The prevalence of smears positive pulmonary tuberculosis in a prison

With regard to existence of all conditions for spreading tuberculosis(TB) in prison including overcrowding, HIV, Injection Drug Users (IDU), malnutrition and poverty, and on the other hand as TB is the most important cause of mortality / morbidity in HIV patients and prisoners, so prisons are one of the main sources of transmission of Multi Drug Resistance Tuberculosis (MDR-TB) to community. Thus an exhaustive investigation about it seems necessary. This descriptive study carried out on all of the volunteer prisoners of Kermanshah city central prison in the first 4 months of 2008.We scored clinical symptoms and sings according to WHO guideline and for the symptoms which were not in the guideline, were separately scored under the title of "total score". Then the prisoners who had WHO score 5 or total score≥8 or BMI<20 or a past history of TB treatment, were evaluated for TB. Finally prisoners with diagnosis of TB were tested for HIV and data was statistically analyzed. 2030 (92.27%) from 2200 prisoners have been visited that 469 (23.1%) of them had WHO score (W≥5); 287 (14.3%) total score (T≥8); 159 (7/83%) BMI (B<20) and 14 prisoners had a past history of TB treatment. Total acquisition of score cut-off points was915 but after deleting overleaps, the net numbers of patients that could enter into the second stage were 612 (30.14%) and among them, 470 (76.8%) chest X-ray and from 198 (32.35%) smears were taken. Finally 5 smears positive pulmonary TB had diagnosed; all cases had w≥5,but 4(80%)T≥8 and 2(20%) had BMI<20 and non of them had no past history of TB treatment. According to these results in addition to traditional methods, periodic active screening of TB should be accomplish accompanying with culture and chest X-ray to control the spread of TB in Prisons and its transmission to community as well as to save milliards of dollars.