The profile of prisoners with tuberculosis in Japan

Abstract

Purpose Although globally, prisoners are considered one of the vulnerable groups to tuberculosis (TB), little is known about the situation of TB in prison setting in Japan. The purpose of this paper is to examine the characteristics of TB among prisoners in Japan. Design/methodology/approach Records of TB patients from one medical prison were analyzed in terms of general demographic characteristics, clinical manifestations, risk factors and delay in diagnosis and in initiating treatment, and compared with data from the national TB surveillance and other published data on health of inmates, where appropriate. Continuous variables were compared using student independent samples t-test. Proportions were compared using χ2 or Fisher exact test as appropriate. Kaplan–Meier survival analysis was conducted to determine the time from entry to prison institution to diagnosis of TB. Findings A total of 49 patients were analyzed. The mean age was 49.5 (±14.3) and 69.4 percent were males. Being unemployed and homeless prior to incarceration, and several co-morbidities were potential risk factors for TB (p<0.01). Analysis of diagnosis and treatment delay showed that 16.1 percent of smear positive patients took more than a week to be placed on treatment after being diagnosed of TB. Approximately 50 percent of the patients were diagnosed within four months of entering the prison institution. Practical implications Several potential risk factors identified suggest the need to strengthen screening for specific sub-groups within the prison population, such as those with poor socio-economic status and co-morbidities, as well as to consider the possible role of systematic screening for latent TB infection. Originality/value This study presents some important data to help understand the profile of TB patients in prisons in Japan, as well as showing that a detailed epidemiological analysis of existing records can provide useful insight.