Interferon gamma release assay and sputum GeneXpert positivity for tuberculosis burden detection in people deprived of liberty in Brazil: a cross-sectional study

BACKGROUND: Globally tuberculosis disease (TB) poses a significant public health challenge. People deprived of liberty (PDL) are one of the most affected. This study aims to evaluate the positivity of interferon gamma release assay (IGRA) and molecular sputum testing for TB through a multicenter survey of Brazilian prisons and evaluate factors associated with IGRA positivity. METHODS: (Xpert). We included individuals with complete data and valid IGRA results for analysis. Multivariable logistical regression was performed to evaluate factors associated with IGRA positivity stratified by gender. RESULTS: Among 1040 PDL randomized, 884 were included. The overall IGRA positivity was 53.6% (95% confidence interval [CI] 50.3-56.9) varying between 29.2% (21.6-38.2) and 84.0% (75.3-90.1) among prisons sites, male and female individuals had a positivity of 61.9% (58.1-65.5) and 30.3% (24.7-36.5), respectively. In the multivariable analysis, IGRA positivity was associated with lower education (adjusted odds ratio [aOR] 1.46, 95% CI 1.03-2.07, p = 0.034), previous incarceration (aOR 2.81, 1.85-4.25, p < 0.001), previous TB history (aOR 2.99, 1.39-6.42, p < 0.001) and incarceration time (< 1 year as reference, 3-4 years: aOR 2.15, 1.18-3.92, p = 0.012; 5 years or above: aOR 2.85, 1.66-4.90, p < 0.001) for males. In females, IGRA positivity was associated with previous TB history (aOR 5.93, 1.97-20.2, p = 0.002). One prison could not collect sputum samples; at the remaining sites we detected 20 individuals (2.5%, 20/770) with positive Xpert. CONCLUSION: Despite variations among prisons and gender, IGRA and Xpert positivity were elevated across sites evaluated in Brazil. These findings underscore the urgent need for systematic and comprehensive tuberculosis screening, prevention, and control strategies in prisons, including the potential evaluation of new preventative technologies such as new TB vaccines.

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Journal
BMC Public Health
Published
2026-05-12
DOI
https://doi.org/10.1186/s12889-026-27643-3
Primary Topic
Tuberculosis Research and Epidemiology
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article
Field-Weighted Citation Impact
0.00

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article

Interferon gamma release assay and sputum GeneXpert positivity for tuberculosis burden detection in people deprived of liberty in Brazil: a cross-sectional study

José Victor Bortolotto Bampi, Allyson Guimarães Costa, M. T. Ventura, K. Renil Thomas et al.
BMC Public Health
Tuberculosis Research and Epidemiology
article

Interferon gamma release assay and sputum GeneXpert positivity for tuberculosis burden detection in people deprived of liberty in Brazil: a cross-sectional study

José Victor Bortolotto Bampi, Allyson Guimarães Costa, M. T. Ventura, K. Renil Thomas, Jaquelane Silva Jesus, Everton Ferreira Lemos, Mayara Gonçalves Tavares, Beatriz do Carmo Veloso de Oliveira, Rosilene Ruffato, Mariana Pinheiro Alves Vasconcelos, Eduarda Gassen Boeira, Lia Gonçalves Possuelo, Karina Marques Santos, Ghislaine Gonçalez de Araujo Arcanjo, Pedro P. Carneiro, Giselle Lima de Freitas, Bruno B. Andrade, Richard G. White, Marcelo Cordeiro-Santos, Beatriz Barreto-Duarte, Rebecca A. Clark, Julio Croda
article en

Abstract

BACKGROUND: Globally tuberculosis disease (TB) poses a significant public health challenge. People deprived of liberty (PDL) are one of the most affected. This study aims to evaluate the positivity of interferon gamma release assay (IGRA) and molecular sputum testing for TB through a multicenter survey of Brazilian prisons and evaluate factors associated with IGRA positivity. METHODS: (Xpert). We included individuals with complete data and valid IGRA results for analysis. Multivariable logistical regression was performed to evaluate factors associated with IGRA positivity stratified by gender. RESULTS: Among 1040 PDL randomized, 884 were included. The overall IGRA positivity was 53.6% (95% confidence interval [CI] 50.3-56.9) varying between 29.2% (21.6-38.2) and 84.0% (75.3-90.1) among prisons sites, male and female individuals had a positivity of 61.9% (58.1-65.5) and 30.3% (24.7-36.5), respectively. In the multivariable analysis, IGRA positivity was associated with lower education (adjusted odds ratio [aOR] 1.46, 95% CI 1.03-2.07, p = 0.034), previous incarceration (aOR 2.81, 1.85-4.25, p < 0.001), previous TB history (aOR 2.99, 1.39-6.42, p < 0.001) and incarceration time (< 1 year as reference, 3-4 years: aOR 2.15, 1.18-3.92, p = 0.012; 5 years or above: aOR 2.85, 1.66-4.90, p < 0.001) for males. In females, IGRA positivity was associated with previous TB history (aOR 5.93, 1.97-20.2, p = 0.002). One prison could not collect sputum samples; at the remaining sites we detected 20 individuals (2.5%, 20/770) with positive Xpert. CONCLUSION: Despite variations among prisons and gender, IGRA and Xpert positivity were elevated across sites evaluated in Brazil. These findings underscore the urgent need for systematic and comprehensive tuberculosis screening, prevention, and control strategies in prisons, including the potential evaluation of new preventative technologies such as new TB vaccines.

BMC Public Health
Universidade Federal de Minas Gerais (BR), Universidade Federal de Mato Grosso do Sul (BR), Johns Hopkins University (US), Universidade de Santa Cruz do Sul (BR), Johns Hopkins Medicine (US), Universidade Estadual de Mato Grosso do Sul (BR), Yale University (US), Fundação de Medicina Tropical (BR), London School of Hygiene & Tropical Medicine (GB), Institute for Research on Population and Social Policies (IT), Universidade Nilton Lins (BR), Universidade do Estado do Amazonas (BR), Fundação Oswaldo Cruz (BR), Universidade Federal do Amazonas (BR), Companhia Energética de Minas Gerais (Brazil) (BR)
Bill and Melinda Gates Foundation, Wellcome Trust, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Medical Research Council, Economic and Social Research Council
Gender equality
Openalex Percentile: Top 5%
Tuberculosis Research and Epidemiology
DOIOpen Access PDFOpenAlex
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