Moreira Tiago Ricardo, Passos Ibsen Barguine Junqueira, Bueno João Vitor L, Maffacciolli Rosana, Colodette Renata Maria, Miguel Paulo Sérgio
Doutor e Saúde Pública. Departamento de Medicina e Enfermagem, Universidade Federal de Viçosa, Viçosa-MG, Brazil.
Graduado Em Medicina. Departamento de Medicina e Enfermagem, Universidade Federal de Viçosa, Viçosa-MG, Brazil.
Indian J Med Microbiol. 2022 Apr-Jun;40(2):193-199. doi: 10.1016/j.ijmmb.2022.01.004. Epub 2022 Feb 1.
In the context of prisons, multidrug-resistant tuberculosis (MDR-TB) is a major problem. In this article, we estimate the prevalence of MDR-TB among the population deprived of freedom from countries in South America, Europe, Asia and Africa.
The articles were retrieved through systematic search at four databases (EMBASE, CINAHL, LILACS and MEDILINE). The meta-analysis was developed by the random effect model, using the Mantel-Haenszel method, with presentation of the aggregated results through the forest plot. The degree of heterogeneity between the studies was verified using Cochran's Q test and I.
Of the 102 articles analyzed, 21 were included in this systematic review. The analysis showed heterogeneity indicated by the Q test (P < 0.001) and I statistics (I = 50.52%). The funnel graph and Egger test (P < 0.830) showed symmetry between investigations. The grouped prevalence of MDR-TB was 0.48% (95% CI: 0.02 to 1.32), advancing to 1.15 (95% CI: 0.15 to 2.73) when culture and sensitivity test were considered by the authors. No specific characteristics were significantly associated with differences in prevalence rates in the population deprived of freedom.
The study reaffirms the magnitude of MDR-TB in the population deprived of freedom in the world context. Political and technical-scientific efforts should be mobilized to mitigate TB and MDR-TB in prisons and for successful national and international disease control programs.
在监狱环境中，耐多药结核病（MDR-TB）是一个主要问题。在本文中，我们估计了南美洲、欧洲、亚洲和非洲国家被剥夺自由人群中的耐多药结核病患病率。
通过在四个数据库（EMBASE、CINAHL、LILACS和MEDILINE）进行系统检索来获取文章。采用随机效应模型，使用Mantel-Haenszel方法进行荟萃分析，并通过森林图展示汇总结果。使用Cochran's Q检验和I统计量来验证研究之间的异质性程度。
在分析的102篇文章中，有21篇被纳入本系统评价。分析显示Q检验（P < 0.001）和I统计量（I = 50.52%）表明存在异质性。漏斗图和Egger检验（P < 0.830）显示各研究之间具有对称性。耐多药结核病的合并患病率为0.48%（95%置信区间：0.02至1.32），当作者考虑培养和药敏试验时，该患病率升至1.15（95%置信区间：0.15至2.73）。没有特定特征与被剥夺自由人群中患病率的差异显著相关。
该研究再次证实了在全球范围内被剥夺自由人群中耐多药结核病的严重程度。应调动政治和技术科学方面的努力，以减轻监狱中的结核病和耐多药结核病，并推动国家和国际疾病控制项目取得成功。
