1
|
Sisay Asgedom Y, Ambaw Kassie G, Melaku Kebede T. Prevalence of tuberculosis among prisoners in sub-Saharan Africa: a systematic review and meta-analysis. Front Public Health 2023; 11:1235180. [PMID: 38222088 PMCID: PMC10787954 DOI: 10.3389/fpubh.2023.1235180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 12/04/2023] [Indexed: 01/16/2024] Open
Abstract
Background Tuberculosis (TB) is a key community health problem in numerous settings, predominantly in sub-Saharan Africa (SSA). TB is the second most lethal infectious disease worldwide. Around 1.6 million people died from TB in 2021. TB prevention and control strategies are difficult to implement in prison, especially in sub-Saharan Africa, owing to overcrowding and poor ventilation. Thus, this systematic review and meta-analysis aimed to synthesize the estimated pooled prevalence of tuberculosis among prisoners in sub-Saharan Africa. Materials and methods Electronic biomedical databases such as Google Scholar, Web of Science, PubMed/Medline, EMBASE, and Science Direct were used to systematically explore candidate studies published until December 2022. Data extraction was performed using a Microsoft Excel spreadsheet. The estimated pooled prevalence of tuberculosis was determined using a fixed-effects model. Cochrane Q-test and I2 statistics were used to check heterogeneity statistically across different studies. Begg's rank and Egger's tests were performed to assess evidence of possible publication bias. Results A total of 40 articles involving 59,300 prisoners were included in this systematic review and meta-analysis. The pooled prevalence of tuberculosis was 4.02% (95% CI: 2.68-5.36). We found the highest prevalence using Gene X pert as a diagnostic method, which was 4.97 (95% CI: 2.22-7.73). There is no evidence of publication bias. Conclusion The outcome of this review revealed a high prevalence of tuberculosis among prisoners in sub-Saharan Africa. To reach the "End Tuberculosis strategy" by 2030, early identification of cases through screening on entry and periodical active case finding is important. Moreover, prevention and prompt treatment after diagnosis must be implemented to limit transmission to the general population. Systematic review registration https://www.crd.york.ac.uk/prospero/#searchadvanced, identifier (CRD42023428933).
Collapse
|
2
|
Mera HB, Wagnew F, Akelew Y, Hibstu Z, Berihun S, Tamir W, Alemu S, Lamore Y, Mesganaw B, Adugna A, Tsegaye TB. Prevalence and Predictors of Pulmonary Tuberculosis among Prison Inmates in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. Tuberc Res Treat 2023; 2023:6226200. [PMID: 37260437 PMCID: PMC10228229 DOI: 10.1155/2023/6226200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/29/2022] [Accepted: 04/03/2023] [Indexed: 06/02/2023] Open
Abstract
Introduction Prisoners in Sub-Saharan Africa (SSA) are at a high risk of tuberculosis (TB) infection due to overcrowding and poor ventilation. Consequently, TB is a leading cause of morbidity and mortality in prison, and many inmates face a number of barriers to TB control and had limited information in the region. Thus, the aim of this systematic review and meta-analysis was to estimate the overall pooled prevalence of pulmonary TB and predictors among prison inmates in SSA. Methods From 2006 to 2019, a systematic review and meta-analysis was conducted using various databases, including PubMed, Embase, Web of Science, and Scopus. The data were extracted in Microsoft Excel using a standardized data extraction format, and the analysis was carried out with STATA version 14. To detect heterogeneity across studies, the I2 and the Cochrane Q test statistics were computed. To determine the overall prevalence of TB and predictors among prison populations, a random effect meta-analysis model was used. Results Of the 3,479 retrieved articles, 37studies comprising 72,844 inmates met the inclusion criteria. The pooled prevalence of pulmonary TB among prison inmates in SSA was 7.74% (95% CI: 6.46-8.47). In the subgroup analysis, the highest prevalence was found in the Democratic Republic Congo (DRC) (19.72%) followed by Zambia (11.68%) and then Ethiopia (9.22%). TB/HIV coinfection (OR 4.99 (95% CI: 2.60-9.58)), Body mass index (BMI < 18.5) (OR 3.62 (95% CI: 2.65-6.49)), incarceration (OR 4.52 (95% CI: 2.31-5.68)), and previous TB exposure (OR 2.43 (95% CI: 1.61-3.56)) had higher odds of pulmonary TB among inmates. Conclusion The prevalence of pulmonary TB among SSA prison inmates was found to be high as compared to total population. TB/HIV coinfection, BMI, incarceration duration, and TB exposure were all predictors with pulmonary tuberculosis in prison inmates. As a result, emphasizing early screening for prisoners at risk of pulmonary TB is an important point to achieving global TB commitments in resource-limited settings.
