Model of screening TB in prison in health service region 11

Abstract

The objective of the cross-sectional survey is to study the rapid and suitable pattern of pulmonary tuberculosis (PTB) screening in prisons of health service region 11 in order to treat TB patients without delays. All 24,249 prisoners of 14 prisons got the chest x-ray examination by x-ray mobile between May to July 2017. The results were 1. All the prisoners received chest x-ray and verbal screening, and 6.3% of them were likely to have PTB, 5.2% had abnormal chest x-ray consistent with PTB. Seventy of them had sputum smear positive for acid fast bacilli (AFB), and 187 prisoners had TB in molecular testing (gene X-pert). Therefore, there were 264 prisoners with PTB. The prevalence rate was 1088.7/100,000, which was 6.4 times higher than the general population. 2. In the settings of providing verbal TB screening before considering chest x-ray, 435 prisoners (1.8%) had abnormal chest x-ray consistent with PTB, with 25 of them had positive for AFB and 50 prisoners had TB in molecular testing (gene X-pert). Therefore, there were 74 prisoners with PTB. The prevalence rate was 305.2/100,000, which was 3.6 times lower than the first pattern. In conclusions, the TB screening with chest x-ray is more sensitive than the verbal screening. Although it is not highly specific, it can be used as a screening tool in conjunction with a diagnostic laboratory to confirm tuberculosis. The appropriate pattern of screening TB in the region 11 depends on contexts and resources: both budget and number of officers in the prison. In addition,
the integration of both pattern 1 and 2 may be adopted. The officers of the prisons should be motivated to realize and conduct TB screening continuously.