Jails, a neglected opportunity for tuberculosis prevention

Background The proportion of tuberculosis (TB) cases diagnosed among residents of correctional facilities in Arizona increased from 2.7% in 1993 to 8.0% in 2000, while the national average remained at approximately 4%. The purpose of this study was to determine the proportion of TB cases in Maricopa County, Arizona with a history of incarceration in the local county jail, and to describe missed opportunities for the prevention and early detection of active TB cases in this population. Methods A cross-match was used to identify persons reported to have TB in Maricopa County in 1999 and 2000 who also had a history of incarceration in the county jail. Jail medical records of cases were reviewed to determine if they had been screened for TB while incarcerated and the type of screening received. TB isolates for cases who had been in jail were genotyped using IS6110 restriction fragment-length polymorphism (RFLP) with secondary spoligotyping. Results Nearly one quarter (24.3%) of TB cases had a history of incarceration in the county jail. Most (82.8%) received no TB screening while in jail. Of 34 cases with available isolates, six shared a single genotype by RFLP and spoligotyping. Conclusions Increased screening and treatment of latent TB infection in jails might assist with TB control in the community.