
- Faculdade de Medicina de São José do Rio Preto, Hospital de Base, São José do Rio Preto, SP, Brasil
| | - Crhistinne Cavalheiro Maymone Gonçalves
- Secretaria Estadual de Saúde de Mato Grosso do Sul, Campo Grande, MS, Brasil
- Universidade Estadual de Mato Grosso do Sul, Curso de Medicina, Campo Grande, MS, Brasil
| | - Jason Andrews
- Stanford University School of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford, CA, United States of America
| | - Albert Ko
- Yale University School of Public Health, Department of Epidemiology of Microbial Diseases, New Haven, United States of America
| | - Julio Croda
- Universidade Estadual de Mato Grosso do Sul, Curso de Medicina, Campo Grande, MS, Brasil
- Fundação Oswaldo Cruz, Mato Grosso do Sul, Campo Grande, MS, Brasil
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13
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Marín D, Keynan Y, Bangdiwala SI, López L, Rueda ZV. Tuberculosis in Prisons: Importance of Considering the Clustering in the Analysis of Cross-Sectional Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5423. [PMID: 37048037 PMCID: PMC10094442 DOI: 10.3390/ijerph20075423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/15/2023] [Accepted: 03/27/2023] [Indexed: 06/19/2023]
Abstract
The level of clustering and the adjustment by cluster-robust standard errors have yet to be widely considered and reported in cross-sectional studies of tuberculosis (TB) in prisons. In two cross-sectional studies of people deprived of liberty (PDL) in Medellin, we evaluated the impact of adjustment versus failure to adjust by clustering on prevalence ratio (PR) and 95% confidence interval (CI). We used log-binomial regression, Poisson regression, generalized estimating equations (GEE), and mixed-effects regression models. We used cluster-robust standard errors and bias-corrected standard errors. The odds ratio (OR) was 20% higher than the PR when the TB prevalence was >10% in at least one of the exposure factors. When there are three levels of clusters (city, prison, and courtyard), the cluster that had the strongest effect was the courtyard, and the 95% CI estimated with GEE and mixed-effect models were narrower than those estimated with Poisson and binomial models. Exposure factors lost their significance when we used bias-corrected standard errors due to the smaller number of clusters. Tuberculosis transmission dynamics in prisons dictate a strong cluster effect that needs to be considered and adjusted for. The omission of cluster structure and bias-corrected by the small number of clusters can lead to wrong inferences.
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Affiliation(s)
- Diana Marín
- Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín 050034, Colombia
| | - Yoav Keynan
- Department of Medical Microbiology and Infectious Disease, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
| | - Shrikant I. Bangdiwala
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON L8S 4K1, Canada
- Population Health Research Institute, McMaster University, Hamilton, ON L8L 2X2, Canada
| | - Lucelly López
- Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín 050034, Colombia
| | - Zulma Vanessa Rueda
- Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín 050034, Colombia
- Department of Medical Microbiology and Infectious Disease, University of Manitoba, Winnipeg, MB R3E 0J9, Canada
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14
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Placeres AF, de Almeida Soares D, Delpino FM, Moura HSD, Scholze AR, dos Santos MS, Arcêncio RA, Fronteira I. Epidemiology of TB in prisoners: a metanalysis of the prevalence of active and latent TB. BMC Infect Dis 2023; 23:20. [PMID: 36631770 PMCID: PMC9835258 DOI: 10.1186/s12879-022-07961-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 12/20/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Tuberculosis (TB) in prisons usually occurs at higher rates than in the general population, especially in developing countries. TB has been reported as the most common cause of death among prisoners. Studies have shown limitations for early detection of TB in prisons that seem to result from mistaken concepts about TB, delayed diagnosis mainly due to the naturalization of lack of healthcare for this population METHODS: A scoping review was performed using the methodology of the Joanna Briggs Institute to assess "What are the scientific evidences on the epidemiology of TB in the prison system?". Then, a meta-analysis was performed to assess the prevalence of TB (active and latent) TB in prisoners. The results are presented as prevalence, in percentage, through random effects models, with a confidence interval of 95%. RESULTS Regarding active TB, the results of the metanalysis showed that countries with a high burden of TB had a prevalence of 3.54% [2.71; 4.63], countries not considered to be high burden TB countries had a prevalence of 1.43% [0.86; 2.37]. Latent TB had a prevalence of 51.61% [39.46; 63.58] in high TB burden countries and a prevalence of 40.24% [23.51; 59.61] in countries with low TB burden. In terms of development, in low- and lower-middle-income countries, the prevalence of active TB was 3.13% [1.84; 5.29] and in high- and upper-middle income countries the prevalence was 2.25% [1.70; 2.99]. The prevalence of latent TB in high- and middle-income countries was 43.77% [28.61; 60.18] and of 49.42% [45.91; 52.94] in low and lower middle-income countries. CONCLUSION Our analysis suggests that TB, and probably other infectious diseases, find fertile ground in prisons where previous acquire social disadvantages seem to thrive-therefore, TB in prisons is a global public health problem and effective strategies are needed to control the disease are needed targeting the prison environment, including rapid health assessments to understand each context and to implement tailored and precision interventions.
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Affiliation(s)
- Aline Ferreira Placeres
- grid.10772.330000000121511713Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, Rua da Junqueira 100, 1349-008 Lisbon, Portugal
| | - Débora de Almeida Soares
- grid.10772.330000000121511713Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, Rua da Junqueira 100, 1349-008 Lisbon, Portugal
| | - Felipe Mendes Delpino
- grid.411221.50000 0001 2134 6519Programa de Pós Graduação em Enfermagem, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Heriederson Sávio Dias Moura
- grid.11899.380000 0004 1937 0722Escola de Enfermagem de Ribeirão Preto (EERP/USP), Universidade de São Paulo, São Paulo, Brazil
| | - Alessandro Rolim Scholze
- grid.441795.aUniversidade Estadual do Norte do Paraná, Campus Luiz Meneguel de Bandeirantes, Bandeirantes, Brazil
| | - Márcio Souza dos Santos
- grid.11899.380000 0004 1937 0722Escola de Enfermagem de Ribeirão Preto (EERP/USP), Universidade de São Paulo, São Paulo, Brazil
| | - Ricardo Alexandre Arcêncio
- grid.11899.380000 0004 1937 0722Escola de Enfermagem de Ribeirão Preto (EERP/USP), Universidade de São Paulo, São Paulo, Brazil
| | - Inês Fronteira
- grid.10772.330000000121511713Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal
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15
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Zhang Y, Lu P, Wu K, Zhou H, Yu H, Yuan J, Dong L, Liu Q, Lu W, Yang H, Cao D, Zhu L. Positive rate and risk factors of latent tuberculosis infection among persons living with HIV in Jiangsu Province, China. Front Cell Infect Microbiol 2023; 13:1051060. [PMID: 36960041 PMCID: PMC10029977 DOI: 10.3389/fcimb.2023.1051060] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 02/16/2023] [Indexed: 03/09/2023] Open
Abstract
Objective To analyze the latent tuberculosis infection (LTBI) among persons living with HIV(PLWH) in Jiangsu Province, to explore the factors affecting the positive rate of LTBI, and to take appropriate measures to control tuberculosis (TB) infection. Methods A cross-sectional study was conducted among PLWH in Jiangsu Province from June to July 2021. All PLWH in Jiangsu Province were used as the study population. Currently, the diagnosis of LTBI lacks a "gold standard" and can only be assisted by the immunological method. In this study, Tuberculin skin test (TST), ESAT6-CFP10 test (EC), and QuantiFERON-TB gold in-tube (QFT) were used to detect the positive rate of LTBI among PLWH and to analyze their risk factors. Results A total of 340 prisoners were included, 89.7% were male, the median age was 38 years [Interquartile Range (IQR):32-46 years], these patients were on Antiviral Therapy (ART), and median CD4 counts was 376 (IQR: 261-496), 103 (30.3%) were positive in at least one test, LTBI by TST was 16.5%, LTBI by EC was 15.9%, LTBI by QFT was 26.2%. Univariate analysis showed the results for TST, EC, and QFT were not affected by CD4 counts (p>0.05), and multivariate analysis showed that a history of incarceration was associated with an increased risk of positive TST (adjusted odds ratio [aOR]=1.98;95% CI,1.03-3.82), EC (aOR=2.65;95% CI,1.37-5.12) and QFT (aOR=2.01;95%CI,1.12-3.57), in addition, female gender was associated with increased risk of positive TST (aOR=3.66;95%CI,1.60-8.37) and EC (aOR=3.43;95%CI,1.46-8.07), and contact history of TB patients was associated with increased risk of TST (aOR= 2.54;95%CI,1.23-5.22) and QFT (aOR=2.03;95%CI,1.03-3.99), and ethnic minorities (aOR=0.26;95%CI,0.12-0.57), longer duration of incarceration was associated with an increased risk of positive QFT (aOR=1.12;95%CI,1.02-1.24). Conclusions Female gender, and ethnic minorities, history of incarceration, longer duration of incarceration, and contact history of TB patients are risk factors for LTBI among PLWH in Jiangsu Province, and attention should be paid to TB control in this population.
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Affiliation(s)
- Yu Zhang
- Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, Jiangsu, China
- School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Peng Lu
- Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, Jiangsu, China
| | - Kai Wu
- Jiangsu Prison Administration, Central Hospital, Changzhou, Jiangsu, China
| | - Hongxi Zhou
- Jiangsu Prison Administration, Central Hospital, Changzhou, Jiangsu, China
| | - Haibing Yu
- Jiangsu Prison Administration, Central Hospital, Changzhou, Jiangsu, China
| | - Ju Yuan
- Jiangsu Prison Administration, Central Hospital, Changzhou, Jiangsu, China
| | - Lang Dong
- Jiangsu Prison Administration, Central Hospital, Changzhou, Jiangsu, China
| | - Qiao Liu
- Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, Jiangsu, China
| | - Wei Lu
- Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, Jiangsu, China
| | - Haitao Yang
- School of Public Health, Southeast University, Nanjing, Jiangsu, China
- Health Policy Research Department, Jiangsu Provincial Health Development Research Center, Jiangsu, China
| | - Dianyi Cao
- Jiangsu Prison Administration, Central Hospital, Changzhou, Jiangsu, China
- *Correspondence: Limei Zhu, ; Dianyi Cao,
| | - Limei Zhu
- Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, Jiangsu, China
- *Correspondence: Limei Zhu, ; Dianyi Cao,
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16
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Da'ar OB, Gele AA. Tuberculosis in a weak health system, conflict and fragile zone: The monetary value of human lives lost associated with deaths of persons older than 14 years in Somalia. Int J Health Plann Manage 2023; 38:53-68. [PMID: 36044037 DOI: 10.1002/hpm.3550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 04/17/2022] [Accepted: 07/11/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Low tuberculosis (TB) detection and conflict and fragility have overburdened Somalia. This study estimated economic loss associated with TB deaths among persons aged >14 years. METHOD Using epidemiologic and economic data, we calculated the cost based on the framework of the World Health Organization guide of identifying the economic consequences of disease and injury. Baseline loss is the product of years of life lost, non-health expenditure, and number of deaths. Adjusting for conflict and fragility conditions and growth of non-health expenditure, we discounted the loss at 3% rate. We conducted a sensitivity analysis of epidemiologic and economic factors. RESULTS In 2017 values, the 9180 reported deaths result in a loss of US$ 44.77 million, a US$ 4877 per death over the discounted years. Conflict conditions would increase the loss by 5.3%, while simultaneous adjustment for conflict and attunement to growth of non-health expenditure would increase the burden by 54% to US$ 67.28 million. Male fatalities account for 59% of the burden. The baseline result is robust to input variations, although sensitivity analysis suggests conflict and fragility conditions account for greater uncertainty of the loss. CONCLUSION Stakeholders in the healthcare system should minimise the sizeable economic loss by taking measures to enhance surveillance of TB and security.
