Epidemiology of TB in prisoners: a metanalysis of the prevalence of active and latent TB

Abstract

Background Tuberculosis (TB) in prisons usually occurs at higher rates than in the general population, especially in developing countries. TB has been reported as the most common cause of death among prisoners. Studies have shown limitations for early detection of TB in prisons that seem to result from mistaken concepts about TB, delayed diagnosis mainly due to the naturalization of lack of healthcare for this population Methods A scoping review was performed using the methodology of the Joanna Briggs Institute to assess “What are the scientific evidences on the epidemiology of TB in the prison system?”. Then, a meta-analysis was performed to assess the prevalence of TB (active and latent) TB in prisoners. The results are presented as prevalence, in percentage, through random effects models, with a confidence interval of 95%. Results Regarding active TB, the results of the metanalysis showed that countries with a high burden of TB had a prevalence of 3.54% [2.71; 4.63], countries not considered to be high burden TB countries had a prevalence of 1.43% [0.86; 2.37]. Latent TB had a prevalence of 51.61% [39.46; 63.58] in high TB burden countries and a prevalence of 40.24% [23.51; 59.61] in countries with low TB burden. In terms of development, in low- and lower-middle-income countries, the prevalence of active TB was 3.13% [1.84; 5.29] and in high- and upper-middle income countries the prevalence was 2.25% [1.70; 2.99]. The prevalence of latent TB in high- and middle-income countries was 43.77% [28.61; 60.18] and of 49.42% [45.91; 52.94] in low and lower middle-income countries. Conclusion Our analysis suggests that TB, and probably other infectious diseases, find fertile ground in prisons where previous acquire social disadvantages seem to thrive—therefore, TB in prisons is a global public health problem and effective strategies are needed to control the disease are needed targeting the prison environment, including rapid health assessments to understand each context and to implement tailored and precision interventions.

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

“…serve as a guide for targeted and cost-effective control, which is a subject of debate globally. 43 The pooled magnitude of TB among prisoners was 9.84% (95% CI: 7.16-12.52; I 2 = 96.9%). This combined magnitude is comparable to findings from prisons in Paraguay, 44 Malaysia, 45 Sub-Saharan Africa (SSA), 46 Iran, 47 Ethiopia, 25 and South Africa, 48 where the prevalence rates are 7.1% in 2009, 7.7%, 7.74%, 7.9%, 8.33%, and 8.8%, respectively.…”

“…The findings will help in assessing the successes of TB control programs in Ethiopia, which usually target prisoners, children, pregnant women, and the general public. Moreover, it provides information that will serve as a guide for targeted and cost‐effective control, which is a subject of debate globally 43 …”