Half of Pulmonary Tuberculosis Cases Were Left Undiagnosed in Prisons of the Tigray Region of Ethiopia: Implications for Tuberculosis Control

Adane, Kelemework; Spigt, Mark; Ferede, Semaw; Asmelash, Tsehaye; Abebe, Markos; Dinant, Geert‐Jan

doi:10.1371/journal.pone.0149453

Cited by 32 publications

(48 citation statements)

References 22 publications

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“…Our estimated TB prevalence falls within the range of figures found in other prison settings across the African continent [ 17 , 18 , 20 – 27 ]. Importantly, though, this high prevalence was found after 16 years of a program that made TB screening and treatment routinely available in the main prisons of Côte d’Ivoire.…”

Section: Discussionsupporting

confidence: 82%

“…Overcrowding is a well known condition for TB transmission in prison [ 16 – 18 ]. The average living surface area at MACA is 1.3 m 2 per male inmate, well below the 4m 2 recommended by the WHO [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, these cases represented only 8% of the overall TB cases found during the study. The remaining 92% were diagnosed thanks to a systematic in-cell screening of all inmates, and would likely have long remained undiagnosed outside the context of this study [ 18 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of pulmonary tuberculosis among prison inmates: A cross-sectional survey at the Correctional and Detention Facility of Abidjan, Côte d'Ivoire

et al. 2017

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BackgroundIn Côte d’Ivoire, a TB prison program has been developed since 1999. This program includes offering TB screening to prisoners who show up with TB symptoms at the infirmary. Our objective was to estimate the prevalence of pulmonary TB among inmates at the Correctional and Detention Facility of Abidjan, the largest prison of Côte d’Ivoire, 16 years after this TB program was implemented.MethodsBetween March and September 2015, inmates, were screened for pulmonary TB using systematic direct smear microscopy, culture and chest X-ray. All participants were also proposed HIV testing. TB was defined as either confirmed (positive culture), probable (positive microscopy and/or chest X-ray findings suggestive of TB) or possible (signs or symptoms suggestive of TB, no X-Ray or microbiological evidence). Factors associated with confirmed tuberculosis were analysed using multivariable logistic regression.ResultsAmong the 943 inmates screened, 88 (9.3%) met the TB case definition, including 19 (2.0%) with confirmed TB, 40 (4.2%) with probable TB and 29 (3.1%) with possible TB. Of the 19 isolated TB strains, 10 (53%) were TB drug resistant, including 7 (37%) with multi-resistance. Of the 10 patients with TB resistant strain, only one had a past history of TB treatment. HIV prevalence was 3.1% overall, and 9.6%among TB cases. Factors associated with confirmed TB were age ≥30 years (Odds Ratio 3.8; 95% CI 1.1–13.3), prolonged cough (Odds Ratio 3.6; 95% CI 1.3–9.5) and fever (Odds Ratio 2.7; 95% CI 1.0–7.5).ConclusionIn the country largest prison, pulmonary TB is still 10 (confirmed) to 44 times (confirmed, probable or possible) as frequent as in the Côte d’Ivoire general population, despite a long-time running symptom-based program of TB detection. Decreasing TB prevalence and limiting the risk of MDR may require the implementation of annual in-cell TB screening campaigns that systematically target all prison inmates.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

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Prevalence of pulmonary tuberculosis among prison inmates: A cross-sectional survey at the Correctional and Detention Facility of Abidjan, Côte d'Ivoire

et al. 2017

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“…It was found that the majority of the PDL in this study did not perform X-ray for diagnosis and only some of them went to the rear services to carry out the examination. This reveals weaknesses in the availability of the equipment and the network for TB screening, which can be caused by the limited financial and human resources present in most penitentiary complexes [10,16]. These results reveal the need to acquire radiological equipment, fixed or mobile, since some studies demonstrate that annual radiological screening, other than symptom-based one, has been used to identify suspected cases of TB and played an important role in the reduction of the disease incidence and prevalence in prisons [11,17].…”

Section: Discussionmentioning

confidence: 99%

“…It should be noted that the PDL receive visits from family, friends and have constant communication with local staff, which make them important sources of the disease, with the risk of dissemination to the population inside and outside of prison [15,16]. Once there is an association between the cases notified by the penitentiary complex and more than ten contacts identified, the investigation of contacts emerges as a strategy to disease control.…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis in prison and aspects associated with the diagnosis site