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Affiliation(s)
- Omar B Da'ar
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,Department of Health Systems Management, College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,Graduate School of Professional Studies, St. Mary's University of Minnesota, Minneapolis, Minnesota, USA
| | - Abdi A Gele
- Unit for Migration and Health, Norwegian Institute of Public Health, Oslo, Norway
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17
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Chen Q, Yu S, Rui J, Guo Y, Yang S, Abudurusuli G, Yang Z, Liu C, Luo L, Wang M, Lei Z, Zhao Q, Gavotte L, Niu Y, Frutos R, Chen T. Transmissibility of tuberculosis among students and non-students: an occupational-specific mathematical modelling. Infect Dis Poverty 2022; 11:117. [PMID: 36461098 PMCID: PMC9716537 DOI: 10.1186/s40249-022-01046-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/17/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Recently, despite the steady decline in the tuberculosis (TB) epidemic globally, school TB outbreaks have been frequently reported in China. This study aimed to quantify the transmissibility of Mycobacterium tuberculosis (MTB) among students and non-students using a mathematical model to determine characteristics of TB transmission. METHODS We constructed a dataset of reported TB cases from four regions (Jilin Province, Xiamen City, Chuxiong Prefecture, and Wuhan City) in China from 2005 to 2019. We classified the population and the reported cases under student and non-student groups, and developed two mathematical models [nonseasonal model (Model A) and seasonal model (Model B)] based on the natural history and transmission features of TB. The effective reproduction number (Reff) of TB between groups were calculated using the collected data. RESULTS During the study period, data on 456,423 TB cases were collected from four regions: students accounted for 6.1% of cases. The goodness-of-fit analysis showed that Model A had a better fitting effect (P < 0.001). The average Reff of TB estimated from Model A was 1.68 [interquartile range (IQR): 1.20-1.96] in Chuxiong Prefecture, 1.67 (IQR: 1.40-1.93) in Xiamen City, 1.75 (IQR: 1.37-2.02) in Jilin Province, and 1.79 (IQR: 1.56-2.02) in Wuhan City. The average Reff of TB in the non-student population was 23.30 times (1.65/0.07) higher than that in the student population. CONCLUSIONS The transmissibility of MTB remains high in the non-student population of the areas studied, which is still dominant in the spread of TB. TB transmissibility from the non-student-to-student-population had a strong influence on students. Specific interventions, such as TB screening, should be applied rigorously to control and to prevent TB transmission among students.
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Affiliation(s)
- Qiuping Chen
- grid.12955.3a0000 0001 2264 7233State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian People’s Republic of China ,grid.8183.20000 0001 2153 9871CIRAD, URM 17, Intertryp, Montpellier, France ,grid.121334.60000 0001 2097 0141Université de Montpellier, Montpellier, France
| | - Shanshan Yu
- grid.12955.3a0000 0001 2264 7233State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian People’s Republic of China
| | - Jia Rui
- grid.12955.3a0000 0001 2264 7233State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian People’s Republic of China ,grid.8183.20000 0001 2153 9871CIRAD, URM 17, Intertryp, Montpellier, France ,grid.121334.60000 0001 2097 0141Université de Montpellier, Montpellier, France
| | - Yichao Guo
- grid.12955.3a0000 0001 2264 7233State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian People’s Republic of China
| | - Shiting Yang
- grid.12955.3a0000 0001 2264 7233State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian People’s Republic of China
| | - Guzainuer Abudurusuli
- grid.12955.3a0000 0001 2264 7233State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian People’s Republic of China
| | - Zimei Yang
- grid.12955.3a0000 0001 2264 7233State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian People’s Republic of China
| | - Chan Liu
- grid.12955.3a0000 0001 2264 7233State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian People’s Republic of China
| | - Li Luo
- grid.12955.3a0000 0001 2264 7233State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian People’s Republic of China
| | - Mingzhai Wang
- Xiamen Center for Disease Control and Prevention, Xiamen, Fujian People’s Republic of China
| | - Zhao Lei
- grid.12955.3a0000 0001 2264 7233State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian People’s Republic of China
| | - Qinglong Zhao
- Jilin Provincial Center for Disease Control and Prevention, Changchun, Jilin People’s Republic of China
| | - Laurent Gavotte
- grid.121334.60000 0001 2097 0141Espace-Dev, Université de Montpellier, Montpellier, France
| | - Yan Niu
- grid.198530.60000 0000 8803 2373Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, China
| | - Roger Frutos
- grid.8183.20000 0001 2153 9871CIRAD, URM 17, Intertryp, Montpellier, France
| | - Tianmu Chen
- grid.12955.3a0000 0001 2264 7233State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian People’s Republic of China
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Busatto C, Bierhals DV, Vianna JS, da Silva PEA, Possuelo LG, Ramis IB. Epidemiology and control strategies for tuberculosis in countries with the largest prison populations. Rev Soc Bras Med Trop 2022; 55:e00602022. [PMID: 36417620 PMCID: PMC9757719 DOI: 10.1590/0037-8682-0060-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Tuberculosis (TB) is a serious infectious disease, and its control is considered a challenge, especially among vulnerable populations such as prisoners. The occurrence of TB in prisons is an alarming public health problem in many countries. This integrative review aims to describe the epidemiology of TB and control strategies for this disease in countries with the largest prison populations. Studies have shown that it is essential to know the prevalence of TB in prisons of each country. This is because it can serve as an indication of the need for action in prisons to reduce TB rates, including improving the structure of prison environments, rapidly and accurately diagnosing new cases, identifying drug-resistant strains, and implementing effective and directly observed treatment for TB.
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Affiliation(s)
- Caroline Busatto
- Universidade Federal do Rio Grande, Programa de Pós-Graduação em Ciências da Saúde, Rio Grande, RS, Brasil
| | - Dienefer Venske Bierhals
- Universidade Federal do Rio Grande, Programa de Pós-Graduação em Ciências da Saúde, Rio Grande, RS, Brasil
| | - Julia Silveira Vianna
- Universidade Federal do Rio Grande, Programa de Pós-Graduação em Ciências da Saúde, Rio Grande, RS, Brasil
| | | | - Lia Gonçalves Possuelo
- Universidade de Santa Cruz do Sul, Programa de Pós-Graduação em Promoção da Saúde, Santa Cruz do Sul, RS, Brasil
| | - Ivy Bastos Ramis
- Universidade Federal do Rio Grande, Programa de Pós-Graduação em Ciências da Saúde, Rio Grande, RS, Brasil
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19
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Tuberculosis control at a South African correctional centre: Diagnosis, treatment and strain characterisation. PLoS One 2022; 17:e0277459. [DOI: 10.1371/journal.pone.0277459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 10/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Correctional centres provide ideal conditions for tuberculosis (TB) transmission and disease progression. Despite the high TB incidence and incarceration rate in South Africa, data from South African correctional centres are scarce. Thus, the study evaluated TB diagnosis, treatment initiation and completion, and identified prevalent Mycobacterium tuberculosis strains among detainees entering a South African correctional centre.
Methods
This study was a prospective observational study that enrolled participants between February and September 2017 from a correctional centre located in the Western Cape, South Africa. All adult male detainees who tested positive for TB during admission screening were eligible to participate in the study. Sputum samples from enrolled participants underwent smear microscopy and culture. Strain typing was performed on culture-positive samples. The time between specimen collection and diagnosis, the time between diagnosis and treatment initiation, and the proportion of detainees completing TB treatment at the correctional centre were calculated.
Results
During the study period, 130 TB cases were detected through routine admission screening (126 male, 2 female, 2 juvenile). Out of the 126 eligible male detainees, 102 were enrolled in the study (81%, 102/126). All TB cases were detected within 30 hrs of admission screening. The majority (78%, 80/102) of participants started treatment within 48 hrs of TB diagnosis. However, only 8% (9/102) of participants completed treatment at the correction centre. Sputa from 90 of the 102 participants were available for smear and culture. There was a high smear positivity, with 49% (44/90) of isolates being smear positive. The Beijing family was the most frequent lineage (55.2%) in the study.
Conclusion
The strengths of the current TB control efforts at the correctional centre include rapid detection of cases through admission screening and prompt treatment initiation. However, a high number of detainees exiting before treatment completion highlights the need to strengthen links between correctional TB services and community TB services to ensure detainees complete TB treatment after release and prevent TB transmission.
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20
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Pelissari DM, Saita NM, Monroe AA, Diaz-Quijano FA. Environmental factors associated with the time to tuberculosis diagnosis in prisoners in São Paulo, Brazil. Am J Infect Control 2022; 50:1246-1252. [PMID: 35644298 DOI: 10.1016/j.ajic.2022.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Environmental conditions play an important role in the high incidence of tuberculosis in prisons. We estimated the effect of environmental factors, including measurements based on cell dimensions, on the time to tuberculosis diagnosis in prison population of Brazil. METHODS This is a retrospective cohort of 2,257 prisoners diagnosed with tuberculosis in 2014 and 2015. We collected environmental data from 105 prisons and linked with routine tuberculosis surveillance and prison data. We estimated tuberculosis-free survival time with Cox risk models, guided by a validated directed acyclic graph. RESULTS The median disease-free time was 1.71 years (95% confidence interval [95% CI] 1.64-1.78). Each 50% increase in occupancy-rate, increased the tuberculosis speed incidence by 16% (95% CI 8%-25%) in the first 2 years, and 9% (95% CI 3%-16%) up to 5 years. An increase in the cell area per person (ln[m2/person]) reduced the hazard of tuberculosis by 13% (95% CI 3%-23%) for up to 2, and 12% (95% CI 3%-21%) for up to 5 years. DISCUSSION Most tuberculosis cases were diagnosed within 2 years of incarceration. Prison overcrowding and physical space per person in the cell were associated with the tuberculosis-free disease time. CONCLUSIONS Interventions to reduce overcrowding or increase physical space are crucial to prevent tuberculosis in prisons.
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Affiliation(s)
- Daniele M Pelissari
- Department of Epidemiology, Postgraduate Program in Epidemiology, School of Public Health, University of São Paulo, São Paulo, SP, Brazil.
| | - Nanci M Saita
- Department of Public Health, Postgraduate Program Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, São Paulo, SP, Brazil
| | - Aline A Monroe
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, São Paulo, SP, Brazil
| | - Fredi A Diaz-Quijano
- Department of Epidemiology - Laboratory of Causal Inference in Epidemiology (LINCE-USP), School of Public Health, University of São Paulo, São Paulo, SP, Brazil; Laboratory of Causal Inference in Epidemiology, University of São Paulo (LINCE-USP), São Paulo, SP, Brazil
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Shrestha S, Winglee K, Hill AN, Shaw T, Smith JP, Kammerer JS, Silk BJ, Marks SM, Dowdy D. Model-based Analysis of Tuberculosis Genotype Clusters in the United States Reveals High Degree of Heterogeneity in Transmission and State-level Differences Across California, Florida, New York, and Texas. Clin Infect Dis 2022; 75:1433-1441. [PMID: 35143641 PMCID: PMC9412192 DOI: 10.1093/cid/ciac121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Reductions in tuberculosis (TB) transmission have been instrumental in lowering TB incidence in the United States. Sustaining and augmenting these reductions are key public health priorities. METHODS We fit mechanistic transmission models to distributions of genotype clusters of TB cases reported to the Centers for Disease Control and Prevention during 2012-2016 in the United States and separately in California, Florida, New York, and Texas. We estimated the mean number of secondary cases generated per infectious case (R0) and individual-level heterogeneity in R0 at state and national levels and assessed how different definitions of clustering affected these estimates. RESULTS In clusters of genotypically linked TB cases that occurred within a state over a 5-year period (reference scenario), the estimated R0 was 0.29 (95% confidence interval [CI], .28-.31) in the United States. Transmission was highly heterogeneous; 0.24% of simulated cases with individual R0 >10 generated 19% of all recent secondary transmissions. R0 estimate was 0.16 (95% CI, .15-.17) when a cluster was defined as cases occurring within the same county over a 3-year period. Transmission varied across states: estimated R0s were 0.34 (95% CI, .3-.4) in California, 0.28 (95% CI, .24-.36) in Florida, 0.19 (95% CI, .15-.27) in New York, and 0.38 (95% CI, .33-.46) in Texas. CONCLUSIONS TB transmission in the United States is characterized by pronounced heterogeneity at the individual and state levels. Improving detection of transmission clusters through incorporation of whole-genome sequencing and identifying the drivers of this heterogeneity will be essential to reducing TB transmission.
