Do Incarcerated Populations Serve as a Reservoir for Tuberculosis in South Africa?

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dc.contributor.authorSharp, Alana
dc.contributor.authorDonahoe, J. Travis
dc.contributor.authorMilliken, Amanda
dc.contributor.authorBarocio, Jacqueline
dc.contributor.authorCharalambous, Salome
dc.contributor.authorMcLaren, Zoe
dc.date.accessioned2021-12-02T17:58:50Z
dc.date.available2021-12-02T17:58:50Z
dc.date.issued2018
dc.description.abstractTuberculosis (TB) prevalence among incarcerated populations is as much as 1,000 times higher than in the general population. This study evaluates whether correctional facilities serve as a reservoir through which TB is transmitted to surrounding communities. Tuberculosis test data were extracted from the South African National Health Laboratory Service database for patients tested for TB between 2005 and 2011. We conducted graphical analysis to assess the relationship of TB rates between incarcerated and non-incarcerated populations over time. We performed generalized linear modeling with a log link function to assess TB risk in communities surrounding correctional facilities, net of confounders. We assessed linkages between incarcerated and non-incarcerated populations over time using Granger causality analysis. Tuberculosis prevalence among incarcerated populations was four times higher than in the general population. Tuberculosis incidence rates in incarcerated and non-incarcerated populations followed similar trends over time. The presence of a correctional facility in a municipality was associated with 34.9% more detected TB cases (confidence interval: 11.6–63.2; P < 0.01), controlling for potential confounders. Detected TB in incarcerated populations did not have predictive power in explaining detected TB rates in the non-incarcerated population after controlling for serial correlation in the time series data. Despite high TB prevalence, trends in correctional facilities do not appear to be driving temporal trends in the general population. However, correctional facilities still act as a TB reservoir that raises the overall TB risk in the vicinity. Intensified TB control policies for correctional facilities, formerly incarcerated individuals, and surrounding communities will reduce TB prevalence overall.en_US
dc.description.sponsorshipFinancial support: Financial support was provided by the University of Michigan School of Public Health Global Public Health Program, the Center for Global Health, and the University of Michigan Health Management and Policy Department McNerney Award.en_US
dc.description.urihttps://www.ajtmh.org/view/journals/tpmd/99/6/article-p1390.xmlen_US
dc.format.extent2 filesen_US
dc.genrejournal articlesen_US
dc.identifierdoi:10.13016/m24b4b-n5jo
dc.identifier.citationSharp, Alana et al.; Do Incarcerated Populations Serve as a Reservoir for Tuberculosis in South Africa?; The American Journal of Tropical Medicine and Hygiene, Volume 99, Issue 6, Page(s): 1390–1396, 2018; https://doi.org/10.4269/ajtmh.17-0652en_US
dc.identifier.urihttps://doi.org/10.4269/ajtmh.17-0652
dc.identifier.urihttp://hdl.handle.net/11603/23503
dc.language.isoen_USen_US
dc.publisherAmerican Society of Tropical Medicine and Hygieneen_US
dc.relation.isAvailableAtThe University of Maryland, Baltimore County (UMBC)
dc.relation.ispartofUMBC School of Public Policy Collection
dc.rightsThis item is likely protected under Title 17 of the U.S. Copyright Law. Unless on a Creative Commons license, for uses protected by Copyright Law, contact the copyright holder or the author.en_US
dc.rightsCopyright © 2018 by The American Society of Tropical Medicine and Hygiene
dc.titleDo Incarcerated Populations Serve as a Reservoir for Tuberculosis in South Africa?en_US
dc.typeTexten_US
dcterms.creatorhttps://orcid.org/0000-0003-2515-9731en_US

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