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Tuberculosis In A Nigerian Medium Security Prison
Abstract
Introduction: Prisons worldwide have been cited as reservoirs for
tuberculosis and also an ideal setting for interventions but little is known about the epidemiology and control of tuberculosis in Nigerian Prisons. Objective: To determine the prevalence of tuberculosis, role of prison in its control and the mortality from tuberculosis among prison inmate in Kuje prison, Abuja, Nigeria.
Materials and Methods: This study was a retrospective study of cases of tuberculosis in Kuje prison between April, 2004 and December, 2008. Data was collected from their medical records. The inclusion criterion was: (1) Cases of tuberculosis in which the diagnosis was based on clinical history, smear positive test and chest x-ray radiograph. (2) Cases where the treatment of tuberculosis was according to treatment strategy recommended by World Health Organization. Results: A total of forty-eight inmates, aged 20 to 45years, were diagnosed with tuberculosis within the period of interest. The prevalence rate was 2.4%, based on a total prison population of 2002. Majority of cases 93.8% were first detected in Prison and the remaining 6.3% were detected prior to incarceration. Out of the 6.3% diagnosed prior to incarceration, 2.1% and 4.2% of cases have defaulted from DOTS for 2weeks and more than 4weeks respectively. Majority (66.7%) completed the treatment before discharging from prison, 29.2% were discharged from prison at various level of treatment and 4.2% of cases died while on reatment. Those who died were co-infected with
HIV Conclusion: It was evident from this study that: The prevalence of tuberculosis in Kuje prison was high, prison has a role in diagnosis and treatment, adherence and treatment outcome were good and the main indicator for mortality was HIV
infection. Primary prevention measures specifically targeting prisoners are needed to reduce prevalence of tuberculosis and also to achieve the objectives of National Health Policy on tuberculosis and leprosy.
Keywords: Prison, tuberculosis, control, mortality
tuberculosis and also an ideal setting for interventions but little is known about the epidemiology and control of tuberculosis in Nigerian Prisons. Objective: To determine the prevalence of tuberculosis, role of prison in its control and the mortality from tuberculosis among prison inmate in Kuje prison, Abuja, Nigeria.
Materials and Methods: This study was a retrospective study of cases of tuberculosis in Kuje prison between April, 2004 and December, 2008. Data was collected from their medical records. The inclusion criterion was: (1) Cases of tuberculosis in which the diagnosis was based on clinical history, smear positive test and chest x-ray radiograph. (2) Cases where the treatment of tuberculosis was according to treatment strategy recommended by World Health Organization. Results: A total of forty-eight inmates, aged 20 to 45years, were diagnosed with tuberculosis within the period of interest. The prevalence rate was 2.4%, based on a total prison population of 2002. Majority of cases 93.8% were first detected in Prison and the remaining 6.3% were detected prior to incarceration. Out of the 6.3% diagnosed prior to incarceration, 2.1% and 4.2% of cases have defaulted from DOTS for 2weeks and more than 4weeks respectively. Majority (66.7%) completed the treatment before discharging from prison, 29.2% were discharged from prison at various level of treatment and 4.2% of cases died while on reatment. Those who died were co-infected with
HIV Conclusion: It was evident from this study that: The prevalence of tuberculosis in Kuje prison was high, prison has a role in diagnosis and treatment, adherence and treatment outcome were good and the main indicator for mortality was HIV
infection. Primary prevention measures specifically targeting prisoners are needed to reduce prevalence of tuberculosis and also to achieve the objectives of National Health Policy on tuberculosis and leprosy.
Keywords: Prison, tuberculosis, control, mortality