Collapse
Affiliation(s)
- Habtamu Belew Mera
- Department of Medical Laboratory Science, College of Health Sciences, Debre Markos University, Debre Markos 269, Ethiopia
| | - Fasil Wagnew
- Department of Pediatrics Nursing, College of Health Sciences, Debre Markos University, Debre Markos 269, Ethiopia
- National Centre for Epidemiology and Population Health (NCEPH), College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Yibeltal Akelew
- Department of Medical Laboratory Science, College of Health Sciences, Debre Markos University, Debre Markos 269, Ethiopia
| | - Zigale Hibstu
- Department of Medical Laboratory Science, College of Health Sciences, Debre Markos University, Debre Markos 269, Ethiopia
| | - Sileshi Berihun
- Department of Public Health, College of Health Sciences, Injibara University, Injibara 40, Ethiopia
| | - Workineh Tamir
- Department of Medical Laboratory Science, College of Health Sciences, Injibara University, Injibara 40, Ethiopia
| | - Simegn Alemu
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos 269, Ethiopia
| | - Yonas Lamore
- Department of Environmental Health Science, College of Health Sciences, Debre Markos University, Debre, Markos, 269, Ethiopia
| | - Bewket Mesganaw
- Department of Medical Laboratory Science, College of Health Sciences, Debre Markos University, Debre Markos 269, Ethiopia
| | - Adane Adugna
- Department of Medical Laboratory Science, College of Health Sciences, Debre Markos University, Debre Markos 269, Ethiopia
| | - Tefsa Birlew Tsegaye
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos 269, Ethiopia
| |
Collapse
|
3
|
Placeres AF, de Almeida Soares D, Delpino FM, Moura HSD, Scholze AR, dos Santos MS, Arcêncio RA, Fronteira I. Epidemiology of TB in prisoners: a metanalysis of the prevalence of active and latent TB. BMC Infect Dis 2023; 23:20. [PMID: 36631770 PMCID: PMC9835258 DOI: 10.1186/s12879-022-07961-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 12/20/2022] [Indexed: 01/13/2023] Open
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.
Collapse
Affiliation(s)
- Aline Ferreira Placeres
- grid.10772.330000000121511713Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, Rua da Junqueira 100, 1349-008 Lisbon, Portugal
| | - Débora de Almeida Soares
- grid.10772.330000000121511713Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, Rua da Junqueira 100, 1349-008 Lisbon, Portugal
| | - Felipe Mendes Delpino
- grid.411221.50000 0001 2134 6519Programa de Pós Graduação em Enfermagem, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Heriederson Sávio Dias Moura
- grid.11899.380000 0004 1937 0722Escola de Enfermagem de Ribeirão Preto (EERP/USP), Universidade de São Paulo, São Paulo, Brazil
| | - Alessandro Rolim Scholze
- grid.441795.aUniversidade Estadual do Norte do Paraná, Campus Luiz Meneguel de Bandeirantes, Bandeirantes, Brazil
| | - Márcio Souza dos Santos
- grid.11899.380000 0004 1937 0722Escola de Enfermagem de Ribeirão Preto (EERP/USP), Universidade de São Paulo, São Paulo, Brazil
| | - Ricardo Alexandre Arcêncio
- grid.11899.380000 0004 1937 0722Escola de Enfermagem de Ribeirão Preto (EERP/USP), Universidade de São Paulo, São Paulo, Brazil
| | - Inês Fronteira
- grid.10772.330000000121511713Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade NOVA de Lisboa, Lisbon, Portugal
| |
Collapse
|
4
|
Naufal F, Chaisson LH, Robsky KO, Delgado-Barroso P, Alvarez-Manzo HS, Miller CR, Shapiro AE, Golub JE. Number needed to screen for TB in clinical, structural or occupational risk groups. Int J Tuberc Lung Dis 2022; 26:500-508. [PMID: 35650693 DOI: 10.5588/ijtld.21.0749] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND: Screening for active TB using active case-finding (ACF) may reduce TB incidence, prevalence, and mortality; however, yield of ACF interventions varies substantially across populations. We systematically reviewed studies reporting on ACF to calculate the number needed to screen (NNS) for groups at high risk for TB.METHODS: We conducted a literature search for studies reporting ACF for adults published between November 2010 and February 2020. We determined active TB prevalence detected through various screening strategies and calculated crude NNS for - TB confirmed using culture or Xpert® MTB/RIF, and weighted mean NNS stratified by screening strategy, risk group, and country-level TB incidence.RESULTS: We screened 27,223 abstracts; 90 studies were included (41 in low/moderate and 49 in medium/high TB incidence settings). High-risk groups included inpatients, outpatients, people living with diabetes (PLWD), migrants, prison inmates, persons experiencing homelessness (PEH), healthcare workers, and miners. Screening strategies included symptom-based screening, chest X-ray and Xpert testing. NNS varied widely across and within incidence settings based on risk groups and screening methods. Screening tools with higher sensitivity (e.g., Xpert, CXR) were associated with lower NNS estimates.CONCLUSIONS: NNS for ACF strategies varies substantially between adult risk groups. Specific interventions should be tailored based on local epidemiology and costs.
