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High utility of active tuberculosis case finding in an Ethiopian prison
Y Merid1, Y Woldeamanuel2, M Abebe3
1Armauer Hansen Research Institute, Addis Ababa, Ethiopia; Addis Ababa University, Addis Ababa, Hawassa University, Hawassa, Ethiopia.
Setting:
Hawassa Prison, Southern Region of Ethiopia.
Objective:
To determine the burden of pulmonary tuberculosis (TB) using active case finding among prisoners.
Design:
In this cross-sectional study, prisoners were screened for TB using a symptom screen. Those with cough of 2 weeks had spot and morning sputum samples collected for acid-fast bacilli (AFB) smear microscopy and molecular diagnostic testing (Xpert® MTB/RIF).
Results:
Among 2068 prisoners, 372 (18%) had a positive cough screen. The median age of these 372 persons was 23 years, 97% were male and 63% were from urban areas. Among those with a positive symptom screen, 8 (2%) were AFB sputum smear-positive and 31 (8%) were Xpert-positive. The point prevalence of pulmonary TB at the prison was 1748 per 100 000 persons. In multivariate analysis, persons with cough >4 weeks were more likely to have TB (OR 3.34, 95%CI 1.54-7.23).
Conclusion:
A high prevalence of TB was detected among inmates at a large Ethiopian prison. Active case finding using a cough symptom screen in combination with Xpert had high utility, and has the potential to interrupt transmission of Mycobacterium tuberculosis in correctional facilities in low- and middle-income, high-burden countries.
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