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Affiliation(s)
- Sourya Shrestha
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kathryn Winglee
- Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Andrew N Hill
- Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Tambi Shaw
- California Department of Public Health, Richmond, California, USA
| | - Jonathan P Smith
- Department of Policy and Administration, Yale University, New Haven, Connecticut, USA
| | - J Steve Kammerer
- Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Benjamin J Silk
- Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Suzanne M Marks
- Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - David Dowdy
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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22
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Stewart RJ, Raz KM, Burns SP, Kammerer JS, Haddad MB, Silk BJ, Wortham JM. Tuberculosis Outbreaks in State Prisons, United States, 2011-2019. Am J Public Health 2022; 112:1170-1179. [PMID: 35830666 PMCID: PMC9342802 DOI: 10.2105/ajph.2022.306864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 11/04/2022]
Abstract
Objectives. To understand the frequency, magnitude, geography, and characteristics of tuberculosis outbreaks in US state prisons. Methods. Using data from the National Tuberculosis Surveillance System, we identified all cases of tuberculosis during 2011 to 2019 that were reported as occurring among individuals incarcerated in a state prison at the time of diagnosis. We used whole-genome sequencing to define 3 or more cases within 2 single nucleotide polymorphisms within 3 years as clustered; we classified clusters with 6 or more cases during a 3-year period as tuberculosis outbreaks. Results. During 2011 to 2019, 566 tuberculosis cases occurred in 41 state prison systems (a median of 3 cases per state). A total of 19 tuberculosis genotype clusters comprising 134 cases were identified in 6 state prison systems; these clusters included a subset of 5 outbreaks in 2 states. Two Alabama outbreaks during 2011 to 2017 totaled 20 cases; 3 Texas outbreaks during 2014 to 2019 totaled 51 cases. Conclusions. Only Alabama and Texas reported outbreaks during the 9-year period; only Texas state prisons had ongoing transmission in 2019. Effective interventions are needed to stop tuberculosis outbreaks in Texas state prisons. (Am J Public Health. 2022;112(8):1170-1179. https://doi.org/10.2105/AJPH.2022.306864).
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Affiliation(s)
- Rebekah J Stewart
- The authors are with the Division of Tuberculosis Elimination, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Kala M Raz
- The authors are with the Division of Tuberculosis Elimination, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Scott P Burns
- The authors are with the Division of Tuberculosis Elimination, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - J Steve Kammerer
- The authors are with the Division of Tuberculosis Elimination, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Maryam B Haddad
- The authors are with the Division of Tuberculosis Elimination, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Benjamin J Silk
- The authors are with the Division of Tuberculosis Elimination, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Jonathan M Wortham
- The authors are with the Division of Tuberculosis Elimination, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA
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23
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Horton KC, White RG, Hoa NB, Nguyen HV, Bakker R, Sumner T, Corbett EL, Houben RMGJ. Population benefits of addressing programmatic and social determinants of gender disparities in tuberculosis in Viet Nam: A modelling study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000784. [PMID: 36962475 PMCID: PMC10021793 DOI: 10.1371/journal.pgph.0000784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 06/23/2022] [Indexed: 11/18/2022]
Abstract
High prevalence of infectious tuberculosis among men suggests potential population-wide benefits from addressing programmatic and social determinants of gender disparities. Utilising a sex-stratified compartmental transmission model calibrated to tuberculosis burden estimates for Viet Nam, we modelled interventions to increase active case finding, to reduce tobacco smoking, and to reduce alcohol consumption by 2025 in line with national and global targets. For each intervention, we examined scenarios differentially targeting men and women and evaluated impact on tuberculosis morbidity and mortality in men, women, and children in 2035. Active case finding interventions targeting men projected greater reductions in tuberculosis incidence in men, women, and children (16.2%, uncertainty interval, UI, 11.4-23.0%, 11.8%, UI 8.0-18.6%, and 21.5%, UI 16.9-28.5%, respectively) than those targeting women (5.2%, UI 3.8-7.1%, 5.4%, UI 3.9-7.3%, and 8.6%, UI 6.9-10.7%, respectively). Projected reductions in tuberculosis incidence for interventions to reduce male tobacco smoking and alcohol consumption were greatest for men (17.4%, UI 11.8-24.7%, and 11.0%, UI 5.4-19.4%, respectively), but still substantial for women (6.9%, UI 3.8-12.5%, and 4.4%, UI 1.9-10.6%, respectively) and children (12.7%, UI 8.4-19.0%, and 8.0%, UI 3.9-15.0%, respectively). Comparable interventions targeting women projected limited impact, with declines of 0.3% (UI 0.2%-0.3%) and 0.1% (UI 0.0%-0.1%), respectively. Addressing programmatic and social determinants of men's tuberculosis burden has population-wide benefits. Future interventions to increase active case finding, to reduce tobacco smoking, and to reduce harmful alcohol consumption, whilst not ignoring women, should focus on men to most effectively reduce tuberculosis morbidity and mortality in men, women, and children.
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Affiliation(s)
- Katherine C. Horton
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- TB Modelling Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Richard G. White
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- TB Modelling Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Hai Viet Nguyen
- National Tuberculosis Control Programme, Hanoi, Viet Nam
- Department of Global Health and Amsterdam Institute of Global Health and Development, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Roel Bakker
- Skardahl IT Solutions, Delft, The Netherlands
| | - Tom Sumner
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- TB Modelling Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Elizabeth L. Corbett
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Rein M. G. J. Houben
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- TB Modelling Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
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24
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Amede PO, Adedire E, Usman A, Ameh CA, Umar FS, Umeokonkwo CD, Balogun MS. Drug-susceptible tuberculosis treatment outcomes and its associated factors among inmates in prison settings in Bauchi State, Nigeria, 2014–2018. PLoS One 2022; 17:e0270819. [PMID: 35789216 PMCID: PMC9255776 DOI: 10.1371/journal.pone.0270819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 06/20/2022] [Indexed: 11/18/2022] Open
Abstract
Tuberculosis (TB) is a contagious disease and its transmissibility is increased in congregate settings. TB incidence rates are five-to-fifty times higher among inmates in prison settings than the general population which has a direct impact on the outcome of TB treatment. There is paucity of information on TB treatment outcomes and its associated factors in Nigerian prison settings. We therefore assessed TB treatment outcomes among inmates in prison settings in Bauchi State, Nigeria. We conducted a retrospective data analysis of inmates with TB in the five-main prison settings in Bauchi State. We extracted socio-demographic, clinical and treatment outcome characteristics from TB treatment register of inmates treated for TB between January 2014 and December 2018, using a checklist. We calculated the TB treatment success rate (TSR) and explored the relationship between the TSR and socio-demographic and clinical characteristics. Related variables were modelled in multiple logistic regression to identify factors associated with TSR at 5% level of significance. All 216 inmates were male with mean (SD) age of 37.6±11.4 years. Seventy-six (35.2%) were cured, 61 (28.2%) completed treatment, 65 (30.1%) were transferred-out without evaluation and 14 (6.5%) died. Overall TSR was 72.9%. Factors associated with successful-treatment-outcome were age, weight, imprisonment duration and HIV status. The results indicate that inmates who are 20–29 years are at least ten times more likely to be successful (aOR = 10.5; 95%CI: 3.2–35.1) than inmates who are 55 years or older. Inmates who are 30–39 years are about four times more likely to be successful than inmates who are 55 years or older (aOR = 4.2; 95% CI: 1.3–13.1). In general, the younger an inmate, the more successful he is. Inmates with pretreatment-weight; 55kg or more are 13 times more likely to be successful (aOR = 13.3; 95%CI: 6.0–29.6) than inmates with weight below 55kg. Inmates who were imprisoned for 2 years or less are about three times more likely to be successful (aOR = 2.6; 95%CI: 1.3–5.4) than inmates who were imprisoned for more than 2 years and HIV negative inmates were three times more likely to succeed (aOR = 3.3; 95%CI:1.4–7.8) than inmates who were HIV positive. We recommended that to improve TB treatment outcome among inmates; age, duration-of-imprisonment, weight and TB/HIV co-infection should be the major consideration during pretreatment, psychological and nutritional counselling and a tracking-system be developed by the authority to follow-up inmates transferred-out to other health facilities to ensure they complete the treatment and outcomes evaluated.
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Affiliation(s)
- Peter Okpeh Amede
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Federal Capital Territory, Nigeria
- * E-mail:
| | - Elizabeth Adedire
- African Field Epidemiology Network- Nigeria, Abuja, Federal Capital Territory, Nigeria
| | - Aishat Usman
- African Field Epidemiology Network- Nigeria, Abuja, Federal Capital Territory, Nigeria
| | - Celestine Attah Ameh
- African Field Epidemiology Network- Nigeria, Abuja, Federal Capital Territory, Nigeria
| | - Faruk Saleh Umar
- Nigerian Correctional Service, Bauchi State Command, Abuja, Federal Capital Territory, Nigeria
| | - Chukwuma David Umeokonkwo
- Nigerian Correctional Service, Bauchi State Command, Abuja, Federal Capital Territory, Nigeria
- Department of Community Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria
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25
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Blumberg S, Lu P, Kwan AT, Hoover CM, Lloyd-Smith JO, Sears D, Bertozzi SM, Worden L. Modeling scenarios for mitigating outbreaks in congregate settings. PLoS Comput Biol 2022; 18:e1010308. [PMID: 35857774 PMCID: PMC9342784 DOI: 10.1371/journal.pcbi.1010308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/01/2022] [Accepted: 06/16/2022] [Indexed: 11/18/2022] Open
Abstract
The explosive outbreaks of COVID-19 seen in congregate settings such as prisons and nursing homes, has highlighted a critical need for effective outbreak prevention and mitigation strategies for these settings. Here we consider how different types of control interventions impact the expected number of symptomatic infections due to outbreaks. Introduction of disease into the resident population from the community is modeled as a stochastic point process coupled to a branching process, while spread between residents is modeled via a deterministic compartmental model that accounts for depletion of susceptible individuals. Control is modeled as a proportional decrease in the number of susceptible residents, the reproduction number, and/or the proportion of symptomatic infections. This permits a range of assumptions about the density dependence of transmission and modes of protection by vaccination, depopulation and other types of control. We find that vaccination or depopulation can have a greater than linear effect on the expected number of cases. For example, assuming a reproduction number of 3.0 with density-dependent transmission, we find that preemptively reducing the size of the susceptible population by 20% reduced overall disease burden by 47%. In some circumstances, it may be possible to reduce the risk and burden of disease outbreaks by optimizing the way a group of residents are apportioned into distinct residential units. The optimal apportionment may be different depending on whether the goal is to reduce the probability of an outbreak occurring, or the expected number of cases from outbreak dynamics. In other circumstances there may be an opportunity to implement reactive disease control measures in which the number of susceptible individuals is rapidly reduced once an outbreak has been detected to occur. Reactive control is most effective when the reproduction number is not too high, and there is minimal delay in implementing control. We highlight the California state prison system as an example for how these findings provide a quantitative framework for understanding disease transmission in congregate settings. Our approach and accompanying interactive website (https://phoebelu.shinyapps.io/DepopulationModels/) provides a quantitative framework to evaluate the potential impact of policy decisions governing infection control in outbreak settings.
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Affiliation(s)
- Seth Blumberg
- University of California San Francisco, Francis I. Proctor Foundation, San Francisco, California, United States of America
- Modeling Infectious Diseases in Healthcare Network, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- University of California San Francisco, Department of Medicine, San Francisco, California, United States of America
| | - Phoebe Lu
- University of California San Francisco, Francis I. Proctor Foundation, San Francisco, California, United States of America
- Modeling Infectious Diseases in Healthcare Network, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ada T. Kwan
- University of California San Francisco, Department of Medicine, San Francisco, California, United States of America
| | - Christopher M. Hoover
- University of California San Francisco, Francis I. Proctor Foundation, San Francisco, California, United States of America
- Modeling Infectious Diseases in Healthcare Network, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - James O. Lloyd-Smith
- University of California Los Angeles, Department of Ecology and Evolutionary Biology, Los Angeles, California, United States of America
| | - David Sears
- University of California San Francisco, Department of Medicine, San Francisco, California, United States of America
| | - Stefano M. Bertozzi
- University of California Berkeley, School of Public Health, Berkeley, California, United States of America
- University of Washington, Department of Global Health, Seattle, Washington, United States of America
- National Institute of Public Health of Mexico, Cuernavaca, Mexico
| | - Lee Worden
- University of California San Francisco, Francis I. Proctor Foundation, San Francisco, California, United States of America
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26
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Uruamo S, McAllister S, Scott N, Hancox RJ, Hayudini R, Baxter J, Hill PC. Feasibility study of the prevalence of latent tuberculosis infection for Māori in the Waikato region, Aotearoa New Zealand. Aust N Z J Public Health 2022; 46:872-877. [PMID: 35735941 DOI: 10.1111/1753-6405.13274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 03/01/2022] [Accepted: 05/01/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE This study aimed to assess the feasibility of conducting a representative tuberculin skin test (TST) survey for Māori in Aotearoa New Zealand and to estimate the prevalence of latent tuberculosis (TB) infection. METHODS Participants were Māori in the Waikato region, recruited by a Māori nurse, through: 1) random household selection from the Electoral Roll; 2) randomly selected prison inmates; and 3) community and health settings. A TB history and symptoms questionnaire was completed, TST performed and investigation of those with TST induration ≥10mm. RESULTS Random household selection was resource intensive and only contributed 14 participants. Repeated random selection of prison lists were required to recruit 207 participants and there were no positive TST cases. Community and health settings yielded the highest participation (n=370) and the three people (0.5%) with TST ≥10mm. Age ≥45 years and history of contact with a TB case were associated with TST induration ≥5mm (n=39; 6.6%). CONCLUSIONS The community and health settings were the only feasible options for recruitment. The overall prevalence of a positive TST in the study population was low. A 5mm cut-off may be best to maximise sensitivity for future studies. IMPLICATIONS FOR PUBLIC HEALTH A mixture of sample selection processes that are more targeted are needed to identify Māori with latent TB infection.