Collapse
Affiliation(s)
- F Naufal
- Department of Medicine, Johns Hopkins University, Baltimore, MD
| | - L H Chaisson
- Division of Infectious Diseases, Department of Medicine, University of Illinois at Chicago, Chicago, IL
| | - K O Robsky
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - P Delgado-Barroso
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - H S Alvarez-Manzo
- Department of Molecular Microbiology and Immunology, Johns Hopkins University, Baltimore, MD, USA
| | - C R Miller
- World Health Organization, Geneva, Switzerland
| | - A E Shapiro
- Departments of Global Health and Medicine, University of Washington, Seattle, WA
| | - J E Golub
- Division of Infectious Diseases, Department of Medicine, University of Illinois at Chicago, Chicago, IL, Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA, Department of International Health, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
5
|
Van't Hoog A, Viney K, Biermann O, Yang B, Leeflang MM, Langendam MW. Symptom- and chest-radiography screening for active pulmonary tuberculosis in HIV-negative adults and adults with unknown HIV status. Cochrane Database Syst Rev 2022; 3:CD010890. [PMID: 35320584 PMCID: PMC9109771 DOI: 10.1002/14651858.cd010890.pub2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Systematic screening in high-burden settings is recommended as a strategy for early detection of pulmonary tuberculosis disease, reducing mortality, morbidity and transmission, and improving equity in access to care. Questioning for symptoms and chest radiography (CXR) have historically been the most widely available tools to screen for tuberculosis disease. Their accuracy is important for the design of tuberculosis screening programmes and determines, in combination with the accuracy of confirmatory diagnostic tests, the yield of a screening programme and the burden on individuals and the health service. OBJECTIVES To assess the sensitivity and specificity of questioning for the presence of one or more tuberculosis symptoms or symptom combinations, CXR, and combinations of these as screening tools for detecting bacteriologically confirmed pulmonary tuberculosis disease in HIV-negative adults and adults with unknown HIV status who are considered eligible for systematic screening for tuberculosis disease. Second, to investigate sources of heterogeneity, especially in relation to regional, epidemiological, and demographic characteristics of the study populations. SEARCH METHODS We searched the MEDLINE, Embase, LILACS, and HTA (Health Technology Assessment) databases using pre-specified search terms and consulted experts for unpublished reports, for the period 1992 to 2018. The search date was 10 December 2018. This search was repeated on 2 July 2021. SELECTION CRITERIA Studies were eligible if participants were screened for tuberculosis disease using symptom questions, or abnormalities on CXR, or both, and were offered confirmatory testing with a reference standard. We included studies if diagnostic two-by-two tables could be generated for one or more index tests, even if not all participants were subjected to a microbacteriological reference standard. We excluded studies evaluating self-reporting of symptoms. DATA COLLECTION AND ANALYSIS We categorized symptom and CXR index tests according to commonly used definitions. We assessed the methodological quality of included studies using the QUADAS-2 instrument. We examined the forest plots and receiver operating characteristic plots visually for heterogeneity. We estimated summary sensitivities and specificities (and 95% confidence intervals (CI)) for each index test using bivariate random-effects methods. We analyzed potential sources of heterogeneity in a hierarchical mixed-model. MAIN RESULTS The electronic database search identified 9473 titles and abstracts. Through expert consultation, we identified 31 reports on national tuberculosis prevalence surveys as eligible (of which eight were already captured in the search of the electronic databases), and we identified 957 potentially relevant articles through reference checking. After removal of duplicates, we assessed 10,415 titles and abstracts, of which we identified 430 (4%) for full text review, whereafter we excluded 364 articles. In total, 66 articles provided data on 59 studies. We assessed the 2 July 2021 search results; seven studies were potentially eligible but would make no material difference to the review findings or grading of the evidence, and were not added in this edition of the review. We judged most studies at high risk of bias in one or more domains, most commonly because of incorporation bias and verification bias. We judged applicability concerns low in more than 80% of studies in all three domains. The three most common symptom index tests, cough for two or more weeks (41 studies), any cough (21 studies), and any tuberculosis symptom (29 studies), showed a summary sensitivity of 42.1% (95% CI 36.6% to 47.7%), 51.3% (95% CI 42.8% to 59.7%), and 70.6% (95% CI 61.7% to 78.2%, all very low-certainty evidence), and a specificity of 94.4% (95% CI 92.6% to 95.8%, high-certainty evidence), 87.6% (95% CI 81.6% to 91.8%, low-certainty evidence), and 65.1% (95% CI 53.3% to 75.4%, low-certainty evidence), respectively. The data on symptom index tests were more heterogenous than those for CXR. The studies on any tuberculosis symptom were the most heterogeneous, but had the lowest number of variables explaining this variation. Symptom index tests also showed regional variation. The summary sensitivity of any CXR abnormality (23 studies) was 94.7% (95% CI 92.2% to 96.4%, very low-certainty evidence) and 84.8% (95% CI 76.7% to 90.4%, low-certainty evidence) for CXR abnormalities suggestive of tuberculosis (19 studies), and specificity was 89.1% (95% CI 85.6% to 91.8%, low-certainty evidence) and 95.6% (95% CI 92.6% to 97.4%, high-certainty evidence), respectively. Sensitivity was more heterogenous than specificity, and could be explained by regional variation. The addition of cough for two or more weeks, whether to any (pulmonary) CXR abnormality or to CXR abnormalities suggestive of tuberculosis, resulted in a summary sensitivity and specificity of 99.2% (95% CI 96.8% to 99.8%) and 84.9% (95% CI 81.2% to 88.1%) (15 studies; certainty of evidence not assessed). AUTHORS' CONCLUSIONS The summary estimates of the symptom and CXR index tests may inform the choice of screening and diagnostic algorithms in any given setting or country where screening for tuberculosis is being implemented. The high sensitivity of CXR index tests, with or without symptom questions in parallel, suggests a high yield of persons with tuberculosis disease. However, additional considerations will determine the design of screening and diagnostic algorithms, such as the availability and accessibility of CXR facilities or the resources to fund them, and the need for more or fewer diagnostic tests to confirm the diagnosis (depending on screening test specificity), which also has resource implications. These review findings should be interpreted with caution due to methodological limitations in the included studies and regional variation in sensitivity and specificity. The sensitivity and specificity of an index test in a specific setting cannot be predicted with great precision due to heterogeneity. This should be borne in mind when planning for and implementing tuberculosis screening programmes.
