Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
Instituto de Evaluacion de Tecnologías en Salud e Investigación, ESSALUD, Lima, Peru.
Trop Med Int Health. 2019 Mar;24(3):328-338. doi: 10.1111/tmi.13199. Epub 2019 Jan 13.
To estimate the prevalence of self-reported tuberculosis TB diagnosed at Peruvian correctional facilities (CFs), and their associated factors.
Cross-sectional study based on secondary analysis of the National Census held in all Peruvian CFs in 2016. Outcome was defined as self-reported TB diagnosed by a healthcare professional intra-penitentiary. A descriptive bivariate analysis was carried out, followed by multivariate analysis using Poisson regression in order to calculate the adjusted prevalence ratios (PRa). Additionally, a mixed effects multilevel model adjusted by CFs as clusters was performed.
Of 77 086 prison inmates in 66 CFs participated in the original census, of which 69 890 were included. Of these, 1754 self-reported TB diagnosed intra-penitentiary, yielding a prevalence of 2510/100 000 PDL. In the final model, self-reported TB was associated with younger age, male gender, lower educational level, not having a stable partner, having prison readmissions and having relatives in prison. There was also strong association with HIV/AIDS (PRa 2.77; 1.84-4.18), STIs (PRa 2.13; 1.46-3.10), DM (PRa 1.99; 1.59-2.50) and recreational drugs use (PRa 1.41; 1.23-1.61). The mixed model showed significant variance for belonging to different CFs (2.13; 1.02-4.44) and CF overcrowding (3.25; 1.37-7.71).
Self-reported TB prevalence found was higher than reported by other lower/lower-middle income countries. Demographic factors, individual clinical features and overcrowding increases the likelihood of self-reported TB.
估计秘鲁惩教设施（CFs）中自我报告的结核病（TB）诊断的患病率及其相关因素。
这是一项基于 2016 年在秘鲁所有 CFs 中进行的全国普查的二次分析的横断面研究。结局定义为医疗保健专业人员在狱中自我报告的 TB 诊断。进行了描述性双变量分析，然后使用泊松回归进行多变量分析，以计算调整后的患病率比（PRa）。此外，还通过 CFs 作为聚类进行了混合效应多水平模型调整。
在参与原始普查的 66 个 CFs 中的 77086 名监狱囚犯中，有 69890 人被纳入。其中，1754 人自我报告狱中诊断出 TB，患病率为 2510/100000 PDL。在最终模型中，自我报告的 TB 与年龄较小、男性、较低的教育水平、没有稳定的伴侣、有监狱再入院和有亲属在监狱有关。与 HIV/AIDS（PRa 2.77；1.84-4.18）、性传播感染（PRa 2.13；1.46-3.10）、DM（PRa 1.99；1.59-2.50）和娱乐性药物使用（PRa 1.41；1.23-1.61）也有很强的关联。混合模型显示出属于不同 CFs（2.13；1.02-4.44）和 CF 过度拥挤（3.25；1.37-7.71）的显著差异。
发现的自我报告的 TB 患病率高于其他低收入/中下收入国家报告的患病率。人口统计学因素、个体临床特征和过度拥挤增加了自我报告的 TB 的可能性。
