Prevalence and associated factors of TB and HIV coinfections among adult inmates with presumptive pulmonary TB in a Kenyan prison.

IF 3.6 Q1 TROPICAL MEDICINE
Suleiman Athuman Mwatenga, Ali A Musa, Margaret W Muturi, Abednego Moki Musyoki
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Abstract

Background: Tuberculosis (TB) is more than ten times higher in prisons compared to the general population, and HIV-infected persons are at increased risk of developing active TB and death. In the World Health Organization (WHO) African region, however, where the TB and HIV coinfections are highest, and prisons rarely factored in national disease surveillance, epidemiological data to inform TB control interventions in correctional facilities is limited. In this study, we assessed the prevalence of TB and HIV coinfections, as well as the factors associated with coinfections in our study setting.

Methods: This was a prospective cross-sectional study among 157 adult (≥ 18 years) prisoners presenting with symptoms of pulmonary TB at Shimo La Tewa Prison, Kenya, between January and June 2023. The study excluded those with a history of anti-TB drugs use or on treatment follow-up and collected demographic and clinical characteristics data using a questionnaire. Sputum samples were collected and processed immediately using Xpert® MTB/RIF assay or stored at 4 °C for three (3) days in case of delay.

Results: The overall prevalence of TB among inmates with presumptive pulmonary TB was 10.2%, 95% CI 6.37-16.91% (16/157), HIV 19.1%, 95% CI 13.73-25.97% (30/157). All the TB cases were positive for HIV (16/16, 100%), translating to TB/HIV coinfection of 10.2%, 95% CI 6.37-16.91% (16/157), and there was no rifampicin resistance. TB and HIV coinfection cases were found among underweight (100%, 16/16) prisoners. The independent factors associated with TB and HIV coinfections were education level (adjusted OR = 0.17, p = 0.007), smoking history (adjusted OR = 3.01, p = 0.009) and illegal drug use history (adjusted OR = 4.55, p = 0.044).

Conclusion: We report a high prevalence of pulmonary TB and HIV coinfections among adult inmates with presumptive pulmonary TB in Kenya, with education level, smoking status, and illegal drug use as the independent factors associated with the coinfection. The authority should take measures to protect HIV-positive prisoners from TB, focusing on education, nutrition, smoking, and illegal drug use.

肯尼亚一所监狱中患有肺结核推定病症的成年囚犯中结核病和艾滋病毒合并感染的流行率和相关因素。
背景:监狱中结核病(TB)的发病率是普通人群的十倍以上,而艾滋病毒感染者罹患活动性结核病和死亡的风险更高。然而,在世界卫生组织(WHO)非洲地区,结核病和艾滋病病毒的合并感染率最高,而且监狱很少被纳入国家疾病监测范围,因此为惩教机构结核病控制干预提供信息的流行病学数据非常有限。在这项研究中,我们评估了结核病和艾滋病病毒双重感染的流行情况,以及在我们的研究环境中与双重感染相关的因素:这是一项前瞻性横断面研究,研究对象是 2023 年 1 月至 6 月期间在肯尼亚 Shimo La Tewa 监狱出现肺结核症状的 157 名成年(≥ 18 岁)囚犯。研究排除了有抗结核药物使用史或治疗随访史的囚犯,并通过问卷调查收集了人口统计学和临床特征数据。痰液样本收集后立即使用 Xpert® MTB/RIF 检测法进行处理,如需延迟处理,则在 4 °C 下保存三(3)天:结果:在推测患有肺结核的囚犯中,结核病的总发病率为 10.2%,95% CI 为 6.37-16.91%(16/157),艾滋病毒感染率为 19.1%,95% CI 为 13.73-25.97%(30/157)。所有肺结核病例的艾滋病毒检测结果均呈阳性(16/16,100%),因此肺结核/艾滋病毒合并感染率为 10.2%,95% CI 为 6.37-16.91%(16/157),且无利福平耐药性。体重不足的囚犯(16/16,100%)中发现了结核病和艾滋病毒合并感染病例。与肺结核和艾滋病病毒双重感染相关的独立因素是受教育程度(调整后 OR = 0.17,p = 0.007)、吸烟史(调整后 OR = 3.01,p = 0.009)和非法吸毒史(调整后 OR = 4.55,p = 0.044):我们报告了肯尼亚推定肺结核成年囚犯中肺结核和艾滋病毒合并感染的高流行率,教育水平、吸烟状况和非法使用毒品是与合并感染相关的独立因素。当局应采取措施保护艾滋病毒呈阳性的囚犯免受肺结核感染,重点关注教育、营养、吸烟和非法使用毒品等问题。
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来源期刊
Tropical Medicine and Health
Tropical Medicine and Health TROPICAL MEDICINE-
CiteScore
7.00
自引率
2.20%
发文量
90
审稿时长
11 weeks
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