Collapse
Affiliation(s)
- Anja Van't Hoog
- Anja van't Hoog, Health Research & Training Consultancy, Utrecht, Netherlands
| | - Kerri Viney
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- School of Public Health, The University of Sydney, Sydney, Australia
- Global Tuberculosis Programme, World Health Organization, Geneva, Switzerland
| | - Olivia Biermann
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Bada Yang
- Epidemiology and Data Science, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Mariska Mg Leeflang
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Miranda W Langendam
- Epidemiology and Data Science, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| |
Collapse
|
6
|
Moreira TR, Passos IBJ, Bueno JVL, Maffacciolli R, Colodette RM, Miguel PS. Prevalence of multidrug-resistant tuberculosis in prisons: Systematic review and meta-analysis. Indian J Med Microbiol 2022; 40:193-199. [PMID: 35120789 DOI: 10.1016/j.ijmmb.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 11/08/2021] [Accepted: 01/15/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND In the context of prisons, multidrug-resistant tuberculosis (MDR-TB) is a major problem. In this article, we estimate the prevalence of MDR-TB among the population deprived of freedom from countries in South America, Europe, Asia and Africa. METHODS The articles were retrieved through systematic search at four databases (EMBASE, CINAHL, LILACS and MEDILINE). The meta-analysis was developed by the random effect model, using the Mantel-Haenszel method, with presentation of the aggregated results through the forest plot. The degree of heterogeneity between the studies was verified using Cochran's Q test and I2. RESULTS Of the 102 articles analyzed, 21 were included in this systematic review. The analysis showed heterogeneity indicated by the Q test (P < 0.001) and I2 statistics (I2 = 50.52%). The funnel graph and Egger test (P < 0.830) showed symmetry between investigations. The grouped prevalence of MDR-TB was 0.48% (95% CI: 0.02 to 1.32), advancing to 1.15 (95% CI: 0.15 to 2.73) when culture and sensitivity test were considered by the authors. No specific characteristics were significantly associated with differences in prevalence rates in the population deprived of freedom. CONCLUSION The study reaffirms the magnitude of MDR-TB in the population deprived of freedom in the world context. Political and technical-scientific efforts should be mobilized to mitigate TB and MDR-TB in prisons and for successful national and international disease control programs.
Collapse
Affiliation(s)
- Tiago Ricardo Moreira
- Doutor e Saúde Pública. Departamento de Medicina e Enfermagem, Universidade Federal de Viçosa, Viçosa-MG, Brazil.
| | | | - João Vitor L Bueno
- Graduado Em Medicina. Departamento de Medicina e Enfermagem, Universidade Federal de Viçosa, Viçosa-MG, Brazil.
| | - Rosana Maffacciolli
- Doutora Em Enfermagem, Escola de Enfermagem, Universidade Federal Do Rio Grande Do Sul, Porto Alegre-RS, Brazil.
| | - Renata Maria Colodette
- Mestre em Ciências da Saúde. Escola Nacional de Saúde Pública Sérgio Arouca. Fundação Oswaldo Cruz, Rio de Janeiro-RJ, Brazil.
| | | |
Collapse
|
7
|
Herrera M, Keynan Y, López L, Marín D, Arroyave L, Arbeláez MP, Vélez L, Rueda ZV. Incidence and Risk Factors Associated with Latent Tuberculosis Infection and Pulmonary Tuberculosis among People Deprived of Liberty in Colombian Prisons. Am J Trop Med Hyg 2022; 106:66-74. [PMID: 34872056 PMCID: PMC8733511 DOI: 10.4269/ajtmh.20-0307] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 08/30/2021] [Indexed: 01/03/2023] Open
Abstract
People deprived of liberty (PDL) are at high risk of acquiring Mycobacterium tuberculosis infection (latent tuberculosis infection [LTBI]) and progressing to active tuberculosis (TB). We sought to determine the incidence rates and factors associated with LTBI and active TB in Colombian prisons. Using information of four cohort studies, we included 240 PDL with two-step tuberculin skin test (TST) negative and followed them to evaluate TST conversion, as well as, 2,134 PDL that were investigated to rule out active TB (1,305 among people with lower respiratory symptoms of any duration, and 829 among people without respiratory symptoms and screened for LTBI). Latent tuberculosis infection incidence rate was 2,402.88 cases per 100,000 person-months (95% CI 1,364.62-4,231.10) in PDL with short incarceration at baseline, and 419.66 cases per 100,000 person-months (95% CI 225.80-779.95) in individuals with long incarceration at baseline (who were enrolled for the follow after at least 1 year of incarceration). The TB incidence rate among PDL with lower respiratory symptoms was 146.53 cases/100,000 person-months, and among PDL without respiratory symptoms screened for LTBI the incidence rate was 19.49 cases/100,000 person-months. History of Bacillus Calmette-Guerin vaccination decreased the risk of acquiring LTBI among PDL who were recently incarcerated. Female sex, smoked drugs, and current cigarette smoking were associated with an increased risk of developing active TB. This study shows that PDL have high risk for LTBI and active TB. It is important to perform LTBI testing at admission to prison, as well as regular follow-up to control TB in prisons.