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Affiliation(s)
- Siobhan Uruamo
- Respiratory Department, Waikato District Health Board, Hamilton, New Zealand
| | - Susan McAllister
- Centre for International Health, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Nina Scott
- Waikato District Health Board, Te Puna Oranga, Hamilton, New Zealand
| | - Robert J Hancox
- Respiratory Department, Waikato District Health Board, Hamilton, New Zealand.,Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Ron Hayudini
- Respiratory Department, Waikato District Health Board, Hamilton, New Zealand
| | - Joanne Baxter
- Kōhatu Centre for Hauora Māori, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Philip C Hill
- Centre for International Health, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
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27
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Walter KS, Dos Santos PCP, Gonçalves TO, da Silva BO, da Silva Santos A, de Cássia Leite A, da Silva AM, Figueira Moreira FM, de Oliveira RD, Lemos EF, Cunha E, Liu YE, Ko AI, Colijn C, Cohen T, Mathema B, Croda J, Andrews JR. The role of prisons in disseminating tuberculosis in Brazil: A genomic epidemiology study. LANCET REGIONAL HEALTH. AMERICAS 2022; 9. [PMID: 35647574 PMCID: PMC9140320 DOI: 10.1016/j.lana.2022.100186] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Globally, prisons are high-incidence settings for tuberculosis. Yet the role of prisons as reservoirs of M. tuberculosis, propagating epidemics through spillover to surrounding communities, has been difficult to measure directly. Methods To quantify the role of prisons in driving wider community M. tuberculosis transmission, we conducted prospective genomic surveillance in Central West Brazil from 2014 to 2019. We whole genome sequenced 1152 M. tuberculosis isolates collected during active and passive surveillance inside and outside prisons and linked genomes to detailed incarceration histories. We applied multiple phylogenetic and genomic clustering approaches and inferred timed transmission trees. Findings M. tuberculosis sequences from incarcerated and non-incarcerated people were closely related in a maximum likelihood phylogeny. The majority (70.8%; 46/65) of genomic clusters including people with no incarceration history also included individuals with a recent history of incarceration. Among cases in individuals with no incarceration history, 50.6% (162/320) were in clusters that included individuals with recent incarceration history, suggesting that transmission chains often span prisons and communities. We identified a minimum of 18 highly probable spillover events, M. tuberculosis transmission from people with a recent incarceration history to people with no prior history of incarceration, occurring in the state’s four largest cities and across sampling years. We additionally found that frequent transfers of people between the state’s prisons creates a highly connected prison network that likely disseminates M. tuberculosis across the state. Interpretation We developed a framework for measuring spillover from high-incidence environments to surrounding communities by integrating genomic and spatial information. Our findings indicate that, in this setting, prisons serve not only as disease reservoirs, but also disseminate M. tuberculosis across highly connected prison networks, both amplifying and propagating M. tuberculosis risk in surrounding communities. Funding Brazil’s National Council for Scientific and Technological Development and US National Institutes of Health.
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Affiliation(s)
- Katharine S Walter
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States
| | | | | | - Bruna Oliveira da Silva
- Health Sciences Research Laboratory, Federal University of Grande Dourados, Dourados, Brazil
| | - Andrea da Silva Santos
- Health Sciences Research Laboratory, Federal University of Grande Dourados, Dourados, Brazil
| | | | - Alessandra Moura da Silva
- School of Medicine, Federal University of Mato Grosso do Sul, School of Medicine, Campo Grande, Brazil
| | | | | | - Everton Ferreira Lemos
- School of Medicine, Federal University of Mato Grosso do Sul, School of Medicine, Campo Grande, Brazil
| | - Eunice Cunha
- Laboratory of Bacteriology, Central Laboratory of Mato Grosso do Sul, Campo Grande, Brazil
| | - Yiran E Liu
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States.,Cancer Biology Graduate Program, Stanford University School of Medicine, Stanford, United States
| | - Albert I Ko
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, United States.,Instituto Gonçalo¸ Moniz, Fundação Oswaldo Cruz, Salvador, BA, Brazil
| | - Caroline Colijn
- Department of Mathematics, Simon Fraser University, Burnaby, Canada
| | - Ted Cohen
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, United States
| | - Barun Mathema
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, United States
| | - Julio Croda
- School of Medicine, Federal University of Mato Grosso do Sul, School of Medicine, Campo Grande, Brazil.,Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, United States.,Mato Grosso do Sul Office, Oswaldo Cruz Foundation, Campo Grande, Brazil
| | - Jason R Andrews
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States
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28
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Smith M, Glidden MD. COVID-19 in Prisons: State Health Care Contracting and the Pandemic Behind Bars. JOURNAL OF CORRECTIONAL HEALTH CARE 2022; 28:164-171. [PMID: 35442803 DOI: 10.1089/jchc.20.11.0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The COVID-19 pandemic has had far-reaching consequences, resulting in millions of infections and deaths worldwide. Given the vast impact of the virus and how it has highlighted health care access/treatment concerns within the general public, this study examined how these issues specifically impacted COVID-19 cases and deaths among incarcerated individuals. In particular, we examined how the method of medical care delivery (i.e., provided by correctional versus contracted practitioners) impacted the reported rates of COVID-19 cases/deaths within correctional institutions. Findings indicated that COVID-19 diagnosis and mortality rates were significantly lower in states where at least some health care for incarcerated individuals was directly provided by correctional employees. We offer various explanations for these findings while also highlighting potential key reporting differences between these two forms of correctional health care delivery.
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Affiliation(s)
- Molly Smith
- School of Criminal Justice and Criminology, University of Arkansas at Little Rock, Little Rock, Arkansas, USA
| | - Marc D Glidden
- Department of Criminology and Justice Studies, California State University - Northridge, Northridge, California, USA
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29
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Kosambiya JK, Vadgama P, Samudyatha UC, Rathod D, Buch R, Damor R. Active case finding of pulmonary tuberculosis and HIV infection among prisoners of South Gujarat: A cross sectional study. Indian J Tuberc 2022; 69:213-219. [PMID: 35379404 DOI: 10.1016/j.ijtb.2021.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 08/05/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND In a close knit congregation such as prison, Tuberculosis (TB) and HIV can be major health problems. However, their prevalence in Indian prisons is under reported. This study aimed at adopting a camp based, active case finding approach to identify cases of TB, HIV and at risk prisoners in a central prison of South Gujarat. METHODS A multidisciplinary team of public health experts, pulmonologists, social workers and lab technicians conducted a week-long camp to screen 1665 prisoners for TB using clinical examination, sputum smear for AFB, CBNAAT and Chest X-Ray and for HIV through Rapid Antigen Testing. RESULTS Majority of participants (1392, 84%) were under trail prisoners, having spent an average of 1.4 years in prison. About 2.9% of participants had previous history of TB, of whom only 59% had completed treatment. About 14% of participants were underweight. Weight reduction was found to be significant in first five years of imprisonment. Of all participants, 3.6% were found to have diabetic range of blood sugar. Seven new active, drug sensitive pulmonary TB cases and three new cases of HIV infection were identified. All new cases of TB, HIV and increased blood sugar levels were linked to treatment. CONCLUSION Camp based approach is effective in active case finding of pulmonary TB and predisposing factors such as malnourishment, Diabetes and HIV among prisoners. Routine screening of all prisoners at the time of entry and monthly thereafter in a camp based approach should be adopted to identify TB and at risk prisoners.
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Affiliation(s)
- J K Kosambiya
- Department of Community Medicine, Government Medical College, Surat, India.
| | - Parul Vadgama
- Department of Pulmonary Medicine, Government Medical College, Surat, India
| | - U C Samudyatha
- Department of Community Medicine, Government Medical College, Surat, India
| | | | - Rutu Buch
- Department of Community Medicine, Government Medical College, Surat, India
| | - Rahul Damor
- Department of Community Medicine, Government Medical College, Surat, India
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30
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López MP, Ulloa AP, Escobar FA. Tuberculosis and prison overcrowding from the perspective of social inequities in health in Colombia, 2018. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2022; 42:159-169. [PMID: 35471178 PMCID: PMC9075111 DOI: 10.7705/biomedica.5894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 11/25/2021] [Indexed: 06/14/2023]
Abstract
Introduction: Prison population is affected by tuberculosis (TB) due to prison overcrowding. This situation reflects an inequity in health, understood as an unfair and avoidable difference between individuals and populations. Objective: To estimate the conditions of prison overcrowding as health inequity in prison population suffering from TB in Colombia during 2018. Materials and methods: This is an ecological study to estimate inequities at the national level in prison population through the use of the World Health Organization methodology for the measurement of inequalities. Based on data from the public health surveillance system, the incidence of TB was taken as an indicator and the percentage of overcrowding as an equity stratifier. Simple and complex measures of inequality were calculated. Results: The relative inequality between the lowest and highest quintiles of crowding showed that TB incidence among prison population with the highest crowding was 1.92 times that of the group with the lowest crowding. The inequality index identified an excess of 724 TB cases per 100,000 among those with the highest concentration of overcrowding. The health concentration index was -0.121, which shows that the incidence was concentrated in the group with the most overpopulation. Conclusion: In Colombia, prison population in overcrowded conditions and suffering from TB has to face unfair and avoidable inequalities as compared with those not living in these conditions. Policies are required to reduce overcrowding and improve living conditions in prisons.
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Affiliation(s)
- Martha Patricia López
- Maestría en Salud Pública y Desarrollo Social, Fundación Universitaria del Área Andina, Bogotá, D.C., Colombia.
| | - Adriana Paola Ulloa
- Maestría en Salud Pública y Desarrollo Social, Fundación Universitaria del Área Andina, Bogotá, D.C., Colombia.
| | - Fabio Alberto Escobar
- Maestría en Salud Pública y Desarrollo Social, Fundación Universitaria del Área Andina, Bogotá, D.C., Colombia.
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Montoya-Barthelemy A, Gibson BR, Lee CD, Bade AM, Butler JW, Smith E, Skipworth D, Gutekunst J, Segula MN, Wicken C, Friedman E, Darbari I, Menegas S, Thatai S, Wheeler L. Occupational and Environmental Hazards of Correctional Settings: A Scoping Literature Review From ACOEM's Presidential Task Force on Correctional Institutions. J Occup Environ Med 2022; 64:e172-e182. [PMID: 35244092 DOI: 10.1097/jom.0000000000002440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Maintaining healthful, safe, and productive work environments for workers in correctional settings is a matter of deep consequence to the workers themselves, the institutions they serve, the incarcerated individuals with whom they share space, and inevitably, to our wider community. We hypothesized that an examination of the academic literature would reveal opportunities for an improved approach to research in these settings. METHODS We performed a scoping literature review using search terms related to the occupational and environmental health of workers in correctional environments, limited to studies performed in the United States. RESULTS A total of 942 studies underwent title and abstract screening, 342 underwent full-text review, and 147 underwent data extraction by a single reviewer. The results revealed a body of literature that tends strongly toward analyses of stress and burnout of correctional staff, largely based on self-reported data from cross-sectional surveys. Those studies related to physical health were predominantly represented by topics of infectious disease. There were few or no studies examining exposures or outcomes related to diagnosable mental health conditions, musculoskeletal injury, environmental hazards, medical or mental health staff, immigration detention settings, or regarding incarcerated workers. There were very few studies that were experimental, longitudinal, or based on objective data. DISCUSSION The National Institute for Occupational Safety and Health (NIOSH) has promulgated a research strategy for correctional officers that should guide future research for all workers in correctional settings, but realization of these goals will rely upon multidisciplinary collaboration, specific grants to engage researchers, and an improved understanding of the barriers inherent to correctional research, all while maintaining rigorous protection for incarcerated persons as an especially vulnerable population.
