Objectives Chest X-ray (CXR) is recommended by the World Health Organization as a TB screening tool on admission to prison. We piloted the offer of CXR on admission to prison to understand if it was acceptable to residents, feasible to deliver within 48 hours of admission, and to inform TB epidemiology. Study Design Cross-sectional Method Between 1 September 2023 and 31 March 2024, CXRs were offered to new prison admissions. We measured the numbers accepting, numbers completed and the results. For each person accepting the CXR we undertook an assessment of clinical and social TB risks. We measured the time taken to deliver the CXR and receive results. Results CXR was acceptable to those in prison with 61% (n=310) of new admissions accepting the offer. Of those accepting the offer, 226 (73%) went on to receive a CXR, equating to 44% of all new arrivals within the pilot period. A quarter of those accepting the CXR offer did not attend their first appointment and needed further appointment offers. We observed that as the number of rearranged appointments increased the number of men attending decreased. The total median number of days from arrival at the prison to completion of CXR was 17 [IQR 13-20 days]. We did not identify any respiratory TB, however nine (4%) CXRs were abnormal. . Conclusion CXR screening was acceptable to prison residents but we could not achieve delivery within 48 hours of arrival to prison. We identified other respiratory abnormalities suggesting CXR screening could be used as a wider respiratory health screen of which TB would be included.

The authors have declared no competing interest.

This study did not receive any funding

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical oversight of the pilot and evaluation was provided by Public Health Wales NHS Trust Research & Development Office. The Public Health Wales NHS Trust Research & Development Office reviewed the project outline and determined this project was not defined as an NHS research project, according to the NHS definition of research, outlined in clause 3.1 of the UK Policy Framework for health and social care research. As a result of this decision, NHS research ethics approval was not required for this study. Public Health Wales received anonymous data and held and processed this under Public Health Wales information governance arrangements, in compliance with the Data Protection Act, Caldicott Principles and Public Health Wales guidance on the release of small numbers. A Data Protection Impact Assessment (DPIA) was completed.

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