Prevalence of and risk factors associated with Mycobacterium tuberculosis infection in prisoners, North West Frontier Province, Pakistan
Prevalence of and risk factors associated with Mycobacterium tuberculosis infection in prisoners, North West Frontier Province, Pakistan
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DOI：
10.1093/ije/dyg247
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发表时间：
2003-10-01
影响因子：
7.7
通讯作者：
Nanan, D
中科院分区：
文献类型：
--
作者：
Hussain, H;Akhtar, S;Nanan, D
背景 这项横断面研究旨在评估西北边境省 (NWFP) 囚犯中潜伏结核分枝杆菌 (MTB) 感染的患病率并确定与该感染相关的因素。 方法 采用分层随机抽样技术，从巴基斯坦西北边境省 5 个中心监狱（白沙瓦、德拉伊斯梅尔汗、哈里普尔、科哈特和乌兹别克斯坦）的 6607 名 18-60 岁男性囚犯中选取 425 名样本。马尔丹）。使用结构化的预测试问卷对选定的囚犯进行访谈；还进行了曼图结核菌素皮肤试验（TST）。囚犯的潜伏 MTB 感染状态由 TST 硬结的大小（之前是否有 BCG 疤痕）来确定。结果 囚犯中潜伏 MTB 感染的总体患病率为 48% (204/425)。使用多重逻辑回归，发现囚犯的年龄、教育水平、吸烟状况、当前监禁时间以及监狱营房中 60 英尺(2) 或以下的平均住宿面积是潜在 MTB 感染的统计显着性 (P < 0.05) 预测因素。结论 通过 TST 评估，囚犯中潜在 MTB 感染流行率很高，需要立即采取措施识别和确认 MTB 感染，并对在这种情况下发现呈阳性的人进行治疗和咨询。阻止监狱内 MTB 传播的努力应包括： 使用痰涂片和 TST 对入狱囚犯进行常规筛查，分别诊断结核病 (TB) 和潜伏 MTB 感染。对结核病阳性囚犯进行隔离和治疗，对 TST 阳性囚犯进行化学预防性治疗，减少过度拥挤，开展有关吸烟有害影响的教育，以及对服刑较长的囚犯进行强化监测，可能有助于减少结核病在该环境和整个社区的传播。
Background This cross-sectional study was conducted to assess the prevalence of and identify factors associated with latent Mycobacterium tuberculosis (MTB) infection in prisoners of North West Frontier Province (NWFP).Methods A stratified random sampling technique was used to select a sample of 425 from a total of 6607 male prisoners aged 18-60 years from the five central prisons of NWFP, Pakistan (Peshawar, Dera Ismail Khan, Haripur, Kohat, and Mardan). The selected inmates were interviewed using a structured pre-tested questionnaire; a Mantoux tuberculin skin test (TST) was also performed. Latent MTB infection status of the prisoner was determined by the size of the induration of the TST in the presence/absence of a previous BCG scar.Results Overall prevalence of latent MTB infection among prisoners was 48% (204/425). Using multiple logistic regression, a prisoner's age, educational level, smoking status, duration of current incarceration, and average accommodation area of 60 ft(2) or less in prison barracks were found to be statistically significant (P < 0.05) predictors of latent MTB infection.Conclusion The high prevalence of latent MTB infection as assessed by TST in prisoners requires immediate steps be taken to identify and confirm MTB infection, and to treat and counsel those found to be positive in this setting. Efforts to halt MTB transmission in prisons should include: routine screening of prisoners on entry using sputum smear and TST for diagnosis of tuberculosis (TB) and latent MTB infection, respectively. The isolation and treatment of TB positive prisoners and chemo-prophylactic treatment of TST positives, reduction of overcrowding, education regarding the harmful effects of smoking, and intensive monitoring of those serving longer prison terms may help reduce the MTB transmission in this setting and in the community at large.