Dataset Information

Epidemic Situation of Tuberculosis in Prisons in the Central Region of China.

ABSTRACT: We aimed to investigate the epidemic situation of tuberculosis (TB) in prisons in the central region of China. Tuberculosis screening was carried out in two prisons in middle China. A sum of 3,459 prisoners accepted chest X-ray examination; 40 of them were diagnosed as active TB patients. The active TB prevalence (1,156/105) was significantly higher than that of the province and China's general population (P < 0.01). As for gender, TB prevalence in men's prison (1,589/105) was higher than that in the women's prison (946/105). Nevertheless, the risk of having TB in women's prison was much higher than that in the men's prison when compared with the TB prevalence from the province (women: OR = 2.37, 95% CI: 1.34, 4.22; men: OR = 1.53, 95% CI: 0.90, 2.60) and the China's general population (women: OR = 3.30, 95% CI: 2.15, 5.09; men: OR = 2.06, 95% CI: 1.29, 3.30). In view of the severe epidemic situation of TB in prisons, integrating medical resources to establish a consummate and effective management system is necessary.

SUBMITTER: Tong Y

PROVIDER: S-EPMC6726957 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Epidemic Situation of Tuberculosis in Prisons in the Central Region of China.

Tong Yeqing Y Jiang Shunli S Guan Xuhua X Hou Shuanyi S Cai Kun K Tong Yemeng Y Cai Li L Liu Jiafa J Lu Qing Q

The American journal of tropical medicine and hygiene 20190901 3

We aimed to investigate the epidemic situation of tuberculosis (TB) in prisons in the central region of China. Tuberculosis screening was carried out in two prisons in middle China. A sum of 3,459 prisoners accepted chest X-ray examination; 40 of them were diagnosed as active TB patients. The active TB prevalence (1,156/105) was significantly higher than that of the province and China's general population (P < 0.01). As for gender, TB prevalence in men's prison (1,589/105< ...[more]

PMID: 31287047

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Project description:BackgroundTransmission of tuberculosis (TB) in prisons has been reported worldwide to be much higher than that reported for the corresponding general population.Methods and findingsA systematic review has been performed to assess the risk of incident latent tuberculosis infection (LTBI) and TB disease in prisons, as compared to the incidence in the corresponding local general population, and to estimate the fraction of TB in the general population attributable (PAF%) to transmission within prisons. Primary peer-reviewed studies have been searched to assess the incidence of LTBI and/or TB within prisons published until June 2010; both inmates and prison staff were considered. Studies, which were independently screened by two reviewers, were eligible for inclusion if they reported the incidence of LTBI and TB disease in prisons. Available data were collected from 23 studies out of 582 potentially relevant unique citations. Five studies from the US and one from Brazil were available to assess the incidence of LTBI in prisons, while 19 studies were available to assess the incidence of TB. The median estimated annual incidence rate ratio (IRR) for LTBI and TB were 26.4 (interquartile range [IQR]: 13.0-61.8) and 23.0 (IQR: 11.7-36.1), respectively. The median estimated fraction (PAF%) of tuberculosis in the general population attributable to the exposure in prisons for TB was 8.5% (IQR: 1.9%-17.9%) and 6.3% (IQR: 2.7%-17.2%) in high- and middle/low-income countries, respectively.ConclusionsThe very high IRR and the substantial population attributable fraction show that much better TB control in prisons could potentially protect prisoners and staff from within-prison spread of TB and would significantly reduce the national burden of TB. Future studies should measure the impact of the conditions in prisons on TB transmission and assess the population attributable risk of prison-to-community spread. Please see later in the article for the Editors' Summary.

Project description:Given the dual epidemics of HIV and tuberculosis in sub-Saharan Africa and evidence suggesting a disproportionate burden of these diseases among detainees in the region, we aimed to investigate the epidemiology of HIV and tuberculosis in prison populations, describe services available and challenges to service delivery, and identify priority areas for programmatically relevant research in sub-Saharan African prisons. To this end, we reviewed literature on HIV and tuberculosis in sub-Saharan African prisons published between 2011 and 2015, and identified data from only 24 of the 49 countries in the region. Where data were available, they were frequently of poor quality and rarely nationally representative. Prevalence of HIV infection ranged from 2·3% to 34·9%, and of tuberculosis from 0·4 to 16·3%; detainees nearly always had a higher prevalence of both diseases than did the non-incarcerated population in the same country. We identified barriers to prevention, treatment, and care services in published work and through five case studies of prison health policies and services in Zambia, South Africa, Malawi, Nigeria, and Benin. These barriers included severe financial and human-resource limitations and fragmented referral systems that prevent continuity of care when detainees cycle into and out of prison, or move between prisons. These challenges are set against the backdrop of weak health and criminal-justice systems, high rates of pre-trial detention, and overcrowding. A few examples of promising practices exist, including routine voluntary testing for HIV and screening for tuberculosis upon entry to South African and the largest Zambian prisons, reforms to pre-trial detention in South Africa, integration of mental health services into a health package in selected Malawian prisons, and task sharing to include detainees in care provision through peer-educator programmes in Rwanda, Zimbabwe, Zambia, and South Africa. However, substantial additional investments are required throughout sub-Saharan Africa to develop country-level policy guidance, build human-resource capacity, and strengthen prison health systems to ensure universal access to HIV and tuberculsosis prevention, treatment, and care of a standard that meets international goals and human rights obligations.

Dataset Information

Epidemic Situation of Tuberculosis in Prisons in the Central Region of China.

Publications

Epidemic Situation of Tuberculosis in Prisons in the Central Region of China.

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