Department of Epidemiology, Wolaita Sodo University, Sodo, Ethiopia.
Institute of Health, Jimma University, Oromia, Ethiopia.
Front Public Health. 2023 Dec 28;11:1235180. doi: 10.3389/fpubh.2023.1235180. eCollection 2023.
Tuberculosis (TB) is a key community health problem in numerous settings, predominantly in sub-Saharan Africa (SSA). TB is the second most lethal infectious disease worldwide. Around 1.6 million people died from TB in 2021. TB prevention and control strategies are difficult to implement in prison, especially in sub-Saharan Africa, owing to overcrowding and poor ventilation. Thus, this systematic review and meta-analysis aimed to synthesize the estimated pooled prevalence of tuberculosis among prisoners in sub-Saharan Africa.
Electronic biomedical databases such as Google Scholar, Web of Science, PubMed/Medline, EMBASE, and Science Direct were used to systematically explore candidate studies published until December 2022. Data extraction was performed using a Microsoft Excel spreadsheet. The estimated pooled prevalence of tuberculosis was determined using a fixed-effects model. Cochrane Q-test and I statistics were used to check heterogeneity statistically across different studies. Begg's rank and Egger's tests were performed to assess evidence of possible publication bias.
A total of 40 articles involving 59,300 prisoners were included in this systematic review and meta-analysis. The pooled prevalence of tuberculosis was 4.02% (95% CI: 2.68-5.36). We found the highest prevalence using Gene X pert as a diagnostic method, which was 4.97 (95% CI: 2.22-7.73). There is no evidence of publication bias.
The outcome of this review revealed a high prevalence of tuberculosis among prisoners in sub-Saharan Africa. To reach the "End Tuberculosis strategy" by 2030, early identification of cases through screening on entry and periodical active case finding is important. Moreover, prevention and prompt treatment after diagnosis must be implemented to limit transmission to the general population.
https://www.crd.york.ac.uk/prospero/#searchadvanced, identifier (CRD42023428933).
结核病（TB）是许多环境中的一个主要社区卫生问题，主要在撒哈拉以南非洲（SSA）。结核病是全球第二大致命传染病。2021 年，约有 160 万人死于结核病。由于过度拥挤和通风不良，监狱中的结核病预防和控制策略很难实施，特别是在撒哈拉以南非洲。因此，本系统评价和荟萃分析旨在综合估计撒哈拉以南非洲囚犯中结核病的患病率。
使用电子生物医学数据库，如 Google Scholar、Web of Science、PubMed/Medline、EMBASE 和 Science Direct，系统地搜索截至 2022 年 12 月发表的候选研究。使用 Microsoft Excel 电子表格进行数据提取。使用固定效应模型确定结核病的估计合并患病率。使用 Cochrane Q 检验和 I 统计量对不同研究之间的异质性进行统计学检验。进行 Begg 秩和 Egger 检验以评估可能存在的发表偏倚的证据。
本系统评价和荟萃分析共纳入 40 篇涉及 59300 名囚犯的文章。结核病的合并患病率为 4.02%（95%CI：2.68-5.36）。使用 Gene X pert 作为诊断方法时，我们发现患病率最高，为 4.97%（95%CI：2.22-7.73）。没有证据表明存在发表偏倚。
本研究结果表明，撒哈拉以南非洲的囚犯中结核病的患病率很高。为了在 2030 年实现“终结结核病战略”，通过入监时筛查和定期主动病例发现来早期发现病例很重要。此外，必须在诊断后实施预防和及时治疗，以限制向普通人群传播。
https://www.crd.york.ac.uk/prospero/#searchadvanced，标识符（CRD42023428933）。
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