Ferreira

Bonfim

Siqueira

et al. 2019

J Infect Dev Ctries

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Introduction: Tuberculosis (TB) is highly endemic in prison environments, and requires special attention in the population deprived of liberty (PDL). Thus, we aimed to describe the epidemiological situation of TB among PDL in a large municipality of the Brazilian Legal Amazon, from 2012 to 2016, and to identify the factors associated with the site of TB cases notification. Methodology: Both descriptive and cross-sectional studies were conducted. Sociodemographic, clinical, diagnostic and treatment data of PDL with TB were collected from the National Disease Notification System - SINAN. Data analysis included frequency distribution, Chi-square test, Fisher exact test and residue analysis, with a significance level of 95%. Results: 256 cases of TB have been notified among PDL in the penitentiary complex situated in the municipality and 100 cases in local health services, such as Primary Health Care units or referral services. Notification in the penitentiary complex was associated with non-X-ray and more than ten contacts identified. An association was found between diagnosis in local health services and female sex, AIDS, alcoholism, illicit drug use, extrapulmonary clinical form, extrapulmonary pulmonary disease, suspected X-ray, sputum smear-negative for diagnosis, HIV positive, culture of sputum not performed/ in progress, DOT ignored/ blank, less than five contacts identified, transfer and others as closure situation. Conclusions: The results show that intricate TB cases were notified by the local health services. Strategies of surveillance and articulation with these health services seem to contribute to the identification of TB cases among PDL.

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Magnitude, associated risk factors, and trend comparisons of identified tuberculosis types among prisons in Ethiopia: A systematic review and meta‐analysis

Genet,

Girma

2024

Health Science Reports

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Background and AimsTuberculosis (TB) remained a major public health threat, particularly in developing countries with vulnerable groups, particularly prison inmates. A systematic review and meta‐analysis of individual studies with varying prevalence rates were performed to identify risk factors associated with the recent magnitude of TB among prisoners.MethodsA systematic search of research articles on the magnitude and risk factors of TB among prisoners in Ethiopia was conducted in registers, databases, and other sources. Cochran's Q, inverse variance (I2), sensitivity analysis, funnel plot, Begg's, and Egger's regression tests were used to check heterogeneity and publication bias. A random‐effects model was used to calculate the pooled burden of TB among prisoners.ResultsThe total national prevalence of TB among prisoners was 9.84% (95% confidence interval [CI]: 7.16–12.52). According to the subgroup analysis, the highest prevalence was observed in patients infected by latent TB (51.20%), the Southern nations, nationalities and people's region (SNNPR) (29.63%), studies conducted in ≤200 (17.50%) sample sizes, and from 2017 to 2022 (11.49%) study periods. TB infection among prisoners was significantly associated with a history of contact with TB patients (adjusted odds ratio [AOR] = 2.75; 95% CI: 0.98–4.52), coughing for ≥2 weeks (AOR = 0.08; 95% CI: −0.16–0.33), being incarcerated in overcrowded cells with poor ventilation (AOR = 0.39; 95% CI: −0.01–0.78), and increasing with the duration of imprisonment (AOR = 1.29; 95% CI: −0.39–2.97].ConclusionExpectably high TB magnitude is found among prison inmates in Ethiopia. Duration of incarceration, coughing, ventilation of the cell, and contact with TB patients were all predictors of TB among prisoners. The management of TB requires early diagnosis, adequate medication, and the implementation of preventative and control measures suitable for prison inmates.

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Half of Pulmonary Tuberculosis Cases Were Left Undiagnosed in Prisons of the Tigray Region of Ethiopia: Implications for Tuberculosis Control

Cited by 32 publications

References 22 publications

Prevalence of pulmonary tuberculosis among prison inmates: A cross-sectional survey at the Correctional and Detention Facility of Abidjan, Côte d'Ivoire

Prevalence of pulmonary tuberculosis among prison inmates: A cross-sectional survey at the Correctional and Detention Facility of Abidjan, Côte d'Ivoire

Tuberculosis in prison and aspects associated with the diagnosis site

Magnitude, associated risk factors, and trend comparisons of identified tuberculosis types among prisons in Ethiopia: A systematic review and meta‐analysis

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