Estudio descriptivo sobre el uso de ensayo de liberación de interferón gamma en población reclusa con prueba de tuberculina positiva en el Centro Penitenciario de Burgos / Interferon-gamma release assay for the diagnosis of latent tuberculosis infection in the prison population with a positive tuberculin test: a descriptive study in a prison (Burgos, Spain)

Objetivos: En prisiones, existe una alta prevalencia de reclusos que tienen una prueba de tuberculina (PT) positiva mayor de 10 mm y, en ocasiones, se realizan tratamientos para infección tuberculosa latente (ITL) innecesarios. El programa de prevención y control de la tuberculosis (TB) en el medio penitenciario no ha generalizado el uso de uso de QuantiFERON®-TB (QFT) en las cárceles. Nos propusimos describir la implementación y la utilidad del QFT en una población de internos con PT positiva y, de forma secundaria, detectar falsos positivos y evitar tratamientos innecesarios. Secundariamente se han analizado las distintas variables sociodemográficas de la población reclusa. Material y método: Entre diciembre de 2020 y diciembre de 2021, de una población promedio de 300 internos de la cárcel de Burgos, se analizaron todas las pruebas de PT positivas. A todos estos casos positivos, se les midió el valor del QFT. Se analizaron diferentes variables sociodemográficas, y finalmente se evaluó la cantidad de internos con PT positiva, pero con resultado de QFT negativo. Resultados: Un total de 41 internos fueron incluidos en el estudio, con una edad media de 44 años. La proporción de internos nacidos en España fue del 56%, el resto habían nacido en otros países. El 48,8% de todas las PT positivas, fueron QFT negativo. De los 21 internos con QFT+, 12 (57%) estaban vacunados con bacilo de Calmette y Guérin (BCG). Discusión: Se ha observado que el QFT es un método seguro para el diagnóstico de la ITL en prisiones, y que su utilización contribuiría a una selección más específica de los internos que realmente necesitan un tratamiento para ITL. (AU)

Objectives: A high prevalence of prison inmates have a positive tuberculin skin test (TST) and sometimes unnecessary treatment for latent tuberculosis infection (LTBI) is prescribed. The prison tuberculosis prevention and control program has not generalized the use of QuantiFERON (QFT) in prisons. We set out to describe the implementation and usefulness o QFT in a population of inmates with positive TST, and to detect false positives and avoid unnecessary treatments. We also analysed the sociodemographic variables of the inmate population. Material and methods: All the positive TST tests between December 2020 and December 2021 from an average population of 300 inmates in Burgos prison were analysed. The QFT value was measured in all the positive cases. Sociodemographic variables were analysed and finally the number of inmates with positive TST, but with a negative QFT result and therefore not requiring LTBI treatment, was evaluated. Results: A total of 41 inmates were included in the study, with a mean age of 44 years. The proportion between Spanish inmates and foreigners was similar. Of all the positive TST, 48.8% were QFT negative. Discussion: It was observed that QFT is a safe method for the diagnosis of LTBI in prisons and that its use would contribute to a more specific selection of inmates who actually need chemoprophylactic treatment for LTBI. (AU)

Interferon-gamma release assay for the diagnosis of latent tuberculosis infection in the prison population with a positive tuberculin test: a descriptive study in a prison (Burgos, Spain).

OBJECTIVES: A high prevalence of prison inmates have a positive tuberculin skin test (TST) and sometimes unnecessary treatment for latent tuberculosis infection (LTBI) is prescribed. The prison tuberculosis prevention and control program has not generalized the use of QuantiFERON (QFT) in prisons. We set out to describe the implementation and usefulness of QFT in a population of inmates with positive TST, and to detect false positives and avoid unnecessary treatments. We also analysed the sociodemographic variables of the inmate population. MATERIAL AND METHODS: All the positive TST tests between December 2020 and December 2021 from an average population of 300 inmates in Burgos prison were analysed. The QFT value was measured in all the positive cases. Sociodemographic variables were analysed and finally the number of inmates with positive TST, but with a negative QFT result and therefore not requiring LTBI treatment, was evaluated. RESULTS: A total of 41 inmates were included in the study, with a mean age of 44 years. The proportion between Spanish inmates and foreigners was similar. Of all the positive TST, 48.8% were QFT negative. DISCUSSION: It was observed that QFT is a safe method for the diagnosis of LTBI in prisons and that its use would contribute to a more specific selection of inmates who actually need chemoprophylactic treatment for LTBI.

