Sexually transmitted infections and other health conditions of women entering prison in Georgia, 1998-1999.

OBJECTIVES: To assess health needs of women entering the Georgia prison system, prevalence of pregnancy and sexually transmitted infections was estimated. STUDY: Results of admission screening tests of women entering the Georgia prison system in 1998 to 1999 were abstracted retrospectively from prison records. RESULTS: Of 3636 women whose data were abstracted from prison records, 4.3% were pregnant and 8.2%, 4.0%, 5.9%, and 0.7%, respectively, had positive screening tests for trichomoniasis, HIV, chlamydia, and gonorrhea; 19.5% had at least 1 of those conditions. HIV prevalence was higher among inmates who were black or had a rapid plasma reagin test for syphilis reactive at > or =1:8 dilutions (6.0%, 15.8%, respectively) than others (1.3%, 3.7%; P < 0.001). CONCLUSION: Inmates in this study had high rates of sexually transmitted infections and many were pregnant. Black inmates were at higher risk for HIV and high rapid plasma reagin titers than white inmates or other routinely tested Georgia female populations.

Intervention to reduce the incidence of methicillin-resistant Staphylococcus aureus skin infections in a correctional facility in Georgia.

BACKGROUND AND OBJECTIVE: In August 2001, a cluster of MRSA skin infections was detected in a correctional facility. An investigation was conducted to determine its cause and to prevent further MRSA infections. DESIGN: Case-control study. SETTING: A 200-bed detention center. PATIENTS: A case was defined as a detainee with a skin lesion from which MRSA was cultured from July 24 through December 31, 2001. Case-patients were identified by review of laboratory culture results and by skin lesion screening through point-prevalence survey and admission examination. Controls were randomly selected from an alphabetized list of detainees. INTERVENTION: Medical staff implemented measures to improve skin disease screening, personal hygiene, wound care, and antimicrobial therapy. RESULTS: Sixteen cases were identified: 11, 5, and 0 in the preintervention, peri-intervention, and postintervention periods, respectively. Seven case-patients and 19 controls were included in the case-control study. On multivariable analysis, working as a dormitory orderly (OR, 9.8; CI95, 0.74-638; P = .10) and a stay of longer than 36 days (OR, 6.9; CI95, 0.65-128.2; P = .14) were the strongest predictors for MRSA skin infection. The preintervention, peri-intervention, and postintervention MRSA infection rates were 11.6, 8.8, and 0 per 10,000 detainee-days, respectively. The rate of MRSA skin infections declined significantly between both the preintervention and peri-intervention periods and the postintervention period (P < .01 for both comparisons). CONCLUSIONS: MRSA skin disease can become an emergent problem in a correctional facility. Interventions targeted at skin disease screening, appropriate antimicrobial treatment, and hygiene may decrease the risk of acquiring MRSA infection in correctional facilities.