Pulmonary Tuberculosis and Drug Resistance in Dhaka Central Jail, the Largest Prison in Bangladesh

Abstract

BackgroundThere are limited data on TB among prison inmates in Bangladesh. The aim of the study was to determine the prevalence of pulmonary tuberculosis (TB), its drug resistance and risk factors in Dhaka Central Jail, the largest prison in Bangladesh.MethodsCross sectional survey with, active screening of a total number of 11,001 inmates over a period of 2 years. Sputum samples from TB suspects were taken for acid- fast bacilli (AFB) microscopy, culture and drug susceptibility testing.ResultsAmong 1,781 TB suspects 245 (13.8%) were positive for AFB on microscopy and/or culture. The prevalence rate of sputum- positive pulmonary TB was 2,227/100,000. Fifty three cases (21.6% of 245 cases) were AFB- negative on microscopy but were found positive on culture. Resistance to isoniazid, rifampicin, streptomycin and ethambutol was 11.4%, 0.8%, 22.4% and 6.5% respectively. No multidrug resistance was observed. The main risk factors of TB in prison were exposure to TB patients (adjusted odds ratio 3.16, 95% CI 2.36–4.21), previous imprisonment (1.86, 1.38–2.50), longer duration of stay in prison (17.5 months for TB cases; 1.004, 1.001–1.006) and low body mass index which is less than 18.5 kg/m2 (5.37, 4.02–7.16).ConclusionsThe study results revealed a very high prevalence of TB in the prison population in Dhaka Central Jail. Entry examinations and active symptom screening among inmates are important to control TB transmission inside the prison. Identifying undiagnosed smear-negative TB cases remains a challenge to combat this deadly disease in this difficult setting.

Investigation on Pulmonary Tuberculosis Among Bedele Woreda Prisoners, Southwest Ethiopia

“…The prevalence of this study was higher than the studies conducted in Bangladesh 13.8 % [9], Cameron 1.2% [13], Brazil 2.5% [19], Iran 0.91% [20], Malawi 0.7% [22] and North Gonder, Ethiopia 8.9% [23]. On the other hand, the prevalence of this study was lower than the studies conducted in Nigeria 54.2 % [4] and Pakistan 26.3 % [21].…”

“…High levels of TB in prison populations are likely to be attributable to the fact that a disproportionate number of prisoners are from population groups already at high risk of TB infection and TB disease .Furthermore, the prison setting, where segregation criteria are based on crime characteristics rather than on public health concerns, may facilitate transmission. In addition, late case detection, inadequate treatment of infectious cases, high turnover of prisoners, and poor implementation of TB infection control measures are all known factors contributing to transmission of Mycobacterium tuberculosis [5][6][7][8][9][10].…”

Active Case Finding of Pulmonary Tuberculosis among Prison Inmates in Aba Federal Prison, Abia State, Nigeria

“…Prisons are often high-risk environments for TB transmission because of severe overcrowding, poor nutrition, poor ventilation, and limited access to often insufficient health care. Moreover, prisoners are overwhelmingly male, are typically aged 15 -45 years, and come predominantly from poorly educated and socioeconomically deprived sectors of the population where TB infection and transmission are higher [1]. One infectious prisoner with TB may infect the others very efficiently.…”

Notified tuberculosis among Singapore residents by ethnicity, 2002–2011

“…25,26 Data from this study show that a signifi cantly higher number of Malays were incarcerated in a correctional facility at the moment of notifi cation. However, using available data, it cannot be ascertained whether more Malay inmates had TB, or whether the proportion of Malays was the same among inmates with TB and among all inmates in Singapore.…”