Diagnostic accuracy of screening algorithms to identify persons with active pulmonary tuberculosis at prison entry: protocol of a systematic review and network meta-analysis

Abstract

Prison inmates are a high-risk group for tuberculosis (TB) infection and disease due to the increasing number of vulnerable fringe groups, risk factors (e.g., alcohol and drug addictions), contagious diseases (HIV, hepatitis), and their high-risk behavior. Compared to the general population, TB incidence and prevalence rates are significantly higher among prison inmates. Early identification of potentially infectious pulmonary TB (PTB) and targeted care of sick inmates are essential to effectively control TB within the prison system. The WHO recommends combining active and passive case-finding in prisons. No study has been published comparing the broad spectrum of screening tools using a diagnostic accuracy network meta-analysis (NMA). We aim to identify the most accurate TB case-finding algorithm at prison entry that is feasible in resource-limited prisons of high-burden TB countries and ensures continuous comprehensive TB detection services in such settings. Evidence generated by this NMA can provide important decision support in selecting the most (cost-) effective algorithms for screening methods for resource-limited settings in the short, medium, and long terms.

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

“…The pooled results showed that prisoners coughing ≥2 weeks were 0.08 times more likely to be infected with TB than their counterparts. Similarly, two studies 67,68 that looked at the length of coughing indicated that patients who coughed for 2 weeks or more had a higher risk of contracting the illness than patients who coughed for less time or did not cough. This is due to the fact that a TB patient's infectiousness is directly correlated with the quantity of tubercle bacilli that they discharge into the air.…”