A prevalence survey for pulmonary tuberculosis among prisoners in the Health Region 4, 2017

Abstract

This descriptive study was conducted during April to August 2017 to determine prevalence of bacteriologically confirmed pulmonary tuberculosis (TB) in both male and female prisoners in prisons of health region 4 areas. A total of 37,564 prisoners were screened for TB suspected symptoms using a standard questionnaire and chest X-ray. Sputum specimens were collected for smear microscopy from those with suspected TB by chest X-ray. The Xpert MTB/RIF assay was performed in cases with smear-negative sputum. Descriptive statistics was used to summarize the results of analysis. The t-test was used for comparison between means and the chi-square test was used for comparison between proportions. Of 37,564 prisoners screened, 322 (0.9%) were bacteriologically confirmed pulmonary TB. Of these 322 TB cases, 60 (18.6%) were found in those with TB suspected symptoms and 262 (81.4%) were detected in those with no symptoms. The Xpert MTB/RIF assay could detect additional 72.8% of the TB cases. The prisoners with TB had significantly higher age and were more male, compared to those with no TB. Symptoms significantly associated with TB were cough > 2 weeks, hemoptysis within previous 1 month, cough < 2 weeks, unknown weight loss within previous 1 month, fever for at least 1 week within previous 1 month and scores of symptoms met the TB suspicion. This study indicates that TB screening by a questionnaire may not be adequate for prisoners and chest X-ray should also be included for screening. The Xpert MTB/RIF assay should be performed in suspected TB cases with smear-negative sputum.