Outbreak of Tuberculosis and Multidrug-Resistant Tuberculosis, Mbuji-Mayi Central Prison, Democratic Republic of the Congo

Kaswa, Michel; Hasker, Epco; Aloni, Muriel; Nkuku, L.; Kazadi, Marcel; Kabengele, Thierry; Muteteke, Dorcas; Kapita, François; Lufulwabo, Alphonse; Mukadi, Ya Diul; Muyembe‐Tamfum, Jean‐Jacques; Ieven, Margareta; Jong, Bouke C. de; Boelaert, Marleen

doi:10.3201/eid2411.180769

Cited by 21 publications

(16 citation statements)

References 25 publications

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“…The TB prevalence found by our study was threefold compared with the national estimate, and it was in line with the prevalence reported by an earlier assessment [ 7 ]. However, it was considerably lower than the rate reported by a study in DRC and was at the lower end of the prevalence reported by a review of studies published from 24 sub-Saharan African countries [ 11 ]. This review reported an HIV prevalence of 2%-35% among inmates with TB, and the prevalence we found was considerably higher (64%).…”

Section: Discussioncontrasting

confidence: 56%

Tuberculosis Case Finding Cascade and Treatment Outcomes among Male Inmates in Two Prisons in Zimbabwe

Mandizvidza

Dlodlo

Chinnakali

et al. 2020

Tuberculosis Research and Treatment

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Setting. Zimbabwe is a high tuberculosis (TB) burden country, with an estimated prevalence of 344/100,000 population. Though prisons are known high-prevalence sites for TB, the paucity of data affects the quantification of the disease and treatment outcomes in these settings. We measured the prevalence of TB disease and treatment outcomes among inmates at two major prisons in Harare, Zimbabwe. Design. A cohort study using programmatic data was undertaken to assess TB diagnostic cascade in one of the study prisons for 2018. Treatment outcomes among male inmates with TB were assessed over a period of four years, in two study prisons. Results. A total of 405 (11%) inmates with presumptive TB were identified, and 370 (91%) of these were evaluated for TB, mostly using rapid molecular testing of sputum specimens. Twenty-five inmates were diagnosed with TB resulting in a prevalence of 649/100,000 population. Of these, 16 (64%) were started on treatment. Nine (36%) were lost to follow-up before treatment initiation. From 2015 to 2018, 280 adult male inmates with TB were started on treatment. Of these, 212 (76%) had pulmonary disease that was bacteriologically confirmed. Almost all (276/280, 99%) had known HIV status, 65% were HIV-infected, and 80% of these were on antiretroviral treatment. The TB treatment success rate (cured or treatment completed) was recorded for 209 (75%) inmates, whilst 14 (5%) died and 11 (4%) were lost to follow-up. The frequency of unfavourable treatment outcomes (death, lost to follow-up, and not evaluated) was higher (54%) among inmates≥60 years than those in the age group of 45-59 years (17%). Conclusion. The findings revealed a threefold burden of TB in prisons, compared with what is reported by national survey. To decrease transmission of TB bacilli, it is essential to promote efforts that address missed opportunities in the TB diagnostic cascade, prompt treatment initiation, and ensure that tracking and documentation of treatment outcomes for all inmates are intensified.

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Section: Discussioncontrasting

confidence: 56%

Tuberculosis Case Finding Cascade and Treatment Outcomes among Male Inmates in Two Prisons in Zimbabwe

Mandizvidza

Dlodlo

Chinnakali

et al. 2020

Tuberculosis Research and Treatment

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“…Species identification and drug susceptibility testing performed with Genotype MTBDRplus Active TB Henostroza et al, 2013 [ 46 ] Zambia Cross-sectional study Lusaka Central Prison 2011 Digital X-ray/sputum smear microscopy, LED fluorescence, Lowenstein-Jensen Medium) culture. Active TB Kalonji et al, 2016 [ 47 ] Democratic Republic of the Congo Cross-sectional study Mbuji-Mayi Central Prison 2015 Clinical examination and bacteriological tests Active TB Karamagi et al, 2018 [ 48 ] Uganda Cross-sectional study 16 central and farm prisons (Names not specified) 2017 Combined quality improvement with facility-led active case finding (QI-ACF) Active TB Kayomo et al, 2018 [ 49 ] Democratic Republic of the Congo Cross-sectional study Mbuji-Mayi Central Prison 2015 Xpert MTB/RIF assay Active TB Kwabla et al, 2015 [ 50 ] Ghana Cross-sectional study Ho Prison 2014 Sputum smear microscopy Active TB Maggard et al, 2015 [ 51 ] Zambia Cross-sectional study Lusaka Central Prison, Livingstone Central Prison, Kabwe Prison Complex, 2011 Fluorescence microscopy, cultures, X-rays and physical examinations. Active TB Merid et al, 2018 [ 52 ] Ethiopia Cross-sectional study Hawassa prison 2016 Acid-fast bacilli, smear microscopy and molecular diagnostic testing (Xpert® MTB/RIF) Active TB Noeske et al, 2006 [ 53 ] Cameroon Cross-sectional study New Bell Central Prison of Douala 2004 Smear microscopy and/or culture Active TB Owokuhaisa et al, 2014 [ …”

