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Prevalence and correlates of latent tuberculosis infection among employees of a high security prison in Malaysia
  1. Haider Abdulrazzaq Abed Al-Darraji1,
  2. Cynthia Tan2,
  3. Adeeba Kamarulzaman1,3,
  4. Frederick L Altice1,3,4
  1. 1Centre of Excellence for Research in AIDS, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  2. 2University of Melbourne, Melbourne, Australia
  3. 3Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale University School of Medicine, New Haven, Connecticut, USA
  4. 4Division of Epidemiology of Microbial Diseases, Yale University School of Public Health, New Haven, Connecticut, USA
  1. Correspondence to Dr Haider Abdulrazzaq Abed Al-Darraji, Centre of Excellence for Research in AIDS, Faculty of Medicine, University of Malaya, Kuala Lumpur 59990, Malaysia; hdarraji{at}gmail.com

Abstract

Objectives Although prison employees share the same tuberculosis (TB) risk environment with prisoners, the magnitude of TB problems among prison employees is unknown in most resource-limited prisons. This survey was conducted to investigate the prevalence and correlates of tuberculin skin test (TST) positivity among employees in Malaysia's largest prison.

Methods Consented, full-time prison employees were interviewed using a structured questionnaire that included sociodemographic data, history of working in the correctional system and TB-related risk. TST was placed intradermally and read after 48–72 h. Induration size of ≥10 mm was considered positive. Logistic regression analyses were conducted to explore associations with TST positivity.

Results Of the 445 recruited prison employees, 420 (94.4%) had complete data. Most were young (median=30.0 years) men (88.8%) who had only worked at this prison (76.4%) for a median total employment period of 60 months (IQR 34.5–132.0). The majority were correctional officers, while civilian employees represented only 7.6% of the sample. Only 26 (6.2%) reported having ever been screened for TB since employment. Prevalence of TST positivity was 81% and was independently associated with longer (≥12 months) prison employment (AOR 4.9; 95% CI 1.5 to 15.9) and current tobacco smoking (AOR=1.9, 95% CI 1.2 to 3.2).

Conclusions Latent TB prevalence was high in this sample, approximating that of prisoners in this setting, perhaps suggesting within prison TB transmission in this facility. Formal TB control programmes for personnel and prisoners alike are urgently needed within the Malaysian correctional system.

  • prisons
  • staff
  • tuberculin
  • occupational health

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