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Not Only COVID-19: Prevalence and Management of Latent Mycobacterium Tuberculosis Infection in Three Penitentiary Facilities in Southern Italy. Healthcare (Basel) 2022; 10:healthcare10020386. [PMID: 35206999 PMCID: PMC8872010 DOI: 10.3390/healthcare10020386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/14/2022] [Accepted: 02/16/2022] [Indexed: 11/16/2022] Open
Abstract
Latent Mycobacterium tuberculosis infection (LTBI) and active tuberculosis in prisoners are higher than the general population and are two public health concerns, especially in low- and middle-income countries. We conducted a cross-sectional study to determine the prevalence and the factors associated with LTBI among the inmate population detained in three Southern Italian penitentiaries. Tuberculin intradermal reaction skin test was performed on the inmates who agreed to participate in the study. In case of positivity, the QuantiFERON-TB test was performed. In those positive to QuantiFERON, chest X-ray films were performed, and treatment initiated. A total of 381 inmates accepted to participate. The prevalence of LTBI was 4.2%. In the analysis, LTBI was associated with no self-reported contact with active tuberculosis patients within the prisons, and 10% of subjects admitted the use of inhaled drugs. No HIV coinfections were found. No cases of active symptomatic tuberculosis were identified during the study period. Our results confirm that incarceration increases the risk of tuberculous infection. Non-EU nationality and a history of drug addiction appear to be major risk factors for tuberculosis infection in the penitentiary setting. Reinforcing tuberculosis control is essential to prevent its transmission in prisons.
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Moreira TR, Passos IBJ, Bueno JVL, Maffacciolli R, Colodette RM, Miguel PS. Prevalence of multidrug-resistant tuberculosis in prisons: Systematic review and meta-analysis. Indian J Med Microbiol 2022; 40:193-199. [PMID: 35120789 DOI: 10.1016/j.ijmmb.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 11/08/2021] [Accepted: 01/15/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND In the context of prisons, multidrug-resistant tuberculosis (MDR-TB) is a major problem. In this article, we estimate the prevalence of MDR-TB among the population deprived of freedom from countries in South America, Europe, Asia and Africa. METHODS The articles were retrieved through systematic search at four databases (EMBASE, CINAHL, LILACS and MEDILINE). The meta-analysis was developed by the random effect model, using the Mantel-Haenszel method, with presentation of the aggregated results through the forest plot. The degree of heterogeneity between the studies was verified using Cochran's Q test and I2. RESULTS Of the 102 articles analyzed, 21 were included in this systematic review. The analysis showed heterogeneity indicated by the Q test (P < 0.001) and I2 statistics (I2 = 50.52%). The funnel graph and Egger test (P < 0.830) showed symmetry between investigations. The grouped prevalence of MDR-TB was 0.48% (95% CI: 0.02 to 1.32), advancing to 1.15 (95% CI: 0.15 to 2.73) when culture and sensitivity test were considered by the authors. No specific characteristics were significantly associated with differences in prevalence rates in the population deprived of freedom. CONCLUSION The study reaffirms the magnitude of MDR-TB in the population deprived of freedom in the world context. Political and technical-scientific efforts should be mobilized to mitigate TB and MDR-TB in prisons and for successful national and international disease control programs.
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Affiliation(s)
- Tiago Ricardo Moreira
- Doutor e Saúde Pública. Departamento de Medicina e Enfermagem, Universidade Federal de Viçosa, Viçosa-MG, Brazil.
| | | | - João Vitor L Bueno
- Graduado Em Medicina. Departamento de Medicina e Enfermagem, Universidade Federal de Viçosa, Viçosa-MG, Brazil.
| | - Rosana Maffacciolli
- Doutora Em Enfermagem, Escola de Enfermagem, Universidade Federal Do Rio Grande Do Sul, Porto Alegre-RS, Brazil.
| | - Renata Maria Colodette
- Mestre em Ciências da Saúde. Escola Nacional de Saúde Pública Sérgio Arouca. Fundação Oswaldo Cruz, Rio de Janeiro-RJ, Brazil.
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Herrera M, Keynan Y, López L, Marín D, Arroyave L, Arbeláez MP, Vélez L, Rueda ZV. Incidence and Risk Factors Associated with Latent Tuberculosis Infection and Pulmonary Tuberculosis among People Deprived of Liberty in Colombian Prisons. Am J Trop Med Hyg 2022; 106:66-74. [PMID: 34872056 PMCID: PMC8733511 DOI: 10.4269/ajtmh.20-0307] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 08/30/2021] [Indexed: 01/03/2023] Open
Abstract
People deprived of liberty (PDL) are at high risk of acquiring Mycobacterium tuberculosis infection (latent tuberculosis infection [LTBI]) and progressing to active tuberculosis (TB). We sought to determine the incidence rates and factors associated with LTBI and active TB in Colombian prisons. Using information of four cohort studies, we included 240 PDL with two-step tuberculin skin test (TST) negative and followed them to evaluate TST conversion, as well as, 2,134 PDL that were investigated to rule out active TB (1,305 among people with lower respiratory symptoms of any duration, and 829 among people without respiratory symptoms and screened for LTBI). Latent tuberculosis infection incidence rate was 2,402.88 cases per 100,000 person-months (95% CI 1,364.62-4,231.10) in PDL with short incarceration at baseline, and 419.66 cases per 100,000 person-months (95% CI 225.80-779.95) in individuals with long incarceration at baseline (who were enrolled for the follow after at least 1 year of incarceration). The TB incidence rate among PDL with lower respiratory symptoms was 146.53 cases/100,000 person-months, and among PDL without respiratory symptoms screened for LTBI the incidence rate was 19.49 cases/100,000 person-months. History of Bacillus Calmette-Guerin vaccination decreased the risk of acquiring LTBI among PDL who were recently incarcerated. Female sex, smoked drugs, and current cigarette smoking were associated with an increased risk of developing active TB. This study shows that PDL have high risk for LTBI and active TB. It is important to perform LTBI testing at admission to prison, as well as regular follow-up to control TB in prisons.
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Affiliation(s)
| | - Yoav Keynan
- Department of Medical Microbiology and Infectious Diseases, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lucelly López
- Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Diana Marín
- Universidad Pontificia Bolivariana, Medellín, Colombia
| | | | | | - Lázaro Vélez
- Universidad de Antioquia, Medellín, Antioquia, Colombia
| | - Zulma Vanessa Rueda
- Department of Medical Microbiology and Infectious Diseases, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, Manitoba, Canada;,Universidad Pontificia Bolivariana, Medellín, Colombia;,Address correspondence to Zulma Vanessa Rueda, Department of Medical Microbiology and Infectious Diseases, Rady Faculty of Health Sciences, University of Manitoba, Rm 512, Basic Medical Sciences Building, 745 Bannatyne Avenue, Winnipeg, MB, R3E 0J9. E-mail:
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Digital Chest X-ray with Computer-aided Detection for TB Screening within Correctional Facilities. Ann Am Thorac Soc 2021; 19:1313-1319. [PMID: 34914539 DOI: 10.1513/annalsats.202103-380oc] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
RATIONALE Realizing the Global Plan to End TB will require reaching at least 90% of people in key populations such as inmates through optimizing case-finding approaches. OBJECTIVES To evaluate the addition of digital chest x-ray (d-CXR) with computer-aided detection (CAD) to symptoms on TB yield among inmates. METHODS Consecutive adult inmates from four correctional facilities in South Africa were screened for TB using symptoms and d-CXR. Any person with >1 symptom or CAD>50 provided two sputa for liquid culture and GeneXpert MTB/RIF Ultra (Xpert Ultra) testing. In a sample of 800 symptom-negative inmates with CAD<50, Xpert Ultra testing was also conducted. TB yield was defined as the proportion of new bacteriologically-confirmed TB patients identified. RESULTS We enrolled 3,576 participants; 99.6% male, median age of 34 years (IQR: 28-41), and 584 (16.3%) HIV-positive. Of those screened, 867 (24.2%) participants required investigation [394 (11.2%) symptomatic, 685 (19.1%) on abnormal CAD and 867 (24.2%) with either]. Sputum was taken in 747 (86.2%) participants, with 28 (7.8 per 1000 population) new TB cases diagnosed. Based on hypothesized screening modalities, yield would have been 3.6 per 1,000 population on symptoms alone and 7.0 per 1,000 population on d-CXR alone. Amongst an additional 800 inmates tested whom initially screened symptom-negative and CAD<50, five TB cases were diagnosed. No difference in TB yield when comparing Xpert Ultra against culture (5.6 vs. 4.8 per 1,000 population; p=0.21). CONCLUSIONS The addition of d-CXR identified two times more undiagnosed TB than patients investigated on symptoms alone. Complimentary use of d-CXR may potentially overcome subjectivity inherent in symptom screening alone for identifying TB in this population.
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Duedu KO, Aninagyei E, Akila DA, Kweku M. Active tuberculosis case findings in Ghanaian health facilities: effectiveness and sensitivity of the symptoms-based screening tool. Pan Afr Med J 2021; 40:111. [PMID: 34887985 PMCID: PMC8627140 DOI: 10.11604/pamj.2021.40.111.28798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 09/26/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction the National Tuberculosis Programme (NTP), Ghana, introduced Symptoms-Based Screening (SBS) Tool for TB case finding. This study aimed to determine the challenges and limitations associated with the use of the SBS Tool for active tuberculosis case finding in Ghanaian health facility settings. Methods this study targeted suspected TB patients attending two health facilities in the Ho Municipality, Ghana. Initially, suspected TB patients were screened with the SBS tool and presumptive patients subsequently tested for M. tuberculosis using microscopy and geneXpert assay. Additionally, health personnel were interviewed to assess the user-friendliness, challenges, and limitations associated with the tool. Results of 636 presumptive TB patients identified, 1.73% had tuberculosis. Coughing for > 2 weeks (χ2=24.8; p<0.05); chest pain (χ2=28.3; p<0.01) and night sweat (χ2=34.8; p<0.05) associated significantly with M. tuberculosis infection status. The health personnel found the tool to be not user-friendly and it also lacked indicators to identify other vulnerable individuals such as diabetics, cigarette smokers, alcoholics, immunocompromised, and malnourished individuals. Therefore, the SBS tool was found not to be sensitive enough to identify probable cases. Conclusion the SBS tool is useful for detecting active TB cases, however, it must be improved to identify vulnerable individuals such as diabetics, immunosuppressed, and malnourished.
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Affiliation(s)
- Kwabena Obeng Duedu
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Hohoe, Ghana
| | - Enoch Aninagyei
- Department of Biomedical Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Hohoe, Ghana
| | - Diana Ayinpokbila Akila
- Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Margaret Kweku
- Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
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Amirkhani A, Humayun M, Ye W, Worku Y, Yang Z. Patient characteristics associated with different types of prison TB: an epidemiological analysis of 921 TB cases diagnosed at an Ethiopian prison. BMC Pulm Med 2021; 21:334. [PMID: 34706685 PMCID: PMC8555052 DOI: 10.1186/s12890-021-01699-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/08/2021] [Indexed: 12/03/2022] Open
Abstract
Background Despite incarcerated population being at an increased risk of tuberculosis (TB) and serving as a potential source of TB transmission for the general population, prison TB remains understudied. Given its adverse impact on progress towards TB elimination, World Health Organization (WHO) has identified prison TB research as a top priority to guide TB treatment/control interventions. Methods We retrospectively analyzed 921 notified TB cases that were diagnosed at Kality Federal Prison, Ethiopia during 2009–2017. To assess trends of microbiologically confirmed pulmonary TB (PTB), extra-pulmonary TB (EPTB), and TB-HIV co-infection, an ecological analysis of aggregated cases was used to report trends over time. Additionally, we used multivariable log binomial regression to identify patient characteristics associated with microbiologically confirmed PTB, EPTB, and TB-HIV co-infection. Results Microbiologically confirmed PTB proportion increased over time. Young age was identified as an important risk factor for EPTB (adjusted prevalence ratio [aPR] = 1.74, 95% CI 0.97, 3.13) while HIV coinfection was negatively associated with EPTB (aPR = 0.73, 95% CI 0.55, 0.97). While previous TB history was associated with a lower likelihood of EPTB (aPR = 0.42, 95% CI 0.25, 0.70), it was associated with an increased risk of TB-HIV coinfection (aPR = 1.37, 95% CI 1.10, 1.71). Clinically diagnosed PTB patients were more likely to have TB-HIV coinfection compared to microbiologically confirmed PTB patients (aPR = 1.32, 95% CI 1.02, 1.72). Conclusions Increasing proportion of microbiologically confirmed PTB may suggest delayed access to treatment, severe disease and increased risk of intramural transmission. Associations with clinical/demographic factors varied for different types of TB and were not always consistent with what has been previously reported for the general population, necessitating the need to refocus prison TB control/treatment strategies based on context specific epidemiological factors. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-021-01699-w.
