Tuberculosis in Correctional Facilities: The Tuberculosis Control Program of the Montefiore Medical Center Rikers Island Health Services

Braun Miles Tusman Benedict Maquire Barbara , George T. DiFerdinando, Wormser Gary Broaddus Raymond Morse Dale L. , “Increasing Incidence of Tuberculosis in a Prison Inmate Population: Association with HIV,” The Journal of the American Medical Association, 261 (Jan. 1989): 293–97; Bellin Eran Fletcher David Safyer Steven M. , “Association of Tuberculosis Infection with Increased Time in or Admission to the New York City Jail System,” The Journal of the American Medical Association, 269 (May 1993): 1–4; Ables H. Feibes E. Mandel E. , Girard J. A. , “The Large City Prison—A Reservoir of Tuberculosis: Tuberculosis Control among Sentenced Male Prisoners in NYC,” American Review of Respiratory Disease, 101 (1970): 706–09; King Lambert Geis George , “Tuberculosis Transmission in a Large Urban Jail,” The Journal of the American Medical Association, 237 (Feb. 1977): 791–92; Stead William , “Undetected Tuberculosis in Prison (Source of Infection for the Community at Large),” Journal of the American Medical Association, 240 (1978): 2544–47.

Mahmoudi Artin Iseman Michael D. , “Pitfalls in the Care of Patients with Tuberculosis,” The Journal of the American Medical Association, 270 (July 1993): 65–8.

Friedan T. Sterling T. Pablos-Mendez A. , “The Emergence of Drug-Resistant Tuberculosis in New York City,” New England Journal of Medicine, 328:521–526 (February 25, 1993).

“Transmission of Multidrug-Resistant Tuberculosis among Immunocompromised Persons in a Correctional System,” Monthly Mortality Weekly Review, 41 (July 1992): 507–09.

Barnes Peter F. Bloch Alan B. Davidson Paul T. Snider Dixie E. , “Tuberculosis in Patients with Human Immunodeficiency Virus Infection,” New England Journal of Medicine, 324 (June 1991): 1644–50

“Tuberculosis in New York City,” Information Summary 1992. Bureau of Tuberculosis Control. New York City Department of Health.

The Federal Anti-Drug Act of 1986 requires prison sentences of low-level carriers as well as high-volume dealers.

Snider Dixie E. Hutton M.D. , “Tuberculosis in Correctional Institutions,” The Journal of the American Medical Association, 261 (Jan. 1989): 436–37; “In 1991, State and Federal prisons were operating at 25.1 percent over capacity,” Americans Behind Bars, Edna McConnell Clark Foundation, (March 1992).

“This represents a 20 percent increase over the previous year,” Americans Behind Bars, Edna McConnell Clark Foundation (March 1992).

Special Report: “Women in Prison,” U.S. Department of Justice, Bureau of Justice Statistics (1991).

National Institute of Justice, Bureau of Justice Statistics. Sourcebook (1991).

Mauer M. , “Young Black Men and the Criminal Justice System: A Growing National Problem,” Washington, The Sentencing Project, 1990:1.

Miller Jerome G. , Hobbling a Generation: Young African-American Mates in the Criminal Justice System of America's Cities; Baltimore, September 1992, National Center on Institutions and Alternatives.

Americans Behind Bars, Edna McConnell Clark Foundation (March 1992).

“Homelessness and Indicators of Mental Illness among Inmates in New York City's Correctional System,” Hospital and Community Psychiatry, 43 (1992): 150–55.

Stead William , “Undetected Tuberculosis in Prison (Source of Infection for Community at Large),” The Journal of the American Medical Association, 240 (1978): 2544–47.

New York City Department of Health, “Tuberculosis in New York City 1991—Information Summary Bureau of Tuberculosis Control,”

“Tuberculosis in New York City,” Information Summmary 1992 New York City Department of Health Bureau of Tuberculosis Control.

“Tuberculosis in New York City,” Information Summary 1992, New York City Department of Health Bureau of Tuberculosis Control.

Brudney Karen Dobkin Jay , “Resurgent Tuberculosis in New York City: Human Immunodeficiency Virus, Homelessness, and the Decline of Tuberculosis Control Program,” American Review of Respiratory Disease, 144 (1991):745–48.

Brudney Karen Dobkin Jay , “Tale of Two Cities: Tuberculosis Control in Nicaragua and New York City,” Seminars in Respiratory Infections, 6 (1991): 261–272.

“Prior to 1980, two thirds of federal anti-drug funding was devoted to prevention, treatment and education. Two years later, the emphasis was reversed and has remained so. In 1991,70 percent of the 10.8 billion drug budget was spent on law enforcement and interdiction; 30 percent went to treatment and prevention,” Americans Behind Bars, Edna McConnell Clark Foundation (March 1992).

National Institute of Justice. Bureau of Justice Statistics. Sourcebook (1991).

Americans Behind Bars, Edna McConnell Clark Foundation, March 1992.

1991 Sourcebook of Criminal Justice Statistics. U.S. Department of Justice, Bureau of Justice Statistics.

Weisfuse I. Back Greenberg B. , “HIV-1 Infection Among New York City Inmates,” AIDS, 5 (1991): 1133–1138.

Richmond L.B. , unpublished data. 1993.

Bickell N.A. Vermund S.H. Holmes M. Safyer S.M. Burke R.D. , “Human Papillomavirus, Gonorrhea, Syphilis and Cervical Dysplasia in Jailed Women,” American Journal of Public Health, 81 (1991): 1318–1320.

The Rikers Island figures are based on prescribing medications. Many patients are discharged from the system before confirmation of diagnostic tests can occur.

The examination and assessment include a Purified Protein Implant (PPD) to detect the presence of tuberculosis infection, complete blood work including a syphilis test. In addition, women receive pregnancy tests, gonorrhea testing, and chlamydia tests. HIV antibody testing is available through our voluntary and confidential HIV counseling and testing program. Patients are given a number and if they are released from the system before receiving their results they can access the results through the Department of Health HIV testing sites.

“Anergy Compromises Screening for Tuberculosis in High Risk Populations,” APHA, 83 (1993): 749–751.

Bellin E. Fletcher D. Safyer S. , “Abnormal Chest X-rays in Intravenous Drug Users: Implications for Tuberculosis Screening Programs,” American Journal of Public Health, 83 (May 1993).

Eran Bellin , M.D. Fletcher David , MPH, unpublished data.

Unpublished data, Bellin E.

Cohn D.L. Catlin B.J. Peterson K.L. , “A 62-Dose, 6-Month Therapy for Pulmonary and Extrapulmonary Tuberculosis: A Twice-Weekly, Directly Observed, and Cost-Effective Regimen,” Annals of Internal Medicine, 112 (1990): 407–415.