Prevalence of tuberculosis and associated risk factors in the Central Prison of Mbuji-Mayi, Democratic Republic of Congo

Abstract

BackgroundTuberculosis still remains a major public health concern in several provinces of the Democratic Republic of Congo, especially in prison settings. The present study aimed at determining tuberculosis (TB) prevalence and associated risk factors in inmates of the Mbuji-Mayi Central Prison.MethodsThis cross-sectional study was performed over a 6-month period (January to June 2015) in Mbuji-Mayi Central Prison. A total of 733 inmates were screened systematically for TB. The diagnosis was based on clinical examination and bacteriological tests.ResultsTuberculosis was diagnosed in 130 inmates, what amounts to a 17.7 % prevalence (95 % confidence interval [CI] 15.1–20.6 %). The mean age ± SD of infected inmates was 31 ± 9.5 years old, and 94.8 % of them were male. Inmates were detained for a median period of 24 months (range: 3 months to 12 years). A cough lasting more than 2 weeks, body temperature higher than 39 °C, and weight loss were the predominating clinical signs. Factors independently associated with TB infection were overcrowding; highest population attributable fraction ([PAF] 88.2 %; adjusted odds ratio [OR] 9.8 [95 % CI 3.1–31.6]); malnutrition (body mass index of less than 18.5 kg/m2) (PAF 35.6 %; adjusted OR 2.1 [1.3–3.0]); and a detention period equal to or greater than 12 months (PAF 38.7 %; adjusted OR 2.1 [1.4–3.1]).ConclusionsImproving detention and sanitary conditions, as well as providing an adequate and early healthcare, are urgently needed to reduce TB prevalence in the prison environment.

The prevalence of tuberculosis among prisoners in Ethiopia: a systematic review and meta-analysis of published studies

“…The pooled prevalence result, on the other hand, was less than prevalence reports from Zambian prisons (22.7%) [ 25 ] and Democratic Republic of Congo (17.7%) [ 26 ]. This might be due to the laboratory tests used to diagnose TB.…”

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

“…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 [ …”

“…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 ].…”

Serum vitamin D levels and risk of prevalent tuberculosis, incident tuberculosis and tuberculin skin test conversion among prisoners

“…A number of structural and host determinants have been implicated in the high rates of TB infection and disease observed in prisons 11 . These include factors associated with increased transmissibility of the disease, such as overcrowding and ventilation 11 , as well host factors associated with both TB risk and incarceration, such as nutritional deficiency 12 , HIV infection, smoking 13 , 14 and drug use 15 , 16 . Previous studies have identified low vitamin D levels among prisoners in correctional facilities, likely due to prolonged indoor incarceration with insufficient sunlight exposure or dietary sources of vitamin D 7 .…”