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October 2005, Vol 95, No. 10 | American Journal of Public Health 1800-1805
© 2005 American Public Health Association
DOI: 10.2105/AJPH.2004.055442


RESEARCH AND PRACTICE

An Unanswered Health Disparity: Tuberculosis Among Correctional Inmates, 1993 Through 2003

Jessica R. MacNeil, MPH, Mark N. Lobato, MD and Marisa Moore, MD, MPH

At the time of the study, Jessica R. MacNeil, Mark N. Lobato, and Marisa Moore were with the Division of Tuberculosis Elimination, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Ga.

Correspondence: Requests for reprints should be sent to National Center for HIV, STD, and TB Prevention, Office of Communications, Centers for Disease Control and Prevention, 1600 Clifton Road, Mail Stop E-06, Atlanta, GA 30333.

Objectives: We sought to describe disparities and trends in tuberculosis (TB) risk factors and treatment outcomes between correctional inmate and noninmate populations.

Methods: We analyzed data reported to the national TB surveillance system from 1993 through 2003. We compared characteristics between inmate and non-inmate men aged 15–64 years.

Results: Of the 210976 total US TB cases, 3.8% (7820) were reported from correctional systems. Federal and state prison case rates were 29.4 and 24.2 cases per 100000 inmates, respectively, which were considerably higher than those in the noninmate population (6.7 per 100000 people). Inmates with TB were more likely to have at least 1 TB risk factor compared with noninmates (60.1% vs 42.0%, respectively) and to receive directly observed therapy (65.0% vs 41.0%, respectively); however, they were less likely to complete treatment (76.8% vs 89.4%, respectively). Among inmates, 58.9% completed treatment within 12 months compared with 73.2% of noninmates.

Conclusions: Tuberculosis case rates in prison systems remain higher than in the general population. Inmates with TB are less likely than noninmates to complete treatment.




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