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Review
. 2023 Jan 11;23(1):20.
doi: 10.1186/s12879-022-07961-8.

Epidemiology of TB in prisoners: a metanalysis of the prevalence of active and latent TB

Aline Ferreira Placeres  1 , Débora de Almeida Soares  2 , Felipe Mendes Delpino  3 , Heriederson Sávio Dias Moura  4 , Alessandro Rolim Scholze  5 , Márcio Souza Dos Santos  4 , Ricardo Alexandre Arcêncio  4 , Inês Fronteira  6
Affiliations
Review

Epidemiology of TB in prisoners: a metanalysis of the prevalence of active and latent TB

Aline Ferreira Placeres et al. BMC Infect Dis. .

Abstract

Background: Tuberculosis (TB) in prisons usually occurs at higher rates than in the general population, especially in developing countries. TB has been reported as the most common cause of death among prisoners. Studies have shown limitations for early detection of TB in prisons that seem to result from mistaken concepts about TB, delayed diagnosis mainly due to the naturalization of lack of healthcare for this population METHODS: A scoping review was performed using the methodology of the Joanna Briggs Institute to assess "What are the scientific evidences on the epidemiology of TB in the prison system?". Then, a meta-analysis was performed to assess the prevalence of TB (active and latent) TB in prisoners. The results are presented as prevalence, in percentage, through random effects models, with a confidence interval of 95%.

Results: Regarding active TB, the results of the metanalysis showed that countries with a high burden of TB had a prevalence of 3.54% [2.71; 4.63], countries not considered to be high burden TB countries had a prevalence of 1.43% [0.86; 2.37]. Latent TB had a prevalence of 51.61% [39.46; 63.58] in high TB burden countries and a prevalence of 40.24% [23.51; 59.61] in countries with low TB burden. In terms of development, in low- and lower-middle-income countries, the prevalence of active TB was 3.13% [1.84; 5.29] and in high- and upper-middle income countries the prevalence was 2.25% [1.70; 2.99]. The prevalence of latent TB in high- and middle-income countries was 43.77% [28.61; 60.18] and of 49.42% [45.91; 52.94] in low and lower middle-income countries.

Conclusion: Our analysis suggests that TB, and probably other infectious diseases, find fertile ground in prisons where previous acquire social disadvantages seem to thrive-therefore, TB in prisons is a global public health problem and effective strategies are needed to control the disease are needed targeting the prison environment, including rapid health assessments to understand each context and to implement tailored and precision interventions.

Keywords: Meta-analysis; Population deprived of liberty; Prevalence; Prisoners; Prisons; Tuberculosis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram illustrating the search process which eligible articles was identified for data synthesis
Fig. 2
Fig. 2
Prevalence of general tuberculosis by burden of TB of the country
Fig. 3
Fig. 3
Prevalence of latent tuberculosis by burden of TB of the country
Fig. 4
Fig. 4
Prevalence of symptomatic tuberculosis by burden of TB of the country
Fig. 5
Fig. 5
Prevalence of general tuberculosis by income level of the country
Fig. 6
Fig. 6
Prevalence of latent tuberculosis level of the country
Fig. 7
Fig. 7
Prevalence of symptomatic tuberculosis by income level of the country
Fig. 8
Fig. 8
Prevalence of general tuberculosis according to the quality of the studies
Fig. 9
Fig. 9
Prevalence of latent tuberculosis according to the quality of the studies
Fig. 10
Fig. 10
Prevalence of Symptomatic tuberculosis according to the quality of the studies
Fig. 11
Fig. 11
Trend in the prevalence of tuberculosis in prisoners
Fig. 12
Fig. 12
Trend in the prevalence of latent tuberculosis in prisoners
Fig. 13
Fig. 13
Trends in the prevalence of tuberculosis in symptomatic prisoners
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