). The incidence rate was 139.3 per 100,000 by 1993 and the unadjusted case rates for prison populations in many areas are significantly higher than the rates for the general population (Braithwaite et al.). According to these authors, "The 1993 TB case rate of 139.3 per 100,000 in the New York state correctional system was more than six times the case rate of 21.7 per 100,000 for the general population of New York state. Similarly, in New Jersey the incidence of TB among state inmates in 1992 was 91.3 per 100,000, compared with 12.6 per 100,000 for the state's general population in the same year" (Braithwaite et al., p. 109). At one California state prison, the annual incidence rate of TB in 1991 was 184 cases per 100,000, a rate that is more than 10 times the statewide rate and the transmission of TB also was also identified in this California prison (Braithwaite et al.).
In several recent TB outbreaks in correctional facilities, failure to detect active TB disease in inmates resulted in transmission of TB to other inmates, correctional facility employees and people in the community. Moreover, outbreaks in New York and California have involved the transmission of multidrug-resistant strains of TB to both inmates and employees of correctional facilities. Unfortunately, if tuberculosis infection is not correctly assessed and treated among in-coming prisoners, and an infected prisoner develops active tuberculosis, the extraordinarily high-density prison environment is the perfect setting for the disease to spread (Coyle et al., 2003); however, previous studies have identified deficiencies in tracking inmate tuberculosis status that have made such assessments problematic (Dolovich, 2005). In response, states across the country have refocused attention on the problem of TB in correctional facilities, and the results of these investigations have revealed a higher incidence of TB among this population than previously thought.
For instance, in one case in Pennsylvania, a court ordered the prison system to implement an appropriate tuberculosis control program throughout the state; this control program resulted in the discovery of over 400 prisoners in just one prison who, unknown to any prison authority, were infected with tuberculosis (Coyle et al., 2003). According to these authors, "The medical records of the prison were not complete enough to determine how many of these infections had resulted from the spread of tuberculosis within the prison, but there was little doubt that at least some of the active cases of tuberculosis within the system had resulted from exposure within the prison system" (Coyle et al., p. 68).
Moreover, it has been repeatedly demonstrated that tuberculosis, including highly dangerous multi-drug resistant tuberculosis, can and does spread from prisons and jails to the community. A study in San Francisco during the period 1997-1999, for example, demonstrated that slightly fewer than 44% of all persons with active tuberculosis had been incarcerated at some point before their diagnosis (Coyle et al.). In addition, medical researchers examined the DNA strains involved and determined that tuberculosis from the jail had infected the community (Coyle et al.). According to these authors, "Indeed, sixty-three percent of persons who had never been incarcerated but had developed active tuberculosis had been infected with the strain of tuberculosis associated with the jail outbreak. An earlier Centers for Disease Control study concluded that an outbreak of multidrug resistant tuberculosis in the New York State prison system involved two hospitals where prisoners were treated" (Coyle et al., p. 68).
This outbreak of TB was responsible for the deaths of 36 prisoners and one correctional officer, as well as the infection of a number of healthcare employees with a strain of multi-drug resistant tuberculosis (Dooley, Jarvis, Martone & Snider, 1992). As Mueller points out, "Medical experts say when patients stop taking the medication at some point during the year, it can keep the patient from getting well and lead to a strain of TB which is partially resistant to such treatment" (p. 101). Likewise, Eckert suggests that noncompliance with treatment regimens represents one of the most important reasons multi-drug resistant strains of TB have evolved in recent years. According to Eckert, "Many patients, for example, abandon treatment when their symptoms disappear but before all of the illness-causing pathogens are effectively killed. The tuberculosis-causing bacterium, for instance, has become increasingly difficult to treat, as too many patients have prematurely abandoned the six-month course of antibiotics" (p. 166). In this regard, Mueller points out that, "This is why health care staff members emphasize direct observation of patients taking their medication" (p. 101). Such comprehensive oversight, though, may be beyond the capabilities of some correctional facilities, as well as their ability to adequately train their staff in appropriate universal precautions that are needed when working with such populations.
Nevertheless, the need is great and time is of the essence. According to one correctional systems analyst, "Stopping the spread of TB has become a top priority because there are more than 24,000 new cases of TB every year in the United States, and TB rates in prisons and jails typically are five times higher than in the general population. Contributing to the TB challenge are the jails and prisons...
Others are more reckless and assume that they simply will not get sick. No matter who they are or where they come from, though, anyone can contract TB if they get around someone who is infected, so people must put social, cultural, and other opinions aside in order to protect themselves and others around them from potentially deadly diseases like TB (Lawlor, 2007). Conclusion It is very easy to see that
The drugs must also be of quality. This is often not the case, as substandard anti-tuberculosis drugs are widely available on the market in man countries. The World Health Organization is at this time assessing the quality of drugs produced by different manufacturers, an important exercise which should make possible developing countries to acquire pre-qualified drugs of guaranteed quality. Today, however, there are no pre-qualified sources of anti-tuberculosis drugs in
M. tuberculosis can extend to other tissues or organs such as the lymph nodes, joints, skin, bones, the central nervous system, the urinary tract and the abdomen. The host immune reaction to M. tuberculosis originally involves the employment of activated macrophages to the site of infection in the lung, where they can form a tuberculous granuloma that serves to restrict the infection. Bacteria that are trapped in the granuloma
Tuberculosis in Newham Borough of London The Urban Health Profile It is true that as long as there have been human beings on planet earth there has been a certain amount of struggle against disease and creatures that carry disease along with bacteria and viruses. These are the types of struggles and successes which have determined whether or not civilizations would triumph or be defeated, and these are the struggles which will
Tuberculosis Communicable disease: Tuberculosis Tuberculosis is a widespread, lethal, and infectious/transmittable disease caused by Mycobacterium tuberculosis. This bacterial infection usually begins in the form of innumerable strains of mycobacteria. In the past, tuberculosis was also termed as Phthisis or Phthisis pulmonalis. Its short form is known worldwide to be TB, or MTB. Stereotypically, tuberculosis is a lung infection that attacks the lungs; however, it can as well affect the other parts of
Microbiology Please develop your own strategy for TB prevention. The Source of the Disease As mentioned in the above question, tuberculosis is a complex disease that has ravaged society for centuries. Whereas in the Western countries, it is now possible to receive treatment and become healthy despite contacting tuberculosis, there are areas of the world where, due to societal or environmental and political problems, it is difficult both to seek and obtain care,
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