Prevalence of smear positive pulmonary tuberculosis and associated risk factors among prisoners in Hadiya Zone prison, Southern Ethiopia

Abstract

BackgroundPeople concentrated in congregated systems such as prisons, are important but often neglected reservoirs for tuberculosis transmission, and threaten those in the outside community. The condition is more serious in Africa particularly in Sub-Saharan Africa (SSA) due to its poor living conditions and ineffective health services.ObjectivesThis study was conducted to determine the prevalence of smear positive pulmonary tuberculosis and associated risk factors among prisoners in Hadiya Zone prison.MethodsA cross-sectional survey was carried out from May to June 2013 in Hadiya Zone prison. Prison inmates who had history of cough for at least a week were included in the study. Three morning sputum samples were collected from suspected inmates and examined through compound light microscopy. The data obtained was analyzed using statistical software like Epidata and STATA.ResultsA total of 164 prisoners were included in the survey using active screening strategy and the point prevalence of smear positive pulmonary tuberculosis (PTB) in the prison was 349.2 per 100,000 populations; about three times higher than its prevalence in the general population. Even though lack of visit from family was the only variable identified as a risk factor for PTB (P = 0.029), almost all of the PTB positive cases were rural residents, farmers, male youngsters and those who shared cell with TB patients and chronically coughing persons as well as those who stayed in a cell that contains >100 inmates.ConclusionThere is high prevalence of TB in Hadiya Zone prison with possible active transmission of TB within the prison. The study also documented a number of factors which may facilitate exposures to TB though most of them are not significantly associated. Therefore, strong cooperation between prison authorities and the national tuberculosis control programmes is urgently required to develop locally appropriate interventions to reduce transmission.

Prevalence of pulmonary tuberculosis and associated factors among prisoners in Western Oromia, Ethiopia: A cross-sectional study

“…This finding is similar with the study conducted in Tanzania [18], and southern Ethiopia [14]. On bivariate analysis participants who had history of chewed ‘chat’ before imprisonment had association and the risk of developing PTB positive among ‘chat’ chewers were 5 times than those who were not chewed ‘chat’ which is not reported in any other previous study done in Ethiopia like, Hadiya, Wolaita and Bedelle [12, 13, 14], which could be due to high numbers of chewers in current study areas but on multivariate analysis it had no association with PTB with (AOR=1.33, 95% CI (0.43, 4.15)).…”

“…The possible reason for this could be malnutrition is equally recognized as a risk factor for the reactivation of latent TB and its progression to disease. This assumption is supported by previous studies in Hadiya [12], this link is besides bi-directional as TB can cause or predispose to malnutrition. Hence, when comparing individuals with and without active PTB in this cross-sectional study with respect to their nutritional status, a causal effect cannot be assigned to malnutrition, even though it came out as a significant predictor in the multivariate analysis.…”

“…The study was done in Southern Ethiopia, Gamo Gofa prison, which indicated about 3.2% prevalence of TB among inmates. Another study was done in the Hadiya Zone; south Ethiopia also showed a three times higher prevalence of TB than in the general population [11, 12]. But there is limited evidence regarding the TB prevalence in Western Ethiopia.…”

Fatores predisponentes de tuberculose em indivíduos privados de liberdade: revisão integrativa

“…O compartilhamento de cela com vários detentos é uma prática comum no sistema prisional, e que constitui um fator de risco entre os detentos quando estes dividem espaço com algum indivíduo que apresente doença infectocontagiosa. Neste sentido, o aumento da predisposição à TB também esteve associado ao compartilhamento de cela entre prisioneiros sadios e aqueles com formas da doença ou apresentando tosse crônica 16,[25][26] . A ausência de janelas nas celas e a má-ventilação destas também estão relacionados à causalidade da TB em alguns dos estudos analisados [26][27] .…”

“…Neste sentido, o aumento da predisposição à TB também esteve associado ao compartilhamento de cela entre prisioneiros sadios e aqueles com formas da doença ou apresentando tosse crônica 16,[25][26] . A ausência de janelas nas celas e a má-ventilação destas também estão relacionados à causalidade da TB em alguns dos estudos analisados [26][27] . Isso se dá devido ao fato de a TB ser uma doença de transmissão aérea, facilitada em ambientes nos quais há pouca ventilação e iluminação, encontrando nos ambientes superlotados como as prisões, condições muito favoráveis para infecção dos detentos 24 .…”