The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #65180

Robert Hung, BS¹, Steven Shelton, MD, CCHP-A², Gary Rischitelli, MD, MPH, JD³, Gary Sexton, PhD⁴, Jay D. Kravitz, MD, MPH, FACPM⁵, and Eldon Edmundson, PhD⁵. (1) Oregon Health Sciences University, 2008 W. Warren Blvd. (1st Floor), Chicago, IL 60612, (312)342-7696, hungr@ohsu.edu, (2) Health Services, Oregon Department of Corrections, 2575 Center Street NE, Salem, OR 97301, (3) Center for Research on Occupational and Environmental Toxicology, Oregon Health & Sciences University, 3181 Sam Jackson Park Rd.L606, Portland, OR 97201, (4) Department of Public Health and Preventive Medicine, Oregon Health Sciences University, 3181 S.W. Sam Jackson Park Rd, CB-669, Portland, OR 97201, (5) Department of Public Health and Preventive Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, CB669, Portland, OR 97201

OBJECTIVES. This study determined the prevalence, incidence, and risk factors for TB conversion among Oregon Department of Correction (ODOC) inmates from July 2000- July 2001. METHODS. Inmates receiving anti-tuberculous drugs were identified through pharmacy records. Once identified, a database query and medical chart review were performed to obtain inmate information. Controls were randomly selected and the case-control study was performed using multivariate logistic regression. RESULTS. The prevalence of TB among inmates was 3.3% (329 out of 10,000 persons). The incidence of PPD conversion was approximately 4.9 per 1,000 person-years. The risk factors for conversion were: 1) being foreign born (p < .001), 2) living in a less dense institution (p <.001), 3) living in multiple institutions (p < .03), 4) having a shorter duration of residence (p <.001), and 5) having a psychiatric assessment for high drug abuse potential (p < .02). Age, education, county of incarceration, prior number of incarcerations, and number of visitors were not significant variables. CONCLUSIONS. The ODOC had a low prevalence and incidence of TB compared to other prisons in the country from July 2000- July 2001. Individuals at high risk for conversion were Latino males from Mexico who were housed in multiple institutions and had a high potential for drug abuse. Previously identified risk factors for conversion, namely living in densely-crowded institutions and residing for long durations were not found to be significant in this population. Prison health officials should consider performing two-step PPD skin testing in this subset of inmates in order to discern the boosting phenomenon from true conversion.

Learning Objectives:

At the conclusion of this session, the participant will be able to:
• List the known risk factors for both latent and active tuberculosis infection
• Discuss the CDC guidelines for tuberculosis control in correctional settings
• Compare their own tuberculosis control program with a model program in a state prison

Keywords: TB, Correctional Health Care

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Oregon Health Sciences University Oregon Department of Corrections
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.