Collapse
Affiliation(s)
| | - Yoav Keynan
- Department of Medical Microbiology and Infectious Diseases, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lucelly López
- Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Diana Marín
- Universidad Pontificia Bolivariana, Medellín, Colombia
| | | | | | - Lázaro Vélez
- Universidad de Antioquia, Medellín, Antioquia, Colombia
| | - Zulma Vanessa Rueda
- Department of Medical Microbiology and Infectious Diseases, Rady Faculty of Health Sciences University of Manitoba, Winnipeg, Manitoba, Canada;,Universidad Pontificia Bolivariana, Medellín, Colombia;,Address correspondence to Zulma Vanessa Rueda, Department of Medical Microbiology and Infectious Diseases, Rady Faculty of Health Sciences, University of Manitoba, Rm 512, Basic Medical Sciences Building, 745 Bannatyne Avenue, Winnipeg, MB, R3E 0J9. E-mail:
| |
Collapse
|
8
|
Kagujje M, Somwe P, Hatwiinda S, Bwalya J, Zgambo T, Thornicroft M, Bozzani FM, Moonga C, Muyoyeta M. Cross-sectional assessment of tuberculosis and HIV prevalence in 13 correctional facilities in Zambia. BMJ Open 2021; 11:e052221. [PMID: 34580101 PMCID: PMC8477336 DOI: 10.1136/bmjopen-2021-052221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To determine the prevalence of tuberculosis (TB) and HIV in 13 Zambian correctional facilities. METHODS Cross-sectional study. SETTING 13 correctional facilities in seven of the 10 provinces in Zambia. PARTICIPANTS All incarcerated individuals were eligible for TB and HIV screening and testing. Of the total study population of 9695 individuals, which represent 46.2% of total correctional population at the beginning of the study, 8267 and 8160 were screened for TB and HIV, respectively. INTERVENTIONS TB and HIV screening and testing was done between July 2018 and February 2019. PRIMARY OUTCOME MEASURES All forms of TB, bacteriologically confirmed TB, drug-resistant TB, HIV. RESULTS Prevalence of all forms of TB and bacteriologically confirmed TB was 1599 (1340-1894) per 100 000 population and 1056 (847-1301) per 100 000 population, respectively. Among those with bacteriologically confirmed TB, 4.6% (1.3%-11.4%) had drug-resistant TB.There was no statistically significant difference in the prevalence of all forms of TB, bacteriologically confirmed TB and drug resistant TB between adults and juveniles: (p=0.82), (p=0.23), (p=0.68) respectively. Of the bacteriologically confirmed TB cases, 28.7% were asymptomatic. The prevalence of HIV was 14.3% (13.6%-15.1%). The prevalence of HIV among females was 1.8 times the prevalence of HIV among males (p=0.01). CONCLUSION Compared with the study in 2011 which screened inmates representing 30% of the country's inmate population, then the prevalence of all forms of TB and HIV in correctional facilities has reduced by about 75% and 37.6%, respectively. However, compared with the general population, the prevalence of all forms of TB and HIV was 3.5 and 1.3 times higher, respectively. TB/HIV programmes in correctional facilities need further strengthening to include aspects of juvenile-specific TB programming and gender responsive HIV programming.
Collapse
Affiliation(s)
- Mary Kagujje
- Tuberculosis Department, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Paul Somwe
- Strategic Information Department, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Sisa Hatwiinda
- Tuberculosis Department, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Joel Bwalya
- Strategic Information Department, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Tamala Zgambo
- Health directorate, Zambia Correctional Service, Lusaka, Zambia
| | - Moomba Thornicroft
- Tuberculosis Department, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Fiammetta Maria Bozzani
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Clement Moonga
- Tuberculosis Department, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Monde Muyoyeta
- Tuberculosis Department, Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| |
Collapse
|
9
|
Bilmumad B, Liabsuetrakul T, Ngamtrairai N, Chongsuvivatwong V. Pulmonary tuberculosis among prisoners in Southern Thailand: prevalence and its association with imprisonment status. Int J Prison Health 2021; ahead-of-print:10.1108/IJPH-01-2021-0012. [PMID: 34464526 PMCID: PMC9719586 DOI: 10.1108/ijph-01-2021-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This study aims to measure the prevalence of pulmonary tuberculosis (PTB), its association with imprisonment status and to document the treatment success rate (TSR) among prisoners in Songkhla province, Southern Thailand. DESIGN/METHODOLOGY/APPROACH A retrospective cross-sectional study was conducted in five prisons in Songkhla province, including all prisoners in the fiscal of year 2019, who had an annual chest radiography (CXR) screening result. Information of prisoners who had been imprisoned from 1 October 2018 to 30 September 2019, were reviewed for PTB diagnosis. Imprisonment status and other associated factors with PTB were analyzed using multiple logistic regression. FINDINGS The prevalence of PTB was 2.72%. Prisoners having new or transfer-in status were more likely to have PTB. Those aged 40-80 years, who had smoked for ten years or more, or who were underweight, had higher odds of having PTB. TSR among prisoners with PTB in this study was 94.9%. ORIGINALITY/VALUE The prevalence of PTB among prisoners having annual CXR screening was high. Detection of PTB was higher among new or transfer-in prisoners; therefore, the CXR for PTB screening before admission to prison should be performed to prevent transmission to other prisoners.
Collapse
Affiliation(s)
- Bintinee Bilmumad
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand, and Songkhla Correctional Institution for Drug Addicts, Department of Corrections Thailand, Mueang, Thailand
| | - Tippawan Liabsuetrakul
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Nipa Ngamtrairai
- Songkhla Central Prison, Department of Corrections Thailand, Mueang, Thailand
| | | |
Collapse
|
10
|
