RT info:eu-repo/semantics/article
T1 Excess tuberculosis risk during and following incarceration in Paraguay : a retrospective cohort study
A1 Sequera Buzarquis, Víctor Guillermo
A1 Estigarribia Sanabria, Gladys
A1 Aguirre, Sarita
A1 Piñanez, Claudia
A1 Martínez, Leonardo
A1 López Olarte, Rafael
A1 Andrews, Jason R.
A1 Walter, Katharine S.
A1 Croda, Julio
A1 García Basteiro, Alberto L.
A2 Asociación de FuncionariosDocentes e Investigadores de la Universidad Nacional de Caaguazú
AB Background. The increased risk of tuberculosis (TB) among people deprived of liberty (PDL) is due to individual and institution-level factors. We followed a cohort of PDL from 5 prisons in Paraguay to describe the risk of TB during incarceration and after they were released.Methods. We linked a 2013 national census of prisons with TB records from the TB Program from 2010 to 2021 to identify TB notifications among incarcerated and formerly incarcerated individuals. We used multivariable Cox regression models to quantify the risk of TB during and following incarceration and to identify risk factors associated with TB.Findings. Among 2996 individuals incarcerated, 451 (15.1%) were diagnosed with TB. Of these, 262 (58.1%) cases occurred during incarceration and 189 (41.9%) occurred in the community after release. In prison, the hazard ratio of developing TB was 1.97 (95% CI: 1.52–2.61) after six months of incarceration and increased to 2.78 (95% CI: 1.82–4.24) after 36 months compared with the first six months. The overall TB notification rate was 2940 per 100,000 person-years. This rate increased with the duration of incarceration from 1335 per 100,000 person-years in the first year to 8455 per 100,000 person-years after 8 years. Among former prisoners, the rate of TB decreased from 1717 inthe first year after release to 593 per 100 000 person-years after 8 years of follow up.Interpretation. Our study shows the alarming risk of TB associated with prison environments in Paraguay, and how this risk persists for years following incarceration. Effective TB control measures to protect the health of people during and following incarceration are urgently needed.
PB Elsevier Ltd.
YR 2024
FD 2024-01-11
LK http://hdl.handle.net/20.500.14066/4364
UL http://hdl.handle.net/20.500.14066/4364
LA eng
NO Corresponding author. Cátedra de Salud Pública, Universidad Nacional de Asunción (UNA), Paraguay. E-mail address: gsequera@med.una.py (G. Sequera).
NO Consejo Nacional de Ciencia y Tecnología
DS MINDS@UW
RD 03-jul-2024