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Article
January 20, 1989

Increasing Incidence of Tuberculosis in a Prison Inmate PopulationAssociation With HIV Infection

Author Affiliations

From the Bureau of Communicable Disease Control, New York State Department of Health (Drs Braun, Truman, DiFerdinando, and Morse), and the New York State Department of Correctional Services (Dr Broaddus and Ms Maguire), Albany; and New York Medical College, Valhalla (Dr Wormser). Dr Braun is currently with the AIDS Program, Centers for Disease Control, Atlanta.

From the Bureau of Communicable Disease Control, New York State Department of Health (Drs Braun, Truman, DiFerdinando, and Morse), and the New York State Department of Correctional Services (Dr Broaddus and Ms Maguire), Albany; and New York Medical College, Valhalla (Dr Wormser). Dr Braun is currently with the AIDS Program, Centers for Disease Control, Atlanta.

JAMA. 1989;261(3):393-397. doi:10.1001/jama.1989.03420030067031
Abstract

The incidence of tuberculosis (TB) among inmates of the New York State prison system increased from 15.4 per 100 000 in 1976 through 1978 to 105.5 per 100 000 in 1986. Matching of TB and acquired immunodeficiency syndrome registries indicated that the majority (56%) of inmates with TB reported in 1985 and 1986 had acquired immunodeficiency syndrome or human immunodeficiency virus infection; none were known to be human immunodeficiency virus seronegative. A case-control study examined 59 inmates with TB reported from 1984 through 1986 and 59 matched control inmates without TB. Inmates who reported street drug use were more likely to develop TB: odds ratio, 9.7; 95% confidence interval, 2.8 to 33.6 and odds ratio, 7.3; 95% confidence interval, 0.9 to 59.3 by unconditional and conditional logistic regression analyses, respectively. Although the majority of cases are thought to be due to reactivation of latent infection, phage typing of 16 Mycobacterium tuberculosis cultures suggested the possibility of inmate-to-inmate transmission in at least one cluster of three cases. It is of crucial importance that TB control measures be reinforced in the prison setting to counter the increased risk created by human immunodeficiency virus infection.

(JAMA 1989;261:393-397)

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