Screening for tuberculosis in jail and clinic follow-up after release.
J P Tulsky,
M C White,
C Dawson,
T M Hoynes,
J Goldenson and
G Schecter
Department of Medicine, University of California, San Francisco, USA.
OBJECTIVES: The purpose of this study was to describe tuberculosis(TB) screening and preventive therapy in the San Francisco CountyJail and to measure the follow-up rate at the public healthdepartment TB clinic. METHODS: The records of male inmates screenedfor 6 months in 1994 were reviewed. Those prescribed isoniazidand released before therapy ended were matched with TB clinicrecords. Inmates were considered to have followed up if theycame to the TB clinic within 1 month of release. RESULTS: Of3352 inmates screened, 553 (16.5%) reported a prior positiveskin test, and 330 (26.9%) of 1229 tests placed and read werepositive. Of those with positive tests, 151 (45.8%) began isoniazid.Most of the inmates were foreign-born Hispanics (80.8%). Ninety-three(61.6%) inmates were released before completion, after an averageof 68.5 days. Three (3.2%) went to the TB clinic within a month.CONCLUSIONS: Jail represents an important screening site forTB, but care is not continued after release. Strategies areneeded to enhance the continuity of isoniazid preventive care.
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