撒哈拉以南非洲监狱囚犯肺结核患病率和预测因素:系统回顾和荟萃分析。

Habtamu Belew Mera, Fasil Wagnew, Yibeltal Akelew, Zigale Hibstu, Sileshi Berihun, Workineh Tamir, Simegn Alemu, Yonas Lamore, Bewket Mesganaw, Adane Adugna, Tefsa Birlew Tsegaye
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引用次数: 0

摘要

简介:撒哈拉以南非洲(SSA)的囚犯由于过度拥挤和通风不良,感染结核病(TB)的风险很高。因此,结核病是监狱中发病和死亡的主要原因,许多囚犯在控制结核病方面面临许多障碍,而且在该地区获得的信息有限。因此,本系统综述和荟萃分析的目的是估计SSA监狱囚犯中肺结核的总体合并患病率和预测因素。方法:2006 - 2019年对PubMed、Embase、Web of Science、Scopus等数据库进行系统综述和meta分析。采用标准化的数据提取格式,在Microsoft Excel中提取数据,使用STATA version 14进行分析。为了检测研究间的异质性,计算I2和Cochrane Q检验统计量。为了确定监狱人群中结核病的总体患病率和预测因素,采用了随机效应荟萃分析模型。结果:在检索到的3479篇文章中,37篇研究包括72844名囚犯符合纳入标准。SSA监狱囚犯肺结核总患病率为7.74% (95% CI: 6.46-8.47)。在亚组分析中,患病率最高的是刚果民主共和国(19.72%),其次是赞比亚(11.68%)和埃塞俄比亚(9.22%)。结核病/艾滋病合并感染(OR 4.99 (95% CI: 2.60-9.58))、体重指数(BMI < 18.5) (OR 3.62 (95% CI: 2.65-6.49))、监禁(OR 4.52 (95% CI: 2.31-5.68))和既往结核病暴露(OR 2.43 (95% CI: 1.61-3.56))在囚犯中患肺结核的几率较高。结论:与总人口相比,SSA监狱在押人员肺结核患病率较高。结核病/艾滋病合并感染、体重指数、监禁时间和结核病暴露都是监狱囚犯肺结核的预测因素。因此,强调对有肺结核风险的囚犯进行早期筛查是在资源有限的环境中实现全球结核病承诺的一个重要方面。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Prevalence and Predictors of Pulmonary Tuberculosis among Prison Inmates in Sub-Saharan Africa: A Systematic Review and Meta-Analysis.

Prevalence and Predictors of Pulmonary Tuberculosis among Prison Inmates in Sub-Saharan Africa: A Systematic Review and Meta-Analysis.

Prevalence and Predictors of Pulmonary Tuberculosis among Prison Inmates in Sub-Saharan Africa: A Systematic Review and Meta-Analysis.

Prevalence and Predictors of Pulmonary Tuberculosis among Prison Inmates in Sub-Saharan Africa: A Systematic Review and Meta-Analysis.

Introduction: Prisoners in Sub-Saharan Africa (SSA) are at a high risk of tuberculosis (TB) infection due to overcrowding and poor ventilation. Consequently, TB is a leading cause of morbidity and mortality in prison, and many inmates face a number of barriers to TB control and had limited information in the region. Thus, the aim of this systematic review and meta-analysis was to estimate the overall pooled prevalence of pulmonary TB and predictors among prison inmates in SSA.

Methods: From 2006 to 2019, a systematic review and meta-analysis was conducted using various databases, including PubMed, Embase, Web of Science, and Scopus. The data were extracted in Microsoft Excel using a standardized data extraction format, and the analysis was carried out with STATA version 14. To detect heterogeneity across studies, the I2 and the Cochrane Q test statistics were computed. To determine the overall prevalence of TB and predictors among prison populations, a random effect meta-analysis model was used.

Results: Of the 3,479 retrieved articles, 37studies comprising 72,844 inmates met the inclusion criteria. The pooled prevalence of pulmonary TB among prison inmates in SSA was 7.74% (95% CI: 6.46-8.47). In the subgroup analysis, the highest prevalence was found in the Democratic Republic Congo (DRC) (19.72%) followed by Zambia (11.68%) and then Ethiopia (9.22%). TB/HIV coinfection (OR 4.99 (95% CI: 2.60-9.58)), Body mass index (BMI < 18.5) (OR 3.62 (95% CI: 2.65-6.49)), incarceration (OR 4.52 (95% