Chlamydia trachomatis and Neisseria gonorrhoeae infections among men and women entering California prisons.

OBJECTIVE: We estimated the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infection among newly arriving inmates at 6 California prisons. METHODS: In this cross-sectional study in 1999, urine specimens collected from 698 men aged 18 to 25 years and 572 women aged 18 years or older were tested at intake for C trachomatis and N gonorrhoeae using ligase chain reaction. An analysis of demographic and arrest-related correlates of C trachomatis and N gonorrhoeae infection was performed. RESULTS: The overall C trachomatis prevalence was 9.9% (95% CI=7.8%, 12.3%) among men aged 18 to 25 years, 8.9% (95% CI = 2.9%, 22.1%) among women aged 18 to 25 years, and 3.3% (95% CI=2.0%, 5.1%) among women overall. Three N gonorrhoeae cases were detected with an overall prevalence of 0.24% (95% CI=0.05%, 0.69%). CONCLUSIONS: The prevalence of C trachomatis infection at entry to California prisons, especially among young female and male inmates, was high, which supports routine screening at entry into prison. In addition, screening in a jail setting where most detainees are incarcerated before entry into the prison setting may provide an excellent earlier opportunity to identify these infections and treat disease to prevent complications and burden of infection in this high-risk population.

Tuberculosis outbreak in a housing unit for human immunodeficiency virus-infected patients in a correctional facility: transmission risk factors and effective outbreak control.

In 1995, an outbreak of tuberculosis (TB) occurred among residents of a correctional-facility housing unit for inmates infected with human immunodeficiency virus (HIV). We isolated and treated patients who were suspected to have TB. To determine risk factors for in-prison transmission of TB, we conducted a case-control study to compare inmate case patients infected with a distinct outbreak strain of TB with control subjects who resided in the HIV unit. We identified 15 case patients during a 4-month period. Among inmates with a CD4 count of <100 cells/mm(3), case patients were more likely than control subjects to spend >/=20 hours per week in a communal day room (odds ratio, 42; P=.002) and were less likely to have a television in their single-person room (odds ratio, 0.10; P=.003). The communal day room was a likely site of transmission. Successful collaboration between the correctional system and public health departments halted the outbreak.