Diendéré EA, Traoré K, Bernatas JJ, Idogo O, Dao AK, Traoré GK, Napon/Zongo PD, Ouédraogo/Dioma S, Bognounou R, Diallo I, Ouédraogo/Sondo AK, Niamba PA. Prison health priorities in Burkina Faso: a cross-sectional study in the two largest detention environments in Burkina Faso. Int J Prison Health 2021; 18:97-113. [PMID: 34392661 DOI: 10.1108/ijph-04-2021-0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this paper is to study the factors associated with the occurrence of diseases and beriberi among prisoners incarcerated in the two largest Remand and Correctional Facilities (RCF). DESIGN/METHODOLOGY/APPROACH This was a cross-sectional descriptive and analytical study carried out from April 20 to May 19, 2017, in the RCFs of Ouagadougou and Bobo-Dioulasso. All prisoners who consulted and those referred to the health center by the health-care team were included in the study. Complaints and diagnosed diseases information were collected using the second version of the International Classification of Primary Care (ICPC-2). The authors used a logistic regression model to perform univariate and multivariate analyses. FINDINGS Of the 1,004 prisoners from the two RCFs included in the study (32.6%), 966 (96%) were male. The median age was 31.6 years. The distribution of diseases diagnosed using the ICPC-2 showed a predominance of gastrointestinal tract, skin and respiratory tract diseases among 206 (19.3%), 188 (17.6%) and 184 (17.2%) prisoners, respectively. A total of 302 prisoners (30.1%) had clinical beriberi, and 80 prisoners (8%) were underweight. Being incarcerated for more than nine months was independently associated with a high risk of digestive and respiratory diseases as well as beriberi. RESEARCH LIMITATIONS/IMPLICATIONS This study highlighted higher frequencies of digestive, skin and respiratory complaints and diseases in the two largest detention centers in Burkina Faso. These diseases are variously related to age, penal status and length of incarceration. In addition, underweight and thiamin vitamin deficiency responsible for beriberi are more frequent in adult prisoners, those not attending school, convicted prisoners and those with a length of stay in detention of more than nine months. These concrete results should help define a strategy and priority actions needed to reduce morbidity in prisons. PRACTICAL IMPLICATIONS The actions should include the intervention of specialists in the field of common diseases in prisons, the improvement of individual hygiene conditions and environment, the improvement of the quality and quantity of the food ration, a strategy to reduce prison overcrowding. Other actions must be planned to allow specific groups such as women and minors to have access to health care that is adapted to them. Beyond the central concern of promoting the rights of prisoners and humanizing prisons, actions to improve the health of prisoners are part of an overall public health approach with its socio-economic and environmental implications. SOCIAL IMPLICATIONS There is a need for a strong commitment from the State to develop a prison health policy that prioritizes the prevention of communicable and non-communicable diseases that are particularly prevalent in this context, without forgetting mental health and nutrition. This requires a collaboration of stakeholders based on better intersectorial communication, the implementation of a monitoring and evaluation system for the health of prisoners, an enhancement of the status of health-care providers working in prisons and an increase in the funding allocated to the health of prisoners with the mobilization of the necessary funds. ORIGINALITY/VALUE This study uses a primary health care classification to assess the health of inmates in a prison in Africa. It contributes to the weak evidence around prison health surveillance and health profiling of prisoners in Africa.
Collapse
Affiliation(s)
- Eric Arnaud Diendéré
- Eric Arnaud Diendéré is based at the Department of Internal Medicine, Bogodogo Teaching Hospital, and Medical association "SOS Médecins - Burkina Faso", Ouagadougou, Burkina Faso
| | - Karim Traoré
- Karim Traoré is based at General Directorate of the Prison Security Guard/Ministry of Justice/Burkina Faso, Ouagadougou, Burkina Faso
| | - Jean-Jacques Bernatas
- Jean-Jacques Bernatas is based at Expertise France, Public Health Department, Paris, France
| | - Ouedan Idogo
- Ouedan Idogo, Abdoul Kader Dao and Go Karim Traoré are all based at Medical association "SOS Médecins - Burkina Faso", Ouagadougou, Burkina Faso
| | - Abdoul Kader Dao
- P. Delphine Napon/Zongo is based at the Department of Internal Medicine, Bogodogo Teaching Hospital, and Association "Assaut Hépatites", Ouagadougou, Burkina Faso
| | - Go Karim Traoré
- Solange Ouedraogo/Dioma is based at Health Office of Expertise France, Ouagadougou, Burkina Faso
| | - P Delphine Napon/Zongo
- René Bognounou is based at Internal Medicine Department, Yalgado Ouédraogo Teaching Hospital, Ouagadougou, Burkina Faso
| | - Solange Ouédraogo/Dioma
- Ismaël Diallo, Apoline Kongnimissom Ouédraogo/Sondo and Pascal Antoine Niamba are all based at Health Sciences Training and Research Unit, Joseph Ki-Zerbo University, Ouagadougou, Burkina Faso
| | - René Bognounou
- Internal Medicine Department, Yalgado OuédraogoTeaching Hospital, Ouagadougou, Burkina Faso
| | - Ismael Diallo
- Health Sciences Training and Research Unit, Joseph Ki-Zerbo University, Ouagadougou, Burkina Faso
| | | | - Pascal Antoine Niamba
- Health Sciences Training and Research Unit, Joseph Ki-Zerbo University, Ouagadougou, Burkina Faso
| |
Collapse
|
11
|
Kuupiel D, Vezi P, Bawontuo V, Osei E, Mashamba-Thompson TP. Tuberculosis active case-finding interventions and approaches for prisoners in sub-Saharan Africa: a systematic scoping review. BMC Infect Dis 2020; 20:570. [PMID: 32758165 PMCID: PMC7405346 DOI: 10.1186/s12879-020-05283-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 07/21/2020] [Indexed: 11/10/2022] Open
Abstract
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 full-text 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, Burkina Faso, Cameroon, Coˆte d'Ivoire, the Democratic Republic of the Congo, Ethiopia, Ghana, Malawi, Nigeria, South Africa, Uganda, and Zambia with most 41.9% (13/31) recorded in Ethiopia. These intervention studies were conducted in 134 prisons between 2001 and 2018 using either a single or combination of mass, facility-led, entry, peer educators for routine screening, and exit ACF approaches. The majority (74%) of the studies utilized only a mass screening approach. The most (68%) reported study outcome was smear-positive TB cases only (68%). We found no evidence in 16 SSA countries although they are classified among the three high-burden country lists for TB TB/HIV and Multidrug resistant-TB group. CONCLUSION Our review highlights a dearth of evidence on TB ACF interventions in most SSA countries prisons. Hence, there is the need to scaling-up ACF interventions in SSA prisons, particularly countries included in the three high-burden country lists for TB, TB/HIV, and MDR-TB.
