Source: Annual Congress 2002 - Epidemiology outlooks of tuberculosis
Disease area: Respiratory infections

Abstract

Congregate settings such as correctional facilities are high-risk areas for TB transmission. We report our initial experience with contact screening and preventive therapy (PT) among close contacts of infectious TB cases in Singapore prisons and drug rehabilitation centres.
There are 15 correctional facilities in Singapore housing a population of 16,000 inmates. There were 38 index cases notified from 1999 to 2001, around whom 703 close contacts were screened using the tuberculin skin test (TST). Chest radiographs were performed if the TST was positive or if there were symptoms of TB. Nine radiologically active TB cases were detected (1.3% yield). Forty-six percent screened (n=323) had TST > 14 mm, while 33% (n=233) had TST between 10 to 14 mm. Sixty percent (n=423) of contacts screened were started on PT.
Compared to a cohort of 5776 household and workplace contacts screened by our centre in 1998, there was a higher yield of active TB cases (1.3% vs 0.3%), and a higher rate of positive TST readings in the prison population (46% vs 22% with TST > 14 mm, and 33% vs 28% with TST of 10 to 14 mm). The high-risk, captive population in correctional facilities provides an important opportunity for screening and preventive therapy for TB control.

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C. B. E. Chee, M. D. Teleman, N. Devi, K. Y. Han, Y. T. Wang (Singapore, Singapore). Contact investigation and preventive therapy in correctional facilities in Singapore - the initial 3-year experience. Eur Respir J 2002; 20: Suppl. 38, 271

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