Golniški simpozij 2011 Zbornik povzetkov

Occurrence of tuberculosis in largest
Slovenian correctional facility ZPKZ
Dob in the period from 2000 to 2008
Nadja Koren Pucelj 1 , Irena Hudoklin 2
1
University Medical Centre, Ljubljana
2
Out-patient Practice for Respiratory Diseases, Trebnje
Background
Inmates are known to be more vulnerable to infection with tuberculosis (TB) compared to general population
(crowded environment, presence of persons of low socioeconomic status, foreign-born individuals,
users of illicit substances, persons with human immunodeficiency virus infection). According
to the Slovenian national central register TB did not occur often in correctional facilities until 2000 (1-
2 cases annually).
Methods
In 2000, after first symptomatic case was found, altogether four cases of pulmonary TB were detected
in epidemiological investigation in largest Slovenian correctional facility ZPKZ Dob (ZPKZ
Dob) with 345 male long term inmates. ZPKZ Dob had been overcrowded for many years (official capacity
is 233 persons). As incidence of TB in general population was 18.9 per 100,000 inhabitants
in the same year, the need for enhanced surveillance for TB in this correctional facility was recognized.
Results
From beginning of 2001 until the end of 2008 all new inmates were screened for symptoms of TB and
had tuberculin skin test and chest x-ray carried out. On average 162 (min 118, max 210, SD 29,1)
new inmates were examined annually (altogether 1251 in 8 years). All were male, on average 36,2
years old (min 19, max 77, SD 10,4). In the period of eight years two cases of pulmonary TB (in 2002
and in 2004) and one person with inactive TB and documented history of adequate treatment for TB
were found. Furthermore 169 cases of latent TB infection, with tuberculin skin test more or equal 10
mm, were detected. Both cases of active and 95,4% cases of latent TB infection (161 of 169) were
treated with standard regimens for active and latent infection respectively.
Conclusions
We believe that the danger of outbreaks of TB in ZPKZ Dob was greatly reduced with treatment of
active and latent TB among new inmates. We also recognize the need to implement the surveillance
protocol for infection with TB among new inmates, already incarcerated inmates and correctional officers
in all correctional facilities in Slovenia because the risk of TB is known to be higher in correctional
facilities compared to general population. This is even more relevant for our country as for
46