Evaluation of Compliance with Anti-tubercular Chemoprophylaxis among the Prison Population. A Study Carried out in Jaen Prison

Abstract

Background: This study highlights the importance of anti-tubercular chemoprophylaxis with isoniazid to control and prevent tuberculosis in prisons. The relationship between compliance with the chemoprophylaxis and study factors was evaluated and we examined whether health education given in our prison motivated the prisoners to comply with this treatment. Methods: Compliance with chemoprophylaxis using isoniazid by 52 inmates of the Jaén Penal Institution was studied for the period February to May 1995. The dose of isoniazid taken was calculated by means of the spectrophotometric determination of isoniazid metabolites in urine using the Eidus Hamilton method. Likewise, the influence of variables such as sex, HIV infection, legal situation and cultural level on compliance was studied. Results: Out of 52 inmates, 23 (44.23%) were taking a daily dose of isoniazid that was considered to be effective and 29 inmates (55.77%) were taking less than the effective isoniazid dose for the chemoprophylaxis. With regard to the variables studied, greater compliance with the chemoprophylaxis was recorded among men (sex variable) and those inmates with a higher educational level (cultural level) although no significant differences were found. Conclusions: Compliance with the chemoprophylaxis among our inmates is inadequate although it matches similar studies that have been carried out on the prison population. This is not the case for the community population where compliance with chemoprophylaxis is greater. This low compliance forces us to review our current health education programme and to take steps that might increase this degree of compliance such as direct observation of treatment, a system of intermittent treatment, etc