Sakala Doris Y, Tamuzi Jacques M, Shumba Constance S, Nyasulu Peter S
Division of Epidemiology and Biostatistics, Faculty of Medicine & Health Sciences, Stellenbosch University, Cape Town, South Africa.
Department of Epidemiology and Social Sciences, Division of Epidemiology and Social Sciences, Institute for Health and Equity, Medical College of Wisconsin Milwaukee, Wisconsin, United States of America.
J Public Health Afr. 2025 Aug 30;16(4):1364. doi: 10.4102/jphia.v16i4.1364. eCollection 2025.
Tuberculosis (TB) is one of the leading causes of death globally because of a single infectious pathogen. The rise in prevalence of multi-drug-resistant tuberculosis (MDR-TB) puts an increased burden on the health system in terms of cost and longer treatment duration. People living in correctional facilities are more likely to develop TB and have poor TB treatment outcomes than the general population, making them a vulnerable group to develop MDR-TB. However, the burden of MDR-TB and associated treatment outcomes among prisoners in sub-Saharan Africa (SSA) is poorly documented.
The study aims to investigate the burden and associated factors of MDR-TB treatment among prisoners in SSA.
The review will include studies of MDR-TB done in prisons and detention centers involving prisoners and inmates in sub Saharan Africa.
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PROSPERO), we will conduct a systematic review and meta-analysis. We will review studies examining MDR-TB patient treatment outcomes among prisoners reported in published literature in SSA from 2000 to 31 December 2024. A search on studies reporting MDR-TB treatment outcomes from the databases such as 'Medline, Embase, CINAHL (EBSCOhost), Scopus and Web of Science' will be conducted. We will analyse continuous outcomes as mean differences for studies using the same scales with standard deviation reported and binary outcome data as odds ratios or risk ratios, all presented with their 95% confidence intervals. Additionally, the pooled proportions will be used to determine the prevalence or incidence of specific MDR-TB treatment outcomes. Heterogeneity will be assessed using the statistic, and where significant heterogeneity is detected, a random-effects model meta-analysis will be performed; otherwise, a fixed-effect model meta-analysis will be carried out. Risk factors will be determined using the meta-regression analysis technique.
After analysis of pooled data, prevalence of MDT-TB in prisons will be presented as proportions. Meta-analysis outcome will be presented as forest plots, showing odd ratios and co-responding 95% confidence intervals. Narrative synthesis of included studies will be presented in a table format.
This proposed systematic review and meta-analysis will help consolidate evidence to support the development of public health guidelines to enhance the reduction of MDT-TB factors among prisoners in the SSA region.
This review will provide evidence to support guideline development on screening, diagnosis, and clinical management of MDR-TB patients in prisons.
结核病是全球因单一传染性病原体导致的主要死亡原因之一。耐多药结核病（MDR-TB）患病率的上升给卫生系统带来了更高的成本负担和更长的治疗时间。与普通人群相比，生活在惩教机构中的人更容易感染结核病，且结核病治疗效果较差，这使他们成为发展为耐多药结核病的弱势群体。然而，撒哈拉以南非洲（SSA）地区囚犯中耐多药结核病的负担及其相关治疗结果的记录却很少。
本研究旨在调查撒哈拉以南非洲地区囚犯中耐多药结核病治疗的负担及相关因素。
本综述将包括在撒哈拉以南非洲地区的监狱和拘留中心对囚犯进行的耐多药结核病研究。
按照系统评价和荟萃分析的首选报告项目（PROSPERO），我们将进行系统评价和荟萃分析。我们将回顾2000年至2024年12月31日期间撒哈拉以南非洲地区已发表文献中报告的关于囚犯中耐多药结核病患者治疗结果的研究。将在“Medline、Embase、CINAHL（EBSCOhost）、Scopus和Web of Science”等数据库中搜索报告耐多药结核病治疗结果的研究。对于使用相同量表并报告了标准差的研究，我们将连续结果分析为均值差异；对于二元结果数据，分析为比值比或风险比，所有结果均给出其95%置信区间。此外，合并比例将用于确定特定耐多药结核病治疗结果的患病率或发病率。将使用Q统计量评估异质性，若检测到显著异质性，则进行随机效应模型荟萃分析；否则，进行固定效应模型荟萃分析。将使用元回归分析技术确定风险因素。
在对汇总数据进行分析后，监狱中耐多药结核病的患病率将以比例形式呈现。荟萃分析结果将以森林图形式呈现，显示比值比及相应的95%置信区间。纳入研究的叙述性综合将以表格形式呈现。
这项拟议的系统评价和荟萃分析将有助于整合证据，以支持制定公共卫生指南，以加强降低撒哈拉以南非洲地区囚犯中耐多药结核病因素。
本综述将为支持监狱中耐多药结核病患者筛查、诊断和临床管理的指南制定提供证据。
