Show simple item record

dc.creatorTelisinghe, Lilanganee.
dc.creatorFielding, Katherine L.
dc.creatorMalden, Justin L.
dc.creatorHanifa, Yasmeen.
dc.creatorChurchyard, Gavin J.
dc.creatorGrant, Alison D.
dc.creatorCharalambous, Salome.
dc.date.accessioned2016-10-25T08:36:57Z
dc.date.available2016-10-25T08:36:57Z
dc.date.created2014
dc.date.issued2014
dc.identifier.citationTelisinghe, L., Fielding, K.L., Malden, J.L., Hanifa, Y., Churchyard, G.J., Grant, A.D. and Charalambous, S. 2014. High tuberculosis prevalence in a South African prison: the need for routine tuberculosis screening. PloS one 9(1), 87262.en_US
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0087262en_US
dc.identifier.urihttp://hdl.handle.net/10413/13541
dc.descriptionCAPRISA, 2014.en_US
dc.description.abstractBackground: Tuberculosis is a major health concern in prisons, particularly where HIV prevalence is high. Our objective was to determine the undiagnosed pulmonary tuberculosis (‘‘undiagnosed tuberculosis’’) prevalence in a representative sample of prisoners in a South African prison. In addition we investigated risk factors for undiagnosed tuberculosis, to explore if screening strategies could be targeted to high risk groups, and, the performance of screening tools for tuberculosis. Methods and Findings: In this cross-sectional survey, male prisoners were screened for tuberculosis using symptoms, chest radiograph (CXR) and two spot sputum specimens for microscopy and culture. Anonymised HIV antibody testing was performed on urine specimens. The sensitivity, specificity and predictive values of symptoms and investigations were calculated, using Mycobacterium tuberculosis isolated on sputum culture as the gold standard. From September 2009 to October 2010, 1046 male prisoners were offered enrolment to the study. A total of 981 (93.8%) consented (median age was 32 years; interquartile range [IQR] 27–37 years) and were screened for tuberculosis. Among 968 not taking tuberculosis treatment and with sputum culture results, 34 (3.5%; 95% confidence interval [CI] 2.4–4.9%) were culture positive for Mycobacterium tuberculosis. HIV prevalence was 25.3% (242/957; 95% CI 22.6–28.2%). Positive HIV status (adjusted odds ratio [aOR] 2.0; 95% CI 1.0–4.2) and being an ex-smoker (aOR 2.6; 95% CI 1.2–5.9) were independently associated with undiagnosed tuberculosis. Compared to the gold standard of positive sputum culture, cough of any duration had a sensitivity of 35.3% and specificity of 79.6%. CXR was the most sensitive single screening modality (sensitivity 70.6%, specificity 92.2%). Adding CXR to cough of any duration gave a tool with sensitivity of 79.4% and specificity of 73.8%. Conclusions: Undiagnosed tuberculosis and HIV prevalence was high in this prison, justifying routine screening for tuberculosis at entry into the prison, and intensified case finding among existing prisoners.en_US
dc.language.isoenen_US
dc.publisherPLoS One.en_US
dc.subjectTuberculosis.en_US
dc.subjectPrisoners.en_US
dc.subjectPrisons.en_US
dc.subjectCoughing.en_US
dc.subjectHIV.en_US
dc.subjectSputum.en_US
dc.subjectHIV clinical manifestations.en_US
dc.subjectTuberculosis diagnosis and management.en_US
dc.titleHigh tuberculosis prevalence in a South African prison : the need for routine tuberculosis screening.en_US
dc.typePeer reviewed journal articleen_US


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record