Collapse
Affiliation(s)
- Desmond Kuupiel
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, 2nd Floor George Campbell Building, Durban, 4001 South Africa
- Research for Sustainable Development Consult, Sunyani, Ghana
| | - Portia Vezi
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, 2nd Floor George Campbell Building, Durban, 4001 South Africa
| | - Vitalis Bawontuo
- Research for Sustainable Development Consult, Sunyani, Ghana
- Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana
| | - Ernest Osei
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, 2nd Floor George Campbell Building, Durban, 4001 South Africa
| | | |
Collapse
|
12
|
The yield of community-based tuberculosis and HIV among key populations in hotspot settings of Ethiopia: A cross-sectional implementation study. PLoS One 2020; 15:e0233730. [PMID: 32469997 PMCID: PMC7259557 DOI: 10.1371/journal.pone.0233730] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 05/11/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To determine the yield of tuberculosis (TB) and the prevalence of Human Immuno-deficiency virus (HIV) among key populations in the selected hotspot towns of Ethiopia. METHODS We undertook a cross-sectional implementation research during August 2017-January 2018. Trained TB focal persons and health extension workers (HEWs) identified female sex workers (FSWs), health care workers (HCWs), prison inmates, homeless, internally displaced people (IDPs), internal migratory workers (IMWs) and residents in missionary charities as key and vulnerable popuaiton. They carried out health education on the importance of TB screening and HIV testing prior to recruitment of the study participants. Symptomatic TB screening and HIV testing was done. The yield of TB was computed per 100,000 background key population. RESULTS A total of 1878 vulnerable people were screened, out of which 726 (38.7%) presumptive TB cases and 87 (4.6%) TB cases were identified. The yield of TB was 1519 (95% CI: 1218.1-1869.9). The highest proportion (19.5%) and yield of TB case (6,286 (95% CI: 3980.8-9362.3)) was among HCWs. The prevalence of HIV infection was 6%, 67 out of 1,111 tested. IMWs and FSWs represented 49.3% (33) and 28.4% (13) of the HIV infections, respectively. There was a statistically significant association of active TB cases with previous history of TB (Adjusted Odds Ratio (AOR): 11 95% CI, 4.06-29.81), HIV infection (AOR: 7.7 95% CI, 2.24-26.40), and being a HCW (AOR: 2.42 95% CI, 1.09-5.34). CONCLUSIONS The prevalence of TB in key populations was nine times higher than 164/100,000 national estimated prevalence rate. The prevalence of HIV was five times higher than 1.15% of the national survey. The highest yield of TB was among the HCWs and the high HIV burden was detected among the FSWs and IMWs. These suggest a community and health facility based integrated and enhanced case finding approaches for TB and HIV in hotspot settings.
Collapse
|
13
|
Chong F, Marín D, Pérez F. [Low detection rate and therapeutic success of tuberculosis in a prison in EcuadorBaixo recrutamento de pacientes e sucesso no tratamento da tuberculose em uma prisão do Equador]. Rev Panam Salud Publica 2020; 43:e106. [PMID: 31908648 PMCID: PMC6938213 DOI: 10.26633/rpsp.2019.106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 11/22/2019] [Indexed: 12/24/2022] Open
Abstract
Objetivo. Evaluar el control de la tuberculosis pulmonar en un centro de privación de la libertad e identificar los factores de riesgo asociados con tratamiento no exitoso en la cárcel más grande en Ecuador. Métodos. Se analizaron los datos de vigilancia de la prisión y de una cohorte de internos diagnosticados con tuberculosis (TB) entre los años 2015 y 2016. Se excluyeron los registros sin desenlace en el tratamiento. Se estimó el porcentaje de sintomáticos respiratorios (SR) identificados y la tasa de incidencia de TB. Los factores asociados con el tratamiento no exitoso se estimaron con regresión logística binomial. Resultados. De 59 846 consultas médicas, 3% se identificó como SR y, de estos, 326 reclusos tenían TB, 184 fueron analizados. La tasa de incidencia de TB en la prisión fue de 3 947/100 000 habitantes. El porcentaje de tratamiento exitoso fue de 70,4% (65,6% curado y 4,8% con tratamiento completo) y 29,4% de tratamiento no exitoso (12,5% de pérdidas durante el seguimiento, 5% fallecieron, 1,1% de fracasos de tratamiento y 10,8% no fueron evaluados). La seropositividad para el virus de la inmunodeficiencia humana (VIH) se asoció con un mayor riesgo de tratamiento no exitoso (riesgo relativo: 1,66, intervalo de confianza de 95%: 1,33-2,07). Conclusión. La incidencia de TB en la prisión es 123 veces más alta que en la población general de Ecuador. Los prisioneros coinfectados con TB-VIH tienen mayor riesgo de no tener un tratamiento exitoso y se requiere articulación entre los ministerios de salud y de justicia que permita la implementación adecuada de protocolos de salud y de la estrategia Fin a la TB.
