METHODS: Consented, full-time prison employees were interviewed using a structured questionnaire that included sociodemographic data, history of working in the correctional system and TB-related risk. TST was placed intradermally and read after 48-72 h. Induration size of ≥10 mm was considered positive. Logistic regression analyses were conducted to explore associations with TST positivity.
RESULTS: Of the 445 recruited prison employees, 420 (94.4%) had complete data. Most were young (median=30.0 years) men (88.8%) who had only worked at this prison (76.4%) for a median total employment period of 60 months (IQR 34.5-132.0). The majority were correctional officers, while civilian employees represented only 7.6% of the sample. Only 26 (6.2%) reported having ever been screened for TB since employment. Prevalence of TST positivity was 81% and was independently associated with longer (≥12 months) prison employment (AOR 4.9; 95% CI 1.5 to 15.9) and current tobacco smoking (AOR=1.9, 95% CI 1.2 to 3.2).
CONCLUSIONS: Latent TB prevalence was high in this sample, approximating that of prisoners in this setting, perhaps suggesting within prison TB transmission in this facility. Formal TB control programmes for personnel and prisoners alike are urgently needed within the Malaysian correctional system.
OBJECTIVE: To determine the seroprevalence of leptospirosis among cattle farmers, prevalence of pathogenic Leptospira, and the workplace environmental risk factors for leptospirosis among cattle farmers in northeastern Malaysia.
METHODS: A cross-sectional study involving 120 cattle farmers was conducted. The participants answered an interviewer-guided questionnaire that consisted of sociodemographic and workplace environment characteristics questionnaire, before having their blood sample taken for microscopic agglutination test (MAT). Seropositivity was determined using a cut-off titer of ≥1:100. 248 environmental samples were also collected from the cattle farms for polymerase chain reaction (PCR).
RESULTS: The overall seroprevalence of leptospiral antibodies was 72.5% (95% CI 63.5% to 80.1%) and the prevalence of pathogenic Leptospira in the cattle farms environment was 12.1% (95% CI 8.4% to 17.0%). The independent factors associated with seropositivity of leptospirosis among cattle farmers were positive pathogenic Leptospira in the environment (Adj OR 5.90, 95% CI 1.34 to 26.01) and presence of garbage dumping in the farm (Adj OR 2.40, 95% CI 1.02 to 5.65).
CONCLUSION: Preventing leptospirosis incidence among cattle farmers necessitates changes in work environment. Identifying modifiable factors may also contribute to the reduction of infection.