Institutional and familial cost of patients in continuous ambulatory peritoneal dialysis.

OBJECTIVE: to determine the cost of institutional and familial care for patients with chronic kidney disease replacement therapy with continuous ambulatory peritoneal dialysis. METHODS: a study of the cost of care for patients with chronic kidney disease treated with continuous ambulatory peritoneal dialysis was undertaken. The sample size (151) was calculated with the formula of the averages for an infinite population. The institutional cost included the cost of outpatient consultation, emergencies, hospitalization, ambulance, pharmacy, medication, laboratory, x-rays and application of erythropoietin. The family cost included transportation cost for services, cost of food during care, as well as the cost of medication and treatment materials acquired by the family for home care. The analysis included averages, percentages and confidence intervals. RESULTS: the average annual institutional cost is US$ 11,004.3. The average annual family cost is US$ 2,831.04. The average annual cost of patient care in continuous ambulatory peritoneal dialysis including institutional and family cost is US$ 13,835.35. CONCLUSION: the cost of chronic kidney disease requires a large amount of economic resources, and is becoming a serious problem for health services and families. It's also true that the form of patient management in continuous ambulatory peritoneal dialysis is the most efficient in the use of institutional resources and family.

Institutional and familial cost of patients in continuous ambulatory peritoneal dialysis / Custo institucional e da família do paciente em diálise peritoneal ambulatorial contínua

Objective: to determine the cost of institutional and familial care for patients with chronic kidney disease replacement therapy with continuous ambulatory peritoneal dialysis. Methods: a study of the cost of care for patients with chronic kidney disease treated with continuous ambulatory peritoneal dialysis was undertaken. The sample size (151) was calculated with the formula of the averages for an infinite population. The institutional cost included the cost of outpatient consultation, emergencies, hospitalization, ambulance, pharmacy, medication, laboratory, x-rays and application of erythropoietin. The family cost included transportation cost for services, cost of food during care, as well as the cost of medication and treatment materials acquired by the family for home care. The analysis included averages, percentages and confidence intervals. Results: the average annual institutional cost is US$ 11,004.3. The average annual family cost is US$ 2,831.04. The average annual cost of patient care in continuous ambulatory peritoneal dialysis including institutional and family cost is US$ 13,835.35. Conclusion: the cost of chronic kidney disease requires a large amount of economic resources, and is becoming a serious problem for health services and families. It's also true that the form of patient management in continuous ambulatory peritoneal dialysis is the most efficient in the use of institutional resources and family. .

Objetivo: determinar o custo da atenção institucional e familiar do paciente com doença renal crônica terminal em tratamento substitutivo com diálise peritoneal ambulatorial contínua. Métodos: foi desenvolvido um estudo de custo da atenção com pacientes com doença crônica renal em tratamento com diálise peritoneal ambulatorial contínua. A amostra foi de 151 pessoas, calculada com a fórmula das médias para população infinita. No custo institucional foi incluído o custo da consulta externa, urgências, internamento, ambulância, farmácia, medicamentos, laboratório, raios X e administração de eritropoetina. No custo da família foi considerado o custo do traslado para receber os serviços, o custo das refeições durante a atenção, além do custo dos medicamentos e do material para curativos comprados pela família no atendimento domiciliar. A análise foi com médias, porcentagens e intervalo de confiança. Resultados: o custo anual institucional é US$11.004,3. O custo anual da família foi em média de US$2.381,04. O custo anual, em média, da atenção do paciente com diálise peritoneal ambulatorial contínua, incluindo o custo institucional e familiar, é de US$13.835,35. Conclusão: o custo da doença renal crônica requer uma grande quantidade de recursos econômicos, convertendo-se em um sério problema para os serviços de saúde e a família. .