Search

Background: The occurrence of tuberculosis (TB) in prisoners is higher than in the general population. Objective: To determine the incidence of Latent tuberculosis infection (LTBI) in newly incarcerated persons in southern Thailand. Materials and Methods: A prospective cohort study was conducted between January 2020 and December 2020 in all new inmates aged 15 years or older. Within two weeks of imprisonment, chest radiography and the two-step tuberculin skin test (TST) were performed. Participants with a negative TST underwent a repeat one-step TST at six months. A positive TST at six months without evidence of TB indicated new LTBI. Results: Six hundred two male inmates were enrolled. Fifty-one prisoners (8.5%) were excluded due to a history of previous incarceration for 4.1%, history of TB for 0.8%, household contact with TB cases for 2.1%, and refusal to participate for 1.3%. The remaining 551 inmates participated in the study. The average age was 31.1 years. The two-step TST was completed in 507 inmates (92.0%). Two hundred thirteen out of 551 participants (38.7%) initially tested positive. Follow-up was conducted on 290 participants. Only 53 participants (9.6%) completed the study protocol at six months due to COVID-19 pandemic lockdown. Tuberculin conversion was found in five inmates (9.4%). Conclusion: LTBI prevalence and incidence rates among Thai inmates are high. Individuals with negative LTBI test at initial imprisonment were at high risk of acquiring infection and should be followed to detect conversion and offered LTBI treatment. [ABSTRACT FROM AUTHOR]

Background: Severe sepsis and septic shock are the most common causes of in-hospital death in Songkhla Provincial Hospital and half of the patients are transferred from community hospitals. A simple severe sepsis and septic shock fast track had been implemented in all community hospitals in Songkhla Province and in Songkhla Provincial Hospital in December 2013., Objective: Evaluate the clinical outcomes and predictors of mortality of severe sepsis and septic shock patients after implementation of the simple severe sepsis and septic shock fast track., Material and Method: A retrospective study of all available medical records between December 2013 and May 2014 of hospitalized patients aged older than 15 years with a final diagnosis of severe sepsis or septic shock., Results: Of 723 patients diagnosed as community acquired sepsis, 228 (31.5%) patients were diagnosed with severe sepsis or septic shock. A simple severe sepsis and septic shock fast track were activated in 69.3%. Patients in the activated fast track group had significantly lower mortality than the non-activated fast track group (21.0% vs. 42.9%, p = 0.001). After adjusted analysis, the four independent risk factors associated with increased mortality in severe sepsis and septic shock were initial presentation with systolic blood pressure lower than 90 mmHg (adjusted odds ratio [aOR] 2.57), central nervous system failure (aOR 7.33), acute renal failure (aOR 5.07), and received norepinephrine (aOR 2.87). Two factors associated with a significant decrease in mortality were the simple fast track activated at the emergency department (aOR 0.22) or at the ward (aOR 0.09) and received appropriate initial antibiotics (aOR 0.09)., Conclusion: Early recognition and early resuscitation in case of severe sepsis and septic shock can reduce mortality. A simple severe sepsis and septic shock fast track should be implemented in all community hospitals. It is a simple clinical diagnosis with simple management that is possible in every community hospital before transfer to a secondary or tertiary care hospital.