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

Abstract

Background: Conditions in prisons favour rapid transmission of Mycobacterium tuberculosis and progression to tuberculosis (TB) disease, resulting in higher prevalence rates of TB in prisons than in the corresponding general population. However, in many developing countries with high TB burden, passive case-finding remains the usual approach to case detection of TB in prisons. On this premise, the Abia State TB Control Programme conducted a pilot study to assess the contribution of active case finding to tuberculosis control in Aba Federal Prison. Methods: The inmates were clinically screened and those with symptoms suggestive of TB cases were tested by sputum smear microscopy. Results: Out of the total number of 477 prison inmates present in the prison at the time of study, 449 (94.1%) were clinically screened for history of cough of 2 weeks' duration; 52 (10.42%) met the inclusion criteria for sputum smear microscopy. Eleven of the 52 (21.15%) tested for acid fast bacilli (AFB) by direct smear light microscopy were positive for AFB. One inmate was on anti-tuberculosis therapy; this with the 11 cases detected in the course of this study gave a total of 12 inmates of Aba prison with active pulmonary tuberculosis at the time of this study. This gives a minimum point prevalence rate of 2405 cases per 100,000 prison inmates. Four of the 11 prison cells had at least one smear positive case with 7 of the 11 cases concentrated in two cells. The age group of 25 -34 years had the highest number of sputum positive cases. Conclusion: Active case-finding resulted in detection of 11 new cases of sputum positive tuberculosis (an increase in detection rate of 1100%) and the prevalence of sputum positive TB is very high (2405 cases per 100,000 prison inmates) in Aba prison. There is an urgent need to institute more effective TB case-finding and control in the prison.

Passive surveillance of communicable diseases among inmates of Jos central prison, Nigeria

“…41 Much higher prevalence rates x14 times higher than the general Nigerian population was seen in Aba prison, Abia State, Nigeria. 6 The average point prevalence rate for African region is x4 times higher than our result. Ekundayo et al 6 observed that the consequences of high prevalence of tuberculosis in the prisons was observed to extend beyond the prison walls because it could spread through visitors, prison staff and discharged inmates into the larger society.…”

“…1 Most of the studies conducted on disease situations in Nigerian prisons have focused mainly on intestinal parasites. 5 Literature on other disease conditions is scanty, except for the study on pulmonary tuberculosis among inmates of Aba Federal Prisons in Nigeria 6 and few others that studied haemoparasites and urinary parasites. 5,7,8 Recent studies conducted in Jos prison facility were centered mainly on helminthes and malaria.…”

Effectiveness of Contact Tracing of Index Tuberculosis Cases in Nigeria

“…The case detection approach in most high burden countries including Nigeria is passive; this is affected by low knowledge of TB and poor health seeking behavior which invariably affects case finding [21]. Though diagnosis and treatment of TB is free however hidden and catastrophic cost incurred by patients affects health seeking behavior [22].…”

“…The key component of the pillar one of the end TB strategy underpins early case detection as vital factor in TB dynamics [2]. Nigeria has adopted the END TB strategy however passive case finding method widely practiced has affected the case detection rate [21]. Consequently, a shift from passive to active case DOI: 10.4236/aid.2018.84016 finding approach is crucial to improve TB case detection in Nigeria [24].…”

“…Furthermore, according to [57] poor knowledge of TB in community is a setback to presumptive TB case referral and early case detection. The case detection approach in Nigeria and most high burden countries is passive this is affected by low knowledge and poor health seeking behavior [21]. The key component of the pillar one of the end TB strategy underpins early case detection as vital factor in TB dynamics [2].…”