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Affiliation(s)
- Asmah Amirkhani
- University of Michigan, M5124 SPH II, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA
| | - Maheen Humayun
- University of Michigan, M5124 SPH II, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA
| | - Wen Ye
- University of Michigan, M5124 SPH II, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA
| | - Yoseph Worku
- St. Paul's Hospital Millennium Medical College, Swaziland St, Gulelle Sub-City, P.O. Box 40742, Addis Ababa, Ethiopia.
| | - Zhenhua Yang
- University of Michigan, M5124 SPH II, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA.
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Goscé L, Abou Jaoude GJ, Kedziora DJ, Benedikt C, Hussain A, Jarvis S, Skrahina A, Klimuk D, Hurevich H, Zhao F, Fraser-Hurt N, Cheikh N, Gorgens M, Wilson DJ, Abeysuriya R, Martin-Hughes R, Kelly SL, Roberts A, Stuart RM, Palmer T, Panovska-Griffiths J, Kerr CC, Wilson DP, Haghparast-Bidgoli H, Skordis J, Abubakar I. Optima TB: A tool to help optimally allocate tuberculosis spending. PLoS Comput Biol 2021; 17:e1009255. [PMID: 34570767 PMCID: PMC8496838 DOI: 10.1371/journal.pcbi.1009255] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 10/07/2021] [Accepted: 07/07/2021] [Indexed: 12/02/2022] Open
Abstract
Approximately 85% of tuberculosis (TB) related deaths occur in low- and middle-income countries where health resources are scarce. Effective priority setting is required to maximise the impact of limited budgets. The Optima TB tool has been developed to support analytical capacity and inform evidence-based priority setting processes for TB health benefits package design. This paper outlines the Optima TB framework and how it was applied in Belarus, an upper-middle income country in Eastern Europe with a relatively high burden of TB. Optima TB is a population-based disease transmission model, with programmatic cost functions and an optimisation algorithm. Modelled populations include age-differentiated general populations and higher-risk populations such as people living with HIV. Populations and prospective interventions are defined in consultation with local stakeholders. In partnership with the latter, demographic, epidemiological, programmatic, as well as cost and spending data for these populations and interventions are then collated. An optimisation analysis of TB spending was conducted in Belarus, using program objectives and constraints defined in collaboration with local stakeholders, which included experts, decision makers, funders and organisations involved in service delivery, support and technical assistance. These analyses show that it is possible to improve health impact by redistributing current TB spending in Belarus. Specifically, shifting funding from inpatient- to outpatient-focused care models, and from mass screening to active case finding strategies, could reduce TB prevalence and mortality by up to 45% and 50%, respectively, by 2035. In addition, an optimised allocation of TB spending could lead to a reduction in drug-resistant TB infections by 40% over this period. This would support progress towards national TB targets without additional financial resources. The case study in Belarus demonstrates how reallocations of spending across existing and new interventions could have a substantial impact on TB outcomes. This highlights the potential for Optima TB and similar modelling tools to support evidence-based priority setting. Tuberculosis (TB) remains a leading global cause of death and morbidity, and 85% of deaths occur in countries where resources for TB care and control are limited. Many countries cannot finance all TB interventions or technologies, which means difficult decisions on what to prioritise and publically finance. Modelling tools can help decision-makers set priorities based on evidence, in a systematic and transparent way. This study presents Optima TB, a tool that estimates which allocations of spending across interventions will most likely maximise specified objectives—such as minimising TB deaths, prevalence and incidence. In partnership with local decision-makers and stakeholders, Optima TB was applied in Belarus. Recommendations from the model findings include focussing investment on outpatient rather than inpatient care and actively finding people with TB (e.g. through contact tracing) rather than mass testing of the population. The recommended reallocations of spending could reduce TB prevalence and deaths by up to 45% and 50%, respectively, by 2035 for the same amount of spending. Key stakeholders were engaged throughout the analysis and findings and uncertainty around the results were clearly communicated with decision-makers. The timeliness of the results helped inform national dialogue on TB care reform, among other key policy discussions.
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Affiliation(s)
- Lara Goscé
- University College London, London, United Kingdom
- * E-mail:
| | | | | | - Clemens Benedikt
- World Bank, Washington, District of Columbia, United States of America
| | | | | | - Alena Skrahina
- The Republican Scientific and Practice Centre for Pulmonology and Tuberculosis, Minsk, Belarus
| | - Dzmitry Klimuk
- The Republican Scientific and Practice Centre for Pulmonology and Tuberculosis, Minsk, Belarus
| | - Henadz Hurevich
- The Republican Scientific and Practice Centre for Pulmonology and Tuberculosis, Minsk, Belarus
| | - Feng Zhao
- World Bank, Washington, District of Columbia, United States of America
| | | | - Nejma Cheikh
- World Bank, Washington, District of Columbia, United States of America
| | - Marelize Gorgens
- World Bank, Washington, District of Columbia, United States of America
| | - David J. Wilson
- World Bank, Washington, District of Columbia, United States of America
| | | | | | | | | | - Robyn M. Stuart
- Burnet Institute, Melbourne, Australia
- University of Copenhagen, Copenhagen, Denmark
| | - Tom Palmer
- University College London, London, United Kingdom
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Taherpour S, Bazzaz MM, Naderi H, Samarghandian S, Amirabadizadeh A, Farkhondeh T, Abedi F. A systematic and meta-analysis study on the prevalence of tuberculosis and relative risk factors for prisoners in Iran. Infect Disord Drug Targets 2021; 22:e130921196422. [PMID: 34517810 DOI: 10.2174/1871526521666210913111612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/20/2021] [Accepted: 07/09/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION This study aimed to evaluate the incidence of Tuberculosis (TB) among prisoners in Iran, by performing a systematic and meta-analysis study on the related articles. METHODOLOGY Scopus, Iran doc, Cochrane, Pubmed, Medline, Embase and Iran Medex, Magiran, SID, Google Scholar, and EBSCO were searched. After quality assessment of the articles, a fixed or random model, as appropriate, was used to pool the results in a meta-analysis. Heterogeneity between the studies was assessed using I-square and Q-test. RESULTS The overall sample size of included studies was 19562 that 64 of them were with TB. The highest prevalence of tuberculosis was related to the study of Rasht, 517 in 100,000 but the lowest rate was related to the study of Sought Khorasan, 25 in 100,000. The ES of the random effect model is 0.003 (95% CI, 0.001-0.005) and p-value <0.0001. The Higgins' I2 of all studies is 86.55%, and the p-value of the Cochrane Q statistics is <0.001, indicating that there is heterogeneity. Based on the Egger regression plot (t=2.18, p = 0.08, CI 95%: -0.001, 0.005) no publication bias existed. CONCLUSION The frequency of TB among the prisoners in Iran was low. Due to important limitations in this study, it is not possible to indicate the exact prevalence of TB among prisoners in Iran and compare this with the general population. More studies are needed to assess the related risk factor for designing health interventions plan to decrease the incidence rate of TB among prisoners.
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Affiliation(s)
- Sedigheh Taherpour
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand. Iran
| | - Mojtaba Mousavi Bazzaz
- Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad. Iran
| | - Hamidreza Naderi
- Department of Infectious Diseases, School of Medicine, Mashhad University of Medical Sciences, Mashhad. Iran
| | - Saeed Samarghandian
- Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur. Iran
| | - Alireza Amirabadizadeh
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran. Iran
| | - Tahereh Farkhondeh
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand. Iran
| | - Farshid Abedi
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand. Iran
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Dadu A, Ciobanu A, Hovhannesyan A, Alikhanova N, Korotych O, Gurbanova E, Mehdiyev R, Doltu S, Gozalov O, Ahmedov S, Dara M. Tuberculosis Notification Trends and Treatment Outcomes in Penitentiary and Civilian Health Care Sectors in the WHO European Region. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189566. [PMID: 34574488 PMCID: PMC8466779 DOI: 10.3390/ijerph18189566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 11/16/2022]
Abstract
SETTING Tuberculosis (TB) morbidity in penitentiary sectors is one of the major barriers to ending TB in the World Health Organization (WHO) European Region. OBJECTIVES AND DESIGN a comparative analysis of TB notification rates during 2014-2018 and of treatment outcomes in the civilian and penitentiary sectors in the WHO European Region, with an assessment of risks of developing TB among people experience incarceration. RESULTS in the WHO European Region, incident TB rates in inmates were 4-24 times higher than in the civilian population. In 12 eastern Europe and central Asia (EECA) countries, inmates compared to civilians had higher relative risks of developing TB (RR = 25) than in the rest of the region (RR = 11), with the highest rates reported in inmates in Azerbaijan, Kazakhstan, Kyrgyzstan, Republic of Moldova, Russian Federation, and Ukraine. The average annual change in TB notification rates between 2014 and 2018 was -7.0% in the civilian sector and -10.9% in the penitentiary sector. A total of 15 countries achieved treatment success rates of over 85% for new penitentiary sector TB patients, the target for the WHO European Region. In 10 countries, there were no significant differences in treatment outcomes between civilian and penitentiary sectors. CONCLUSION 42 out of 53 (79%) WHO European Region countries reported TB data for the selected time periods. Most countries in the region achieved a substantial decline in TB burden in prisons, which indicates the effectiveness of recent interventions in correctional institutions. Nevertheless, people who experience incarceration remain an at-risk population for acquiring infection, developing active disease and unfavourable treatment outcomes. Therefore, TB prevention and care practices in inmates need to be improved.
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Affiliation(s)
- Andrei Dadu
- Regional Office for Europe, World Health Organization, 2100 Copenhagen, Denmark; (A.H.); (O.K.); (O.G.); (M.D.)
- Correspondence: ; Tel.: +45-4533-6609
| | - Ana Ciobanu
- Health Primary Care Department, University of Medicine and Pharmacy ‘N. Testemitanu’, 2004 Chisinau, Moldova;
| | - Araksya Hovhannesyan
- Regional Office for Europe, World Health Organization, 2100 Copenhagen, Denmark; (A.H.); (O.K.); (O.G.); (M.D.)
| | - Natavan Alikhanova
- Main Medical Department of the Ministry of Justice of Azerbaijan Republic, Baku AZ1000, Azerbaijan; (N.A.); (R.M.)
| | - Oleksandr Korotych
- Regional Office for Europe, World Health Organization, 2100 Copenhagen, Denmark; (A.H.); (O.K.); (O.G.); (M.D.)
| | - Elmira Gurbanova
- WHO Collaborating Centre on Prevention and Control of TB in Prisons, Baku AZ1000, Azerbaijan;
| | - Rafael Mehdiyev
- Main Medical Department of the Ministry of Justice of Azerbaijan Republic, Baku AZ1000, Azerbaijan; (N.A.); (R.M.)
| | - Svetlana Doltu
- Council for Preventing and Eliminating Discrimination and Ensuring Equality, 2004 Chisinau, Moldova;
| | - Ogtay Gozalov
- Regional Office for Europe, World Health Organization, 2100 Copenhagen, Denmark; (A.H.); (O.K.); (O.G.); (M.D.)
| | - Sevim Ahmedov
- United States Agency for International Development, Arlington, VA 22202, USA;
| | - Masoud Dara
- Regional Office for Europe, World Health Organization, 2100 Copenhagen, Denmark; (A.H.); (O.K.); (O.G.); (M.D.)
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41
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Bilmumad B, Liabsuetrakul T, Ngamtrairai N, Chongsuvivatwong V. Pulmonary tuberculosis among prisoners in Southern Thailand: prevalence and its association with imprisonment status. Int J Prison Health 2021; ahead-of-print:10.1108/IJPH-01-2021-0012. [PMID: 34464526 PMCID: PMC9719586 DOI: 10.1108/ijph-01-2021-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This study aims to measure the prevalence of pulmonary tuberculosis (PTB), its association with imprisonment status and to document the treatment success rate (TSR) among prisoners in Songkhla province, Southern Thailand. DESIGN/METHODOLOGY/APPROACH A retrospective cross-sectional study was conducted in five prisons in Songkhla province, including all prisoners in the fiscal of year 2019, who had an annual chest radiography (CXR) screening result. Information of prisoners who had been imprisoned from 1 October 2018 to 30 September 2019, were reviewed for PTB diagnosis. Imprisonment status and other associated factors with PTB were analyzed using multiple logistic regression. FINDINGS The prevalence of PTB was 2.72%. Prisoners having new or transfer-in status were more likely to have PTB. Those aged 40-80 years, who had smoked for ten years or more, or who were underweight, had higher odds of having PTB. TSR among prisoners with PTB in this study was 94.9%. ORIGINALITY/VALUE The prevalence of PTB among prisoners having annual CXR screening was high. Detection of PTB was higher among new or transfer-in prisoners; therefore, the CXR for PTB screening before admission to prison should be performed to prevent transmission to other prisoners.
