Findings could help fight tuberculosis in prisons around the world
The results of a Queen’s-led program review could help curtail the spread of tuberculosis (TB) in prisons, and lead to a more cost-effective preventative therapy program, benefitting countries burdened by the high rates of TB in their prison populations.
“Our findings have international significance in countries struggling and almost paralyzed by TB in their prisons,” says Wendy Wobeser, the clinical consultant on the project and a professor in the Department of Medicine’s Division of Infectious Diseases. “Furthermore, Canadian federal institutions could become even higher risk environments for TB if recent legislation results in a higher inmate concentration in federal institutions as some experts predict.”
Even though Correctional Service of Canada (CSC) TB screening sets the standard for prisons in other countries, improved screening offers several benefits. A disproportionate number of inmates in Canadian federal institutions were born in countries with a high burden of TB, and in some cases in countries where there is a form of drug-resistant TB. Consequently, they are at higher risk of developing the disease.
The Queen’s team evaluated a new diagnostic tool the CSC is considering implementing into its TB screening program. The experts looked at 100 cases of inmates with “latent infection” who were not sick and did not pose a risk of spreading the disease. Under current CSC policies, these inmates receive nine months of the medication isoniazid to prevent them from developing active TB in the future.
However, using the diagnostic tool doctors assessed that only 30 of the inmates were actually at risk of developing active TB and required the medication. By treating only the 30 at-risk cases, the cost of the preventative therapy TB program can be reduced.
The Queen’s team of Dr. Wobeser, Ilan Schwartz, an internal medicine resident, and Paxton Bach, a Meds’13 student, collaborated with CSC, the Public Health Agency of Canada, the Ontario Agency of Health Protection and Promotion, and the Kingston, Frontenac, Lennox and Addington Health Unit.
The team recently presented its findings at the 42nd Union World Conference on Lung Health in Lille, France.