The Status of TB Prevention and Control Measures
in Large City and County Jails in the U.S.
Provide More Comprehensive and Timely Screening and
Although most jail systems had adequate policies for
TB screening, most still need to strengthen their screening practices.
First, there was a lack of information in the medical records about
TB history and risk factors, including HIV status. Second, at least
one quarter of the jail systems did not have policies requiring
chest radiographs for all known HIV-positive inmates. Third, the
study found routine lengthy delays in obtaining chest radiograph
results for inmates who were symptomatic, skin test positive, or
HIV positive. In the intervening time, potentially contagious inmates
were housed with the general population.
In terms of diagnostic practices, TB symptoms and abnormal chest
radiographs did not always trigger an evaluation for TB. According
to medical records reviewed, several cases of active TB were initially
misdiagnosed or missed.
- Screen inmates for TB symptoms in a timely manner after entry
and ask about key symptoms, such as persistent cough.
- Systematically gather data about TB risk factors during the
initial medical screening and evaluation.
- Routinely administer chest radiographs to all known HIV-positive
inmates and to inmates who are at risk for HIV but whose status
- Periodically assess the timeliness of chest radiograph results
so that jail medical staff have a chest radiograph interpretation
within 24 hours of symptoms and within 72 hours of a positive
Released October 2008
Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Division of Tuberculosis Elimination - http://www.cdc.gov/tb
Please send comments/suggestions/requests
CDC/Division of Tuberculosis Elimination
Communications, Education, and Behavioral Studies Branch
1600 Clifton Rd., NE - Mailstop E-10, Atlanta, GA 30333