Is mass screening enough to control tuberculosis in Ecuador’s prisons?

OBJECTIVE: To evaluate mass screening campaigns for tuberculosis in prisoners in Ecuador. MATERIAL AND METHOD: Cross-sectional study of Chronic Cough (CC) detected amongst inmates who entered two prisons in Ecuador between January and December 2016 (n = 12,365). The time distribution of the CCs was analyzed with the uniformity test and its relationship with the diagnosed cases of PTB, the prevalence of PTB was calculated. A logistic regression model was performed to determine the factors modifiers of PTB positivity. RESULTS: 1.332 chronic cougher were recorded, the positivity rate was 17.3% (95% CI, 15.1-19.4), and the prevalence was 1.9% (95% CI, 1.6 - 2.1). There was an absence of uniformity in the detection and diagnosis by epidemiological weeks; there was a positive correlation between CC and PTB cases. The positivity rate was associated with the prison with the highest density (adjusted OR 3.8; 95% CI, 2.5-5.5). DISCUSSION: Massive screening campaigns are not enough to control tuberculosis in Ecuador’s prisons. The incidence found is high. It is necessary to strengthen the diagnostic process to treat all the cases found and thus break the chain of transmission.