Association of tuberculosis infection with increased time in or admission to the New York City jail system

E. Y. Bellin, D. D. Fletcher and S. M. Safyer
Montefiore Medical Center, Rikers Island Health Service, East Elmhurst, NY 11370.

OBJECTIVE--To establish the association between time spent in jail or number of jail admissions and development of tuberculosis in a cohort of inmates incarcerated without evidence of tuberculosis infection on entry. DESIGN--Nested case-control design within a prospective cohort. A cohort of 2636 tuberculin skin test-negative inmates incarcerated in 1985 was matched against the Tuberculosis Registry of New York City. Each case of tuberculosis reported prior to May 15, 1992, was assigned to three randomly selected controls from the cohort. We determined time spent in jail by reviewing the computer records of the New York City Inmate Information System. Conditional logistic regression modeling was performed to establish the association of jail time with the development of tuberculosis. SETTING--New York City Jail. RESULTS--Sixty inmates developed tuberculosis by May 15, 1992. Eighty-five percent of these had pulmonary tuberculosis. Univariate analysis identified the number of jail admissions (P = .02), age greater than or equal to 30 years (P = .001), and assignment to a methadone detoxification unit (P = .001) as significant in predicting tuberculosis. Multivariate modeling identified these same variables and jail time as significant. One year of jail time increased the odds of tuberculosis to 2.2 (95% confidence interval, 1.1 to 4.4). CONCLUSION--The demonstrated association between jail time or jail admissions and development of tuberculosis suggests that the New York City jail system may be an important amplification point in the ongoing tuberculosis epidemic, deserving significant public health attention.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Coming Home From Jail: The Social and Health Consequences of Community Reentry for Women, Male Adolescents, and Their Families and Communities
Freudenberg et al.
Am. J. Public Health 2008;98:S191-S202.
ABSTRACT | FULL TEXT  

The Impact of New York City's 1975 Fiscal Crisis on the Tuberculosis, HIV, and Homicide Syndemic
Freudenberg et al.
Am. J. Public Health 2006;96:424-434.
ABSTRACT | FULL TEXT  

American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America: Controlling Tuberculosis in the United States
Am. J. Respir. Crit. Care Med. 2005;172:1169-1227.
FULL TEXT  

Coming Home From Jail: The Social and Health Consequences of Community Reentry for Women, Male Adolescents, and Their Families and Communities
Freudenberg et al.
Am. J. Public Health 2005;95:1725-1736.
ABSTRACT | FULL TEXT  

An Unanswered Health Disparity: Tuberculosis Among Correctional Inmates, 1993 Through 2003
MacNeil et al.
Am. J. Public Health 2005;95:1800-1805.
ABSTRACT | FULL TEXT  

Correlates of Mycobacterium tuberculosis infection in a prison population
Carbonara et al.
Eur Respir J 2005;25:1070-1076.
ABSTRACT | FULL TEXT  

Improving tuberculosis therapy completion after jail: translation of research to practice
White et al.
Health Educ Res 2005;20:163-174.
ABSTRACT | FULL TEXT  

Prevalence of and risk factors associated with Mycobacterium tuberculosis infection in prisoners, North West Frontier Province, Pakistan
Hussain et al.
Int J Epidemiol 2003;32:794-799.
ABSTRACT | FULL TEXT  

Management of Tuberculosis in the Texas Prison System
Baillargeon et al.
JOURNAL OF CORRECTIONAL HEALTH CARE 2002;9:77-93.
ABSTRACT  

Miniature Chest Radiograph Screening for Tuberculosis in Jails . A Cost-effectiveness Analysis
JONES and SCHAFFNER
Am. J. Respir. Crit. Care Med. 2001;164:77-81.
ABSTRACT | FULL TEXT  

Acceptability of Short-Course Rifampin and Pyrazinamide Treatment of Latent Tuberculosis Infection Among Jail Inmates
Bock et al.
Chest 2001;119:833-837.
ABSTRACT | FULL TEXT  

Tuberculosis in prisons in countries with high prevalence
Coninx et al.
BMJ 2000;320:440-442.
FULL TEXT  

Transmission of Tuberculosis in a Jail
Jones et al.
ANN INTERN MED 1999;131:557-563.
ABSTRACT | FULL TEXT  

On Target: A Tuberculosis Control Strategy Whose Time Has Come
Reichman
ANN INTERN MED 1999;131:617-618.
FULL TEXT  

Tuberculosis in New York City -- Turning the Tide
Frieden et al.
NEJM 1995;333:229-233.
ABSTRACT | FULL TEXT  

Tuberculosis in Prison: Balancing Justice and Public Health
Greifinger et al.
J Law Med Ethics 1993;21:332-341.