Section: Resultsmentioning

confidence: 99%

“…All 31 articles scored between 57 and 86%. The majority (45.2%) of the included articles scored 71.4% (14/31) [ 36 , 39 , 40 , 42 , 45 , 46 , 49 , 50 , 53 – 56 , 60 , 61 ] and 10 (32.2%) scored 57.1% [ 35 , 37 , 38 , 41 , 43 , 44 , 47 , 48 , 52 , 57 ]. The remaining seven included articles scored the highest (85.7%) [ 32 – 34 , 51 , 58 , 59 , 62 ].…”

Section: Resultsmentioning

confidence: 99%

Tuberculosis active case-finding interventions and approaches for prisoners in sub-Saharan Africa: a systematic scoping review

et al. 2020

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Background: In sub-Saharan Africa (SSA), most prisons are overcrowded with poor ventilation and put prisoners disproportionally at risk of exposure to Mycobacterium tuberculosis (TB) and developing TB infection but are mostly missed due to poor access to healthcare. Active case-finding (ACF) of TB in prisons facilitates early diagnosis and treatment of inmates and prevent the spread. We explored literature and described evidence on TB ACF interventions and approaches for prisoners in SSA prisons. Methods: Guided by the Arksey and O'Malley framework, we searched PubMed, Google Scholar, SCOPUS, Academic search complete, CINAHL and MEDLINE with full text via EBSCOhost for articles on prisoners and ACF from 2000 to May 2019 with no language restriction. Two investigators independently screened the articles at the abstract and fulltext stages in parallel guided by the eligibility criteria as well as performed the methodological quality appraisal of the included studies using the latest mixed-method appraisal tool. We extracted all relevant data, organized them into themes and sub-themes, and presented a narrative summary of the results. Results: Of the 391 eligible articles found, 31 met the inclusion criteria. All 31 articles were published between 2006 and 2019 with the highest six (19.4%) in 2015. We found evidence in 11 countries. That is

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“…With the increase in crowded high-rise office buildings using central air-conditioning, TB outbreaks in these settings will likely become more frequent. Although many TB outbreaks have been described in schools, prisons, homeless shelters and long-term care facilities [9][10][11][12], there have been very few reports of outbreaks in office buildings [5]. To illustrate how these outbreaks are handled and the problems involved, this report describes the interventions, investigations and results in a representative TB outbreak in an office building located in the centre of the HE region of Nanshan.…”

Section: Introductionmentioning

confidence: 99%

An office building outbreak: the changing epidemiology of tuberculosis in Shenzhen, China

et al. 2020

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Tuberculosis (TB) is generally considered a disease that principally afflicts the low-income segments of a population. In the Nanshan District of Shenzhen, China, with the economic transformation and a new Headquarters Economy (HE) emerging, there are now more cases in office workers than in manufacturing workers. To illustrate this trend, we describe a small TB outbreak in an office building located in the centre of the rapidly growing HE district. Two active pulmonary tuberculosis cases were found in workers who shared an office, and whole genome sequencing showed that the genetic distance between the strains of the two cases was just one single nucleotide polymorphism, consistent with intra-office transmission. Investigation of 30 other workers in the same or adjacent offices with interviews, interferon-gamma release assays (IGRAs) and chest X-rays, identified one new TB case and latent tuberculosis infection (LTBI) in 40.0% (12/30) of the contacts. The offices were under-ventilated. None of the IGRA positive, asymptomatic contacts agreed to receive treatment for LTBI, presumably due to TB stigma, and over the next 2 years 69.0% (20/29) of the contacts were lost to follow-up. Treatment for LTBI and stigma of TB remain challenges here. Office workers in the HE of rapidly economic developing areas should be targeted with increased vigilance by TB control programmes.

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Outbreak of Tuberculosis and Multidrug-Resistant Tuberculosis, Mbuji-Mayi Central Prison, Democratic Republic of the Congo

Cited by 21 publications

References 25 publications

Tuberculosis Case Finding Cascade and Treatment Outcomes among Male Inmates in Two Prisons in Zimbabwe

Tuberculosis Case Finding Cascade and Treatment Outcomes among Male Inmates in Two Prisons in Zimbabwe

Tuberculosis active case-finding interventions and approaches for prisoners in sub-Saharan Africa: a systematic scoping review

An office building outbreak: the changing epidemiology of tuberculosis in Shenzhen, China

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