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Tuberculosis in a prison population in Malawi

D S Nyangulu1, A D Harries, C Kang'ombe

  • 1National Tuberculosis Control Programme, Ministry of Health, Malawi, Central Africa.

Lancet (London, England)
|November 14, 1997
PubMed
Summary

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A study in Malawi

Area of Science:

  • Public Health
  • Infectious Disease Epidemiology
  • Global Health

Background:

  • High tuberculosis prevalence is a concern in industrialized nations' prisons.
  • Limited data exists on tuberculosis rates in prisons within developing countries.
  • This study investigated pulmonary tuberculosis in a Malawian prison.

Purpose of the Study:

  • To determine the prevalence of pulmonary tuberculosis in Zomba Central Prison, Malawi.
  • To assess the potential for active tuberculosis transmission within the prison setting.
  • To inform tuberculosis control strategies in correctional facilities in developing countries.

Main Methods:

  • An active case-finding survey was conducted in Zomba Central Prison between May and July 1996.
  • Prisoners with a cough lasting at least one week were screened using sputum-smear microscopy.
Keywords:
AfricaAfrica South Of The SaharaDeveloping CountriesDiseasesEastern AfricaEnglish Speaking AfricaExaminations And DiagnosesInfectionsLaboratory Examinations And DiagnosesMalawiMeasurementPrevalencePrisonersResearch MethodologyResearch ReportRetrospective StudiesStudiesTuberculosis

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  • Chest radiography and voluntary HIV testing were offered to eligible prisoners.

    • Main Results:

    • 5% of screened prisoners (47 out of 914) had pulmonary tuberculosis, with most cases undiagnosed at study onset.
    • A high proportion of prisoners with undiagnosed pulmonary tuberculosis or cough were HIV seropositive.
    • Symptoms of pulmonary tuberculosis predominantly developed after prisoners entered the facility.

    Conclusions:

    • The high rate of pulmonary tuberculosis in Zomba Central Prison indicates active transmission.
    • The National Tuberculosis Control Programme implemented interventions in eight Malawian prisons based on these findings.
    • Interventions include data collection, prisoner education, and active screening for tuberculosis.