Collapse
Affiliation(s)
- Félix Chong
- Ministerio de Salud Pública del Ecuador Ministerio de Salud Pública del Ecuador Ecuador Ministerio de Salud Pública del Ecuador, Ecuador
| | - Diana Marín
- Universidad Pontificia Bolivariana Universidad Pontificia Bolivariana Colombia Universidad Pontificia Bolivariana, Colombia
| | - Freddy Pérez
- Departamento de Enfermedades Transmisibles Determinantes Ambientales de la Salud Organización Panamericana de la Salud Washington D.C. Estados Unidos de América Departamento de Enfermedades Transmisibles y Determinantes Ambientales de la Salud, Organización Panamericana de la Salud, Washington D.C., Estados Unidos de América
| |
Collapse
|
14
|
Pulmonary Tuberculosis among Male Inmates in the Largest Prison of Eastern Nepal. Tuberc Res Treat 2019; 2019:3176167. [PMID: 31687207 PMCID: PMC6803721 DOI: 10.1155/2019/3176167] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 07/21/2019] [Accepted: 07/30/2019] [Indexed: 11/18/2022] Open
Abstract
Introduction The prevalence of Pulmonary Tuberculosis (PTB) is much higher in the prison population than in the general population. This study aims to find out the prevalence of PTB and its associated factors among inmates in eastern Nepal. Methods This cross-sectional study was conducted in Jhumka Regional Prison, the largest male prison of Eastern Nepal from September 2014 to August 2015. Semi-structured questionnaires were used to identify individuals with a cough more than one-week duration among 434 randomly selected inmates. Screening of PTB was done by sputum smear test and/or GeneXpert test. Prevalence of TB was defined as the number of cases detected during the study period divided by the total number of inmates screened during that period. Fisher's exact test was used to find out the association of PTB with related variables. Results A total of 434 inmates were screened for PTB with mean age 35.7 years and body mass index 22.7 kg/m2. A total of 68 inmates had a productive cough of more than a week and two patients were already on anti-tuberculosis therapy at the time of screening. Sixty sputum samples were considered for sputum smear/GeneXpert test and 6 of them (10%) had positive results. The prevalence of TB in the Prison was 1843/100,000 population. Chest pain and abnormal chest auscultation findings were found to be significantly associated with PTB. Conclusions This study showed that there was a high rate of PTB among inmates in Nepal. The results suggest a need for effective screening of PTB and strategies to improve management including reduction of PTB transmission in the prison.
Collapse
|
15
|
Zhang J, Kern-Allely S, Yu T, Price RK. HIV and tuberculosis co-infection in East Asia and the Pacific from 1990 to 2017: results from the Global Burden of Disease Study 2017. J Thorac Dis 2019; 11:3822-3835. [PMID: 31656655 DOI: 10.21037/jtd.2019.09.23] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background Periodic surveillance is crucial to provide information for resource allocation to control HIV/AIDS, tuberculosis (TB), and their co-infection, especially in areas with high morbidity and mortality like East Asia and the Pacific. Therefore, we examined the morbidity and mortality of HIV/AIDS and TB co-infection in this region from 1990 to 2017. Methods Utilizing the Global Burden of Disease (GBD) Study 2017, we obtained incidence, prevalence, and mortality numbers and rates of HIV/AIDS and TB co-infection, including HIV and drug-susceptible TB (DS-TB), multidrug-resistant TB without extensive drug resistance (MDR-TB without XDR), and extensive drug-resistant TB (XDR-TB). The trends in incidence, prevalence, and mortality from 1990 to 2017 for each co-infection type were analyzed using join-point regression modelling. Results In 2017, there were 238,372, 4,294, and 392 new cases of HIV-infected DS-TB, HIV-infected MDR-TB without XDR, and HIV-infected XDR-TB, respectively. The number of prevalent cases and deaths were 383,809 and 12,197 of HIV-infected DS-TB, 7,811 and 1,168 of HIV-infected MDR-TB without XDR, and 713 and 282 of HIV-infected XDR-TB. From 1990 to 2017, the age-standardized incidence rate and prevalence rate of HIV-infected DS-TB, and the prevalence rate of HIV-infected XDR-TB continuously increased; the incidence rate of HIV-infected XDR-TB increased from 1990 to 2005 before stabilizing. However, the incidence and prevalence rates of HIV-infected MDR-TB without XDR-as well as the mortality rates of all co-infection types-have decreased in the last 5 years. Conclusions Even though the mortality rates of all HIV and TB co-infection types have decreased recently, the overall trends in both incidence and prevalence rates of HIV-infected DS-TB and XDR-TB have been increasing since 1990. Efforts to control co-infection across drug resistance types should be continued and further strengthened.
Collapse
Affiliation(s)
- Jianrong Zhang
- Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | | | - Tiange Yu
- Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Rumi Kato Price
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| |
Collapse
|
16
|
Herce ME, Muyoyeta M, Topp SM, Henostroza G, Reid SE. Coordinating the prevention, treatment, and care continuum for HIV-associated tuberculosis in prisons: a health systems strengthening approach. Curr Opin HIV AIDS 2018; 13:492-500. [PMID: 30222608 PMCID: PMC7705648 DOI: 10.1097/coh.0000000000000505] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE OF REVIEW To advance a re-conceptualized prevention, treatment, and care continuum (PTCC) for HIV-associated tuberculosis (TB) in prisons, and to make recommendations for strengthening prison health systems and reducing HIV-associated TB morbidity and mortality throughout the cycle of pretrial detention, incarceration, and release. RECENT FINDINGS Despite evidence of increased HIV-associated TB burden in prisons compared to the general population, prisoners face entrenched barriers to accessing anti-TB therapy, antiretroviral therapy, and evidence-based HIV and TB prevention. New approaches, suitable for the complexities of healthcare delivery in prisons, have emerged that may address these barriers, and include: novel TB diagnostics, universal test and treat for HIV, medication-assisted treatment for opioid dependence, comprehensive transitional case management, and peer navigation, among others. SUMMARY Realizing ambitious international HIV and TB targets in prisons will only be possible by first addressing the root causes of the TB/HIV syndemic, which are deeply intertwined with human rights violations and weaknesses in prison health systems, and, second, fundamentally re-organizing HIV and TB services around a coordinated PTCC. Taking these steps can help ensure universal access to comprehensive, good-quality, free and voluntary TB/HIV prevention, treatment, and care, and advance efforts to strengthen health resourcing, staffing, information management, and primary care access within prisons.
Collapse
Affiliation(s)
- Michael E Herce
- Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia
- Division of Infectious Diseases, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Monde Muyoyeta
- Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia
| | - Stephanie M Topp
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland, Australia
| | - German Henostroza
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, School of Medicine, Birmingham, Alabama, USA
| | - Stewart E Reid
- Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, School of Medicine, Birmingham, Alabama, USA
| |
Collapse
|