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Affiliation(s)
- Bintinee Bilmumad
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand, and Songkhla Correctional Institution for Drug Addicts, Department of Corrections Thailand, Mueang, Thailand
| | - Tippawan Liabsuetrakul
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Nipa Ngamtrairai
- Songkhla Central Prison, Department of Corrections Thailand, Mueang, Thailand
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42
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Blumberg S, Lu P, Hoover CM, Lloyd-Smith JO, Kwan AT, Sears D, Bertozzi SM, Worden L. Mitigating outbreaks in congregate settings by decreasing the size of the susceptible population. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.07.05.21260043. [PMID: 34268514 PMCID: PMC8282103 DOI: 10.1101/2021.07.05.21260043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
While many transmission models have been developed for community spread of respiratory pathogens, less attention has been given to modeling the interdependence of disease introduction and spread seen in congregate settings, such as prisons or nursing homes. As demonstrated by the explosive outbreaks of COVID-19 seen in congregate settings, the need for effective outbreak prevention and mitigation strategies for these settings is critical. Here we consider how interventions that decrease the size of the susceptible populations, such as vaccination or depopulation, impact the expected number of infections due to outbreaks. Introduction of disease into the resident population from the community is modeled as a branching process, while spread between residents is modeled via a compartmental model. Control is modeled as a proportional decrease in both the number of susceptible residents and the reproduction number. We find that vaccination or depopulation can have a greater than linear effect on anticipated infections. For example, assuming a reproduction number of 3.0 for density-dependent COVID-19 transmission, we find that reducing the size of the susceptible population by 20% reduced overall disease burden by 47%. We highlight the California state prison system as an example for how these findings provide a quantitative framework for implementing infection control in congregate settings. Additional applications of our modeling framework include optimizing the distribution of residents into independent residential units, and comparison of preemptive versus reactive vaccination strategies.
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Affiliation(s)
- Seth Blumberg
- University of California San Francisco, Francis I. Proctor Foundation, San Francisco, California, USA
- CDC MInD Healthcare Program
- University of California San Francisco, Department of Medicine, San Francisco, California, USA
| | - Phoebe Lu
- University of California San Francisco, Francis I. Proctor Foundation, San Francisco, California, USA
- CDC MInD Healthcare Program
| | - Christopher M. Hoover
- University of California San Francisco, Francis I. Proctor Foundation, San Francisco, California, USA
- CDC MInD Healthcare Program
| | - James O. Lloyd-Smith
- University of California Los Angeles, Department of Ecology and Evolutionary Biology, Los Angeles, California, USA
| | - Ada T. Kwan
- University of California San Francisco, Department of Medicine, San Francisco, California, USA
| | - David Sears
- University of California San Francisco, Department of Medicine, San Francisco, California, USA
| | - Stefano M. Bertozzi
- University of California, Berkeley, California, USA
- University of Washington, Seattle, Washington, USA
- National Institute of Public Health, Mexico, Cuernavaca, Mexico
| | - Lee Worden
- University of California San Francisco, Francis I. Proctor Foundation, San Francisco, California, USA
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43
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Gygli SM, Loiseau C, Jugheli L, Adamia N, Trauner A, Reinhard M, Ross A, Borrell S, Aspindzelashvili R, Maghradze N, Reither K, Beisel C, Tukvadze N, Avaliani Z, Gagneux S. Prisons as ecological drivers of fitness-compensated multidrug-resistant Mycobacterium tuberculosis. Nat Med 2021; 27:1171-1177. [PMID: 34031604 PMCID: PMC9400913 DOI: 10.1038/s41591-021-01358-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 04/19/2021] [Indexed: 02/04/2023]
Abstract
Multidrug-resistant tuberculosis (MDR-TB) accounts for one third of the annual deaths due to antimicrobial resistance1. Drug resistance-conferring mutations frequently cause fitness costs in bacteria2-5. Experimental work indicates that these drug resistance-related fitness costs might be mitigated by compensatory mutations6-10. However, the clinical relevance of compensatory evolution remains poorly understood. Here we show that, in the country of Georgia, during a 6-year nationwide study, 63% of MDR-TB was due to patient-to-patient transmission. Compensatory mutations and patient incarceration were independently associated with transmission. Furthermore, compensatory mutations were overrepresented among isolates from incarcerated individuals that also frequently spilled over into the non-incarcerated population. As a result, up to 31% of MDR-TB in Georgia was directly or indirectly linked to prisons. We conclude that prisons fuel the epidemic of MDR-TB in Georgia by acting as ecological drivers of fitness-compensated strains with high transmission potential.
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Affiliation(s)
- Sebastian M. Gygli
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland.,These authors contributed equally: Sebastian M. Gygli, Chloé Loiseau
| | - Chloé Loiseau
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland.,These authors contributed equally: Sebastian M. Gygli, Chloé Loiseau
| | - Levan Jugheli
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland.,National Center for Tuberculosis and Lung Diseases (NCTLD), Tbilisi, Georgia
| | - Natia Adamia
- National Center for Tuberculosis and Lung Diseases (NCTLD), Tbilisi, Georgia
| | - Andrej Trauner
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Miriam Reinhard
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Amanda Ross
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Sonia Borrell
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | | | - Nino Maghradze
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland.,National Center for Tuberculosis and Lung Diseases (NCTLD), Tbilisi, Georgia
| | - Klaus Reither
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Christian Beisel
- Department of Biosystems Science and Engineering, ETH Zürich, Basel, Switzerland
| | - Nestani Tukvadze
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland.,National Center for Tuberculosis and Lung Diseases (NCTLD), Tbilisi, Georgia
| | - Zaza Avaliani
- National Center for Tuberculosis and Lung Diseases (NCTLD), Tbilisi, Georgia
| | - Sebastien Gagneux
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Correspondence and requests for materials should be addressed to S.G.
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44
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Gray BJ, Perrett SE, Gudgeon B, Shankar AG. Investigating the prevalence of latent Tuberculosis infection in a UK remand prison. J Public Health (Oxf) 2021; 42:e12-e17. [PMID: 30608602 DOI: 10.1093/pubmed/fdy219] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 01/11/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) remains a major global public health issue and in low-incidence countries guidance identifies the need to screen for and treat latent tuberculosis infection (LTBI) with the prison environment recommended as a setting to perform LTBI screening. This study describes the findings of a LTBI screening programme which took place on entry to a remand prison in the UK. METHODS Testing for LTBI was undertaken alongside screening for blood borne viruses in 567 men. During the screening process, information was collected on demographic variables and also specific risk factors based on World Health Organization recommendations. LTBI analysis was performed using Interferon-Gamma Release Assay (IGRA) technique. RESULTS In total, 40 men returned an IGRA positive result (7.1%). However, irrespective of IGRA/LTBI status there was a substantial burden of risk factors present including previous prison stay, history of substance misuse and no BCG vaccination. Non-White ethnicity, a history of substance misuse and age over 34 years were the most significant factors in identifying individuals who would require treatment for LTBI (Positive IGRA result). CONCLUSIONS The study further demonstrates that the prevalence of LTBI remains increased within the prison environment and is a setting that still requires effective LTBI management.
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Affiliation(s)
- Benjamin J Gray
- Policy, Research and International Development, Public Health Wales NHS Trust, Cardiff, UK
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45
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Strodel R, Dayton L, Garrison-Desany HM, Eber G, Beyrer C, Arscott J, Rubenstein L, Sufrin C. COVID-19 vaccine prioritization of incarcerated people relative to other vulnerable groups: An analysis of state plans. PLoS One 2021; 16:e0253208. [PMID: 34129620 PMCID: PMC8205184 DOI: 10.1371/journal.pone.0253208] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/28/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Carceral facilities are epicenters of the COVID-19 pandemic, placing incarcerated people at an elevated risk of COVID-19 infection. Due to the initial limited availability of COVID-19 vaccines in the United States, all states have developed allocation plans that outline a phased distribution. This study uses document analysis to compare the relative prioritization of incarcerated people, correctional staff, and other groups at increased risk of COVID-19 infection and morbidity. METHODS AND FINDINGS We conducted a document analysis of the vaccine dissemination plans of all 50 US states and the District of Columbia using a triple-coding method. Documents included state COVID-19 vaccination plans and supplemental materials on vaccine prioritization from state health department websites as of December 31, 2020. We found that 22% of states prioritized incarcerated people in Phase 1, 29% of states in Phase 2, and 2% in Phase 3, while 47% of states did not explicitly specify in which phase people who are incarcerated will be eligible for vaccination. Incarcerated people were consistently not prioritized in Phase 1, while other vulnerable groups who shared similar environmental risk received this early prioritization. States' plans prioritized in Phase 1: prison and jail workers (49%), law enforcement (63%), seniors (65+ years, 59%), and long-term care facility residents (100%). CONCLUSIONS This study demonstrates that states' COVID-19 vaccine allocation plans do not prioritize incarcerated people and provide little to no guidance on vaccination protocols if they fall under other high-risk categories that receive earlier priority. Deprioritizing incarcerated people for vaccination misses a crucial opportunity for COVID-19 mitigation. It also raises ethical and equity concerns. As states move forward with their vaccine distribution, further work must be done to prioritize ethical allocation and distribution of COVID-19 vaccines to incarcerated people.
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Affiliation(s)
- Rachel Strodel
- Johns Hopkins School of Medicine, Baltimore, MD, United States of America
| | - Lauren Dayton
- Department of Health, Behavior, and Society, Johns Hopkins School of Public Health, Baltimore, MD, United States of America
| | - Henri M. Garrison-Desany
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, United States of America
| | - Gabriel Eber
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, United States of America
| | - Chris Beyrer
- Johns Hopkins School of Medicine, Baltimore, MD, United States of America
- Department of Health, Behavior, and Society, Johns Hopkins School of Public Health, Baltimore, MD, United States of America
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, United States of America
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, United States of America
| | - Joyell Arscott
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, United States of America
| | - Leonard Rubenstein
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, United States of America
| | - Carolyn Sufrin
- Johns Hopkins School of Medicine, Baltimore, MD, United States of America
- Department of Health, Behavior, and Society, Johns Hopkins School of Public Health, Baltimore, MD, United States of America
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46
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Robsky KO, Mukiibi J, Nalutaaya A, Kitonsa PJ, Isooba D, Nakasolya O, Baik Y, Kamoga CE, Kendall EA, Katamba A, Dowdy DW. Spatial distribution of TB among individuals with a history of incarceration. Int J Tuberc Lung Dis 2021; 25:513-515. [PMID: 34049618 PMCID: PMC8730719 DOI: 10.5588/ijtld.21.0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- K O Robsky
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda
| | - J Mukiibi
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda
| | - A Nalutaaya
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda
| | - P J Kitonsa
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda
| | - D Isooba
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda
| | - O Nakasolya
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda
| | - Y Baik
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda
| | - C E Kamoga
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda
| | - E A Kendall
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda, Johns Hopkins School of Medicine, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - A Katamba
- Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda, Clinical Epidemiology and Biostatistics Unit, Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - D W Dowdy
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, Uganda Tuberculosis Implementation Research Consortium, Makerere University, Kampala, Uganda, Johns Hopkins School of Medicine, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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47
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Ohata PJ, Su Lwin HM, Han WM, Khwairakpam G, Tangkijvanich P, Matthews GV, Avihingsanon A. Elimination of hepatitis C among HIV-positive population in Asia: old and new challenges. Future Virol 2021. [DOI: 10.2217/fvl-2021-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Hepatitis C virus (HCV) prevalence is high among people living with HIV co-infected with HCV, people who inject drugs, men who have sex with men and inmates in correctional settings. The barriers to eliminate HCV among these key populations include diagnosis challenges, lack of awareness, discrimination and stigmatization. In addition, scaling up of HCV treatment has been a challenge in Asia–Pacific with the lack of national policies, targets and unavailability of appropriate direct-acting antivirals regimens. In order to achieve HCV micro elimination within these high-risk populations, novel strategies to improve the cascade of care from diagnosis to treatment with direct-acting antivirals, complemented by behavioral change interventions, harm reduction services for people who inject drugs, civil society led advocacy and policies from the government, will be necessary.
