Author | Urrego, Juliana | |
Author | Ko, Albert Icksang | |
Author | Carbone, Andrea da Silva Santos | |
Author | Paião, Dayse Sanchez Guimarães | |
Author | Sgarbi, Renata Viebrantz Enne | |
Author | Yeckel, Catherine W | |
Author | Andrews, Jason R | |
Author | Croda, Julio | |
Access date | 2017-06-06T13:05:14Z | |
Available date | 2017-06-06T13:05:14Z | |
Document date | 2015 | |
Citation | URREGO, J. et al. The Impact of Ventilation and Early Diagnosis on Tuberculosis Transmission in Brazilian Prisons. American Journal of Tropical Medicine and Hygiene, v. 93, n. 4, p. 739–746, 2015. | pt_BR |
ISSN | 0002-9637 | pt_BR |
URI | https://www.arca.fiocruz.br/handle/icict/19312 | |
Sponsorship | Foundation for the Development of Teaching, Science, and Technology of the State of Mato Grosso do Sul (0067/12 and 0059/13); Secretariat of Health Surveillance, Brazilian Ministry of Health (20/2013); Ciências sem
Fronteiras Program of the Brazilian National Research Council; Fogarty Global Health Equity Scholars Program (NIH 1 R25 TW009338); Jan A. J. Stolwijk Fellowship at the Yale School of Public Health (to J.U.); and National Institute of Allergy and Infectious Disease (K01 AI104411 to J.R.A.) | pt_BR |
Language | eng | pt_BR |
Publisher | American Society of Tropical Medicine and Hygiene | pt_BR |
Rights | open access | pt_BR |
Subject in Portuguese | Tuberculose Pulmonar | pt_BR |
Subject in Portuguese | Diagnóstico precoce | pt_BR |
Subject in Portuguese | Ventilação | pt_BR |
Subject in Portuguese | Fatores de risco | pt_BR |
Subject in Portuguese | Prisões | pt_BR |
Subject in Portuguese | Humanos | pt_BR |
Subject in Portuguese | Brasil | pt_BR |
Title | The Impact of Ventilation and Early Diagnosis on Tuberculosis Transmission in Brazilian Prisons | pt_BR |
Type | Article | pt_BR |
DOI | 10.4269/ajtmh.15-0166 | |
Abstract | Prisoners have among the highest incidence of tuberculosis (TB) globally. However, the contribution of the prison environment on transmission is not well understood and structural characteristics have received little attention as effective epidemiological interventions in TB control. We evaluated architectural characteristics and estimated ventilation rates in 141 cells in three prisons in central west Brazil using steady-state exhaled carbon dioxide (CO2) levels. We used a modified Wells-Riley equation to estimate the probability of infection for inmates sharing a cell with an infectious case and projected the impact of interventions, including early diagnosis and improved ventilation. Overall, prison cells were densely populated (mean 2.1 m(2) per occupant) and poorly ventilated, with only three cells meeting World Health Organization (WHO) standards for per-person ventilation (60 L/s) applied in infection control settings. In the absence of interventions, projected mean risk of infection was 78.0% during a 6-month period. Decreasing time-to-diagnosis by 25% reduced transmission risk by 8.3%. Improving ventilation to WHO standards decreased transmission by 38.2%, whereas optimizing cross-ventilation reduced transmission by 64.4%. Prison environments promote high infection risk over short-time intervals. In this context, enhanced diagnostics have a limited impact on reducing transmission. Improving natural ventilation may be required to effectively control TB in prisons. | pt_BR |
Affilliation | Yale School of Public Health. New Haven, CT | pt_BR |
Affilliation | Yale School of Public Health. New Haven, CT / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil | pt_BR |
Affilliation | Hospital Universitário de Dourados. Dourados, MS, Brasil | pt_BR |
Affilliation | Hospital Universitário de Dourados. Dourados, MS, Brasil | pt_BR |
Affilliation | Hospital Universitário de Dourados. Dourados, MS, Brasil | pt_BR |
Affilliation | Yale School of Public Health. New Haven, CT | pt_BR |
Affilliation | Stanford University School of Medicine. Stanford, CA | pt_BR |
Affilliation | Universidade Federal da Grande Dourados. Faculdade de Ciências da Saúde. Dourados, MS, Brasil | pt_BR |
Subject | Tuberculosis Pulmonary | pt_BR |
Subject | Early Diagnosis | pt_BR |
Subject | Ventilation | pt_BR |
Subject | Risk Factors | pt_BR |
Subject | Prisons | pt_BR |
Subject | Humans | pt_BR |
Subject | Brazil | pt_BR |
DeCS | Tuberculose Pulmonar | pt_BR |
DeCS | Diagnóstico precoce | pt_BR |
DeCS | Ventilação | pt_BR |
DeCS | Fatores de risco | pt_BR |
DeCS | Prisões | pt_BR |
DeCS | Humanos | pt_BR |
DeCS | Brazil | pt_BR |