Treatment outcomes of drug-susceptible tuberculosis and its predictors among male prison inmates in Bauchi State, Nigeria, 2014-2018

Abstract

Background : Tuberculosis (TB) is a contagious disease and its transmissibility potential is increased in congregate settings like the prisons. TB incidence rates are five to fifty times higher among prison inmates than the general population which has a direct impact on the outcome of TB treatment. There is paucity of information on TB treatment outcomes and its predictors in Nigerian prisons. We therefore assessed TB treatment outcomes among prison inmates in Bauchi State, Nigeria. Method: We conducted a retrospective data analysis of inmates with TB in the five main prisons in Bauchi State. We extracted sociodemographic, clinical and treatment outcome characteristics from TB treatment register of inmates treated for TB between January 2014 and December 2018, using a standardized checklist. We estimated the TB treatment success rate (TSR) and explored the relationship between the TSR and sociodemographic and clinical characteristics. Related variables were modelled in multiple logistic regression to identify predictors of TSR at 5% level of significance. Results: All 216 inmates were male with mean (SD) age of 37.6±11.4 years. Seventy-six (35.2%) were cured, 61 (28.2%) completed treatment, 48 (22.2%) were lost to follow-up, 17 (7.9%) were transferred out without evaluation and 14 (6.5%) died. Overall TSR was 72.9%. Predictors of successful treatment outcome were age; 20-29 years (AOR=10.5; 95% CI: 3.2-35.1), 30-39 years (AOR=4.2; 95% CI: 1.3-13.1), pretreatment weight; ≥ 55kg (AOR= 13.3; 95% CI: 6.0-29.6), imprisonment for ≤ 2 years (AOR= 2.6; 95% CI: 1.3-5.4) and being HIV negative (AOR=3.3; 95% CI:1.4-7.8). Conclusion: The predictors of successful TB treatment outcome were being less than 40 years of age, having a pretreatment body weight of or greater than 55 kg, imprisonment for less than 2 years, and being HIV negative. We recommended that to improve TB TSR among prison inmates; age, duration of imprisonment, weight and TB/HIV co-infection should be the major consideration during pretreatment, psychological and nutritional counselling and a tracking system be developed by the prisons authority to follow-up inmates transferred-out to other health facilities to ensure they complete the treatment and outcomes evaluated.