NEW YORK, Mar 15 (Reuters Health) - Factors such as overcrowding and malnourishment put prison inmates at high risk for tuberculosis (TB), yet short incarceration periods make it difficult for these individuals to complete the standard treatment with isoniazid, according to researchers. A new two-drug treatment that lasts for 2 months may help solve this problem, new study findings suggest.

"2RZ appears to be a promising regimen for improving completion of treatment of (latent tuberculosis infection) in this difficult-to-reach, high-risk population, and its expanded use could contribute to our goal to eliminate tuberculosis in the United States," according to Dr. Naomi N. Bock, of the Centers for Disease Control and Prevention, and colleagues.

In a year-long study, the investigators found that 1,360 of the more than 234,000 new inmates admitted to Fulton County Jail in Georgia tested positive for TB. Of that group, 168 were eligible for the 2RZ drug treatment, the authors report in the March issue of Chest. The ineligible group included inmates who were released before being interviewed by the 2RZ drug treatment coordinator as well as those who said they were previously treated for TB.

About 50% of the 2RZ group completed the 2-month treatment which includes daily doses of rifampin and pyrazinamide, while 44% were released before completion of therapy, the report indicates. Treatment was discontinued in the remaining individuals due to side effects such as rash, headaches or nausea.

These findings show an almost fourfold increase in the number of inmates who completed 2RZ treatment in comparison to the number of inmates who completed isoniazid therapy during the previous year, the authors comment.

"2RZ was acceptable to and well tolerated by inmates, and led to a marked increase in the number of inmates completing treatment of (TB) during incarceration," Bock and her team report.

As a result, "jail and public health programs can build on these successes to expand its successful use," the researchers add.

In a related editorial, Dr. Rafael Laniado-Laborin comments that the new 2RZ drug treatment is an "innovative approach" to solving the lack of compliance among jail inmates.

Citing the importance of treatment completion, he writes, "Interrupted or incomplete treatment increases the risk of treatment failure, relapse of disease, and transmission of drug-resistant TB."

Laniado-Laborin concludes, "Let's not forget that TB in any segment of the population endangers every member of society."

According to Dr. Charles Daley, medical director of the TB Training Center at the F.J. Curry National TB Center in San Francisco, the study represents "an excellent first step toward improving the completion rates of treatment for latent infection in inmates in jail."

Daley points out, however, that while "the results are convincing regarding the higher completion rates among inmates in Fulton County Jail...unfortunately, as has been demonstrated in other studies, once an inmate leaves the jail, the completion rate is very low."

He also questions whether "this (is) a cost-effective strategy. Are the added drug costs offset by the higher completion rates?"

• More news on Tuberculosis

Related MEDLINEplus Pages:

• Tuberculosis