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Affiliation(s)
- Pirapon June Ohata
- HIV-NAT, Thai Red Cross – AIDS Research Centre, 104 Ratchadamri Road, Pathumwan, Bangkok, 10330, Thailand
| | - Hay Mar Su Lwin
- HIV-NAT, Thai Red Cross – AIDS Research Centre, 104 Ratchadamri Road, Pathumwan, Bangkok, 10330, Thailand
| | - Win Min Han
- HIV-NAT, Thai Red Cross – AIDS Research Centre, 104 Ratchadamri Road, Pathumwan, Bangkok, 10330, Thailand
| | - Giten Khwairakpam
- TREAT Asia, Exchange Tower, 388 Sukhumvit Road, Suite 2104, Klongtoey, Bangkok, 10110, Thailand
| | - Pisit Tangkijvanich
- Center of Excellence in Hepatitis & Liver Cancer, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Gail V Matthews
- The Kirby Institute, University of New South Wales, NSW, Sydney, 2052, Australia
| | - Anchalee Avihingsanon
- HIV-NAT, Thai Red Cross – AIDS Research Centre, 104 Ratchadamri Road, Pathumwan, Bangkok, 10330, Thailand
- Tuberculosis Research Unit (TB RU), Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
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48
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Minja LT, Hella J, Mbwambo J, Nyandindi C, Omary US, Levira F, Mpagama S, Shimwela M, Okuma J, Gagneux S, Bruce RD, Reither K. High burden of tuberculosis infection and disease among people receiving medication-assisted treatment for substance use disorder in Tanzania. PLoS One 2021; 16:e0250038. [PMID: 33914753 PMCID: PMC8084249 DOI: 10.1371/journal.pone.0250038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/29/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To determine the prevalence of tuberculosis (TB) disease and infection as well as incident TB disease among people who use drugs (PWUD) attending Medication Assisted Treatment (MAT) clinics in Dar-es-Salaam, Tanzania. METHODS In this prospective cohort study, a total of 901 consenting participants were enrolled from November 2016 to February 2017 and a structured questionnaire administered to them through the open data kit application on android tablets. Twenty-two months later, we revisited the MAT clinics and reviewed 823 of the 901 enrolled participant's medical records in search for documentation on TB disease diagnosis and treatment. Medical records reviewed included those of participants whom at enrolment were asymptomatic, not on TB disease treatment, not on TB preventive therapy and those who had a documented tuberculin skin test (TST) result. RESULTS Of the 823 medical records reviewed 22 months after enrolment, 42 had documentation of being diagnosed with TB disease and initiated on TB treatment. This is equivalent to a TB disease incidence rate of 2,925.2 patients per 100,000 person years with a total follow up time of 1,440 person-years. At enrolment the prevalence of TB disease and TB infection was 2.6% and 54% respectively and the HIV prevalence was 44% and 16% among females and males respectively. CONCLUSION PWUD attending MAT clinics bear an extremely high burden of TB and HIV and are known to have driven TB epidemics in a number of countries. Our reported TB disease incidence is 12 times that of the general Tanzanian incidence of 237 per 100,000 further emphasizing that this group should be prioritized for TB screening, testing and treatment. Gender specific approaches should also be developed as female PWUDs are markedly more affected with HIV and TB disease than male PWUDs.
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Affiliation(s)
- Lilian Tina Minja
- Ifakara Health Institute, Dar es Salaam, Tanzania
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Muhimbili National Hospital, Dar es Salaam, Tanzania
- * E-mail: ,
| | - Jerry Hella
- Ifakara Health Institute, Dar es Salaam, Tanzania
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Jessie Mbwambo
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Ubuguyu Said Omary
- Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | | | | | | | - James Okuma
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Sebastien Gagneux
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - R. Douglas Bruce
- Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Klaus Reither
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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49
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Athni TS, Shocket MS, Couper LI, Nova N, Caldwell IR, Caldwell JM, Childress JN, Childs ML, De Leo GA, Kirk DG, MacDonald AJ, Olivarius K, Pickel DG, Roberts SO, Winokur OC, Young HS, Cheng J, Grant EA, Kurzner PM, Kyaw S, Lin BJ, López RC, Massihpour DS, Olsen EC, Roache M, Ruiz A, Schultz EA, Shafat M, Spencer RL, Bharti N, Mordecai EA. The influence of vector-borne disease on human history: socio-ecological mechanisms. Ecol Lett 2021; 24:829-846. [PMID: 33501751 PMCID: PMC7969392 DOI: 10.1111/ele.13675] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 01/14/2023]
Abstract
Vector-borne diseases (VBDs) are embedded within complex socio-ecological systems. While research has traditionally focused on the direct effects of VBDs on human morbidity and mortality, it is increasingly clear that their impacts are much more pervasive. VBDs are dynamically linked to feedbacks between environmental conditions, vector ecology, disease burden, and societal responses that drive transmission. As a result, VBDs have had profound influence on human history. Mechanisms include: (1) killing or debilitating large numbers of people, with demographic and population-level impacts; (2) differentially affecting populations based on prior history of disease exposure, immunity, and resistance; (3) being weaponised to promote or justify hierarchies of power, colonialism, racism, classism and sexism; (4) catalysing changes in ideas, institutions, infrastructure, technologies and social practices in efforts to control disease outbreaks; and (5) changing human relationships with the land and environment. We use historical and archaeological evidence interpreted through an ecological lens to illustrate how VBDs have shaped society and culture, focusing on case studies from four pertinent VBDs: plague, malaria, yellow fever and trypanosomiasis. By comparing across diseases, time periods and geographies, we highlight the enormous scope and variety of mechanisms by which VBDs have influenced human history.
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Affiliation(s)
- Tejas S. Athni
- Department of Biology, Stanford University, Stanford, CA, USA
| | - Marta S. Shocket
- Department of Biology, Stanford University, Stanford, CA, USA
- Department of Ecology and Evolutionary Biology, University of California, Los Angeles, CA, USA
| | - Lisa I. Couper
- Department of Biology, Stanford University, Stanford, CA, USA
| | - Nicole Nova
- Department of Biology, Stanford University, Stanford, CA, USA
| | - Iain R. Caldwell
- ARC Centre of Excellence for Coral Reef Studies, James Cook University, Townsville, Queensland, Australia
| | - Jamie M. Caldwell
- Department of Biology, Stanford University, Stanford, CA, USA
- Department of Biology, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Jasmine N. Childress
- Department of Ecology, Evolution, and Marine Biology, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Marissa L. Childs
- Emmett Interdisciplinary Program in Environment and Resources, Stanford University, Stanford, CA, USA
| | - Giulio A. De Leo
- Hopkins Marine Station of Stanford University, Pacific Grove, CA, USA
- Woods Institute for the Environment, Stanford University, Stanford, CA, USA
| | - Devin G. Kirk
- Department of Biology, Stanford University, Stanford, CA, USA
- Department of Zoology, University of British Columbia, Vancouver, BC, Canada
| | - Andrew J. MacDonald
- Bren School of Environmental Science and Management, University of California, Santa Barbara, CA, USA
- Earth Research Institute, University of California, Santa Barbara, CA, USA
| | | | - David G. Pickel
- Department of Classics, Stanford University, Stanford, CA, USA
| | | | - Olivia C. Winokur
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Hillary S. Young
- Department of Ecology, Evolution, and Marine Biology, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Julian Cheng
- Department of Biology, Stanford University, Stanford, CA, USA
| | | | | | - Saw Kyaw
- Department of Biology, Stanford University, Stanford, CA, USA
| | - Bradford J. Lin
- Department of Biology, Stanford University, Stanford, CA, USA
| | | | | | - Erica C. Olsen
- Department of Biology, Stanford University, Stanford, CA, USA
| | - Maggie Roache
- Department of Biology, Stanford University, Stanford, CA, USA
| | - Angie Ruiz
- Department of Biology, Stanford University, Stanford, CA, USA
| | | | - Muskan Shafat
- Department of Biology, Stanford University, Stanford, CA, USA
| | | | - Nita Bharti
- Department of Biology, Center for Infectious Disease Dynamics, Penn State University, University Park, PA, USA
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Cords O, Martinez L, Warren JL, O'Marr JM, Walter KS, Cohen T, Zheng J, Ko AI, Croda J, Andrews JR. Incidence and prevalence of tuberculosis in incarcerated populations: a systematic review and meta-analysis. LANCET PUBLIC HEALTH 2021; 6:e300-e308. [PMID: 33765455 PMCID: PMC8168455 DOI: 10.1016/s2468-2667(21)00025-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/17/2020] [Accepted: 01/25/2021] [Indexed: 12/24/2022]
Abstract
Background Prisons are recognised as high-risk environments for tuberculosis, but there has been little systematic investigation of the global and regional incidence and prevalence of tuberculosis, and its determinants, in prisons. We did a systematic review and meta-analysis to assess the incidence and prevalence of tuberculosis in incarcerated populations by geographical region. Methods In this systematic review and meta-analysis, we searched MEDLINE, Embase, Web of Knowledge, and the LILACS electronic database from Jan 1, 1980, to Nov 15, 2020, for cross-sectional and cohort studies reporting the incidence of Mycobacterium tuberculosis infection, incidence of tuberculosis, or prevalence of tuberculosis among incarcerated individuals in all geographical regions. We extracted data from individual studies, and calculated pooled estimates of incidence and prevalence through hierarchical Bayesian meta-regression modelling. We also did subgroup analyses by region. Incidence rate ratios between prisons and the general population were calculated by dividing the incidence of tuberculosis in prisons by WHO estimates of the national population-level incidence. Findings We identified 159 relevant studies; 11 investigated the incidence of M tuberculosis infection (n=16 318), 51 investigated the incidence of tuberculosis (n=1 858 323), and 106 investigated the prevalence of tuberculosis (n=6 727 513) in incarcerated populations. The overall pooled incidence of M tuberculosis infection among prisoners was 15·0 (95% credible interval [CrI] 3·8–41·6) per 100 person-years. The incidence of tuberculosis (per 100 000 person-years) among prisoners was highest in studies from the WHO African (2190 [95% CrI 810–4840] cases) and South-East Asia (1550 [240–5300] cases) regions and in South America (970 [460–1860] cases), and lowest in North America (30 [20–50] cases) and the WHO Eastern Mediterranean region (270 [50–880] cases). The prevalence of tuberculosis was greater than 1000 per 100 000 prisoners in all global regions except for North America and the Western Pacific, and highest in the WHO South-East Asia region (1810 [95% CrI 670–4000] cases per 100 000 prisoners). The incidence rate ratio between prisons and the general population was much higher in South America (26·9; 95% CrI 17·1–40·1) than in other regions, but was nevertheless higher than ten in the WHO African (12·6; 6·2–22·3), Eastern Mediterranean (15·6; 6·5–32·5), and South-East Asia (11·7; 4·1–27·1) regions. Interpretation Globally, people in prison are at high risk of contracting M tuberculosis infection and developing tuberculosis, with consistent disparities between prisons and the general population across regions. Tuberculosis control programmes should prioritise preventive interventions among incarcerated populations. Funding US National Institutes of Health.
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Affiliation(s)
- Olivia Cords
- Division of Infectious Diseases and Geographic Medicine, Stanford, CA, USA
| | - Leonardo Martinez
- Division of Infectious Diseases and Geographic Medicine, Stanford, CA, USA; Department of Epidemiology, School of Public Health, Boston University, Boston, MA, USA.
| | - Joshua L Warren
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Jamieson Michael O'Marr
- Division of Infectious Diseases and Geographic Medicine, Stanford, CA, USA; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Katharine S Walter
- Division of Infectious Diseases and Geographic Medicine, Stanford, CA, USA
| | - Ted Cohen
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Jimmy Zheng
- Stanford University School of Medicine, Stanford, CA, USA
| | - Albert I Ko
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA; Oswaldo Cruz Foundation, Salvador, Brazil
| | - Julio Croda
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA; Universidade Federal de Mato Grosso do Sul, Faculdade de Medicina, Campo Grande, Mato Grosso do Sul, Brazil; Fundação Oswaldo Cruz, Campo Grande, Mato Grosso do Sul, Brazil
| | - Jason R Andrews
- Division of Infectious Diseases and Geographic Medicine, Stanford, CA, USA
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