SET TI NGS :Twenty-seven prisons in Thailand. sputum smear, for a prevalence of 354.8/100000. Males
OBJECTI VES : To measur e the pr evalence o f smear- were most likely to be diagnosed with TB disease (OR
positive tuberculosis (TB) and to compare its detection 2.6), as were those transferring in from another prison
using the World Health Organization (WHO) guidelines versus new prisoners (OR 3.0). The positive predictive
for prisons or the International Standards for Tubercu- value of the WHO criteria was 1.2%, and that of the
losis Care (ISTC) criteria. ISTC standard was 5.9%.
M ETH OD: P risoners who were not on TB medications andCONCLUSION: TB prevalence in this survey remained
who had not been treated for TB in the previous 6 monthshigh. WHO guidelines, recognised as a standard, require
were enrolled in the survey. Prison nurses conducted a health workers to question prisoners and measure height
one-time mass screening using the WHO questionnaire, and weight. The ISTC standard, a single question about
with follow-up sputum collection in TB suspects. cough 2 weeks, is simple, may be asked by non-health
RESULTS: Of 71594 prisoners, 22132 (30.9%) were personnel and may be a better alternative.
identiÞed as TB suspects, and 254 were conÞrmed by K EY W ORD S: prisons; tuberculosis; screening; Thailand