Teketel Tedegn, Agide Feleke Doyore, Yirga Yohannes, Hamdalla Tadesse, Beykaso Gizachew
Department of Diseases Prevention and Control, Lemo Woreda Health Office, Hadiya Zone, Hossana, Central Ethiopia Region, Ethiopia.
School of Public Health, College of Medicine and Health Science, Wachemo University, P.O. Box 667, Hossana, Ethiopia.
Can J Infect Dis Med Microbiol. 2025 Aug 11;2025:4170420. doi: 10.1155/cjid/4170420. eCollection 2025.
Tuberculosis (TB) remains a major public health problem globally, particularly in resource-limited settings where deprived ventilation, overcrowding, and limited healthcare services. Incarcerated individuals are among vulnerable populations disproportionately affected by TB due to confined living conditions and delayed diagnosis. In Ethiopia, the prison setting provides an environment favorable to the rapid spread of TB and a threat to the outside community. Thus, this study aims to determine the prevalence of undiagnosed pulmonary tuberculosis (PTB) and its predictors among incarcerated individuals in Central Ethiopia. A facility-based cross-sectional study was conducted from September to December 2023 among 363 selected incarcerated individuals in Central Ethiopia. Sociodemographic, clinical, and other risk-related data were collected using a structured questionnaire. Sputum samples were collected from incarcerated individuals with clinical symptoms of cough for two or more weeks and processed using GeneXpert MTB/RIF. The study was not formally powered to detect specific odds ratios for risk factor analysis; therefore, the associated predictors were explored through multivariable analysis and interpreted cautiously. In 3802 total incarcerated individuals in the region's prisons, 363 (9.5%) with clinical symptoms and 13 (0.34%) already on anti-TB treatment were identified. Among these 363 (9.5%) with clinical symptoms, 35 (9.64%) previously undiagnosed PTB cases were detected. Hence, the point prevalence of undiagnosed PTB among incarcerated individuals was 0.92% or 920 per 100,000 population (95% CI: 830-998/100,000), which is about 7.7 times higher than Ethiopia's general population (119/100,000). This previously undiagnosed PTB was associated with incarcerated individuals who had smoking, increased age, contact with coughing/TB patients, chronic illness comorbidity, overcrowding, and low BMI. This study revealed a high point prevalence of undiagnosed PTB among incarcerated individuals. This mightily highlights that prisons are explicitly taken as a risky place for the transmission of PTB. Routine TB screening during prison entrance and periodical active case finding are highly recommended to identify missing people with TB who have a high spreading. After diagnosis, early treatment must be implemented to limit further transmission to incarcerated individuals and the surrounding community.
结核病（TB）仍然是全球主要的公共卫生问题，尤其是在资源有限的环境中，那里通风不良、过度拥挤且医疗服务有限。由于生活条件受限和诊断延迟，被监禁者是受结核病影响尤为严重的弱势群体之一。在埃塞俄比亚，监狱环境为结核病的迅速传播提供了条件，并对外部社区构成威胁。因此，本研究旨在确定埃塞俄比亚中部被监禁者中未诊断出的肺结核（PTB）患病率及其预测因素。2023年9月至12月，在埃塞俄比亚中部对363名选定的被监禁者进行了一项基于机构的横断面研究。使用结构化问卷收集社会人口学、临床和其他风险相关数据。从有咳嗽等临床症状两周或更长时间的被监禁者中采集痰样本，并使用GeneXpert MTB/RIF进行处理。该研究没有正式设定检测风险因素分析的特定比值比的能力；因此，通过多变量分析探索相关预测因素并谨慎解释。在该地区监狱的3802名被监禁者中，识别出363名（9.5%）有临床症状的人和13名（0.34%）已经在接受抗结核治疗的人。在这363名（9.5%）有临床症状的人中，检测到35名（9.64%）以前未诊断出的PTB病例。因此，被监禁者中未诊断出的PTB的点患病率为0.92%或每10万人中有920例（95%可信区间：830 - 998/10万），这比埃塞俄比亚普通人群（119/10万）高出约7.7倍。这种以前未诊断出的PTB与吸烟、年龄增加、与咳嗽/结核病患者接触、慢性病合并症、过度拥挤和低体重指数的被监禁者有关。本研究揭示了被监禁者中未诊断出的PTB的高患病率。这有力地凸显了监狱被明确视为PTB传播的危险场所。强烈建议在入狱时进行常规结核病筛查，并定期进行主动病例发现，以识别传播风险高的未被发现的结核病患者。诊断后，必须实施早期治疗，以限制向被监禁者和周围社区的进一步传播。
