Assessment of Tuberculosis Screening and Management Practices of Large Jail Systems

Objective. This descriptive study sought to explore the use and timeliness of tuberculosis (TB) screening and management activities in jail facilities. Methods. Study personnel visited 20 large U.S. jail systems and reviewed the medical records of 56 inmates who had recently been evaluated for TB disease and 376 inmates who were diagnosed with or confirmed to have latent TB infection (LTBI). Data from these records were analyzed to determine comple-tion and timeliness of screening, diagnostic, and treatment activities. Results. In 14 % of 56 inmates evaluated for TB disease and 24 % of 376 inmates with LTBI, chest radiographs were either not performed or not docu-mented. Of 48 inmates evaluated for TB disease who were not receiving treatment when admitted to jail, 10 had no record of sputum collection being done. A mean delay of 3.1 days occurred from symptom report to respiratory isolation. Time from tuberculin skin test reading to chest radiograph reading was a mean of 5.3 days in inmates evaluated for TB disease and a mean of 7.0 days in inmates with LTBI. Follow-up was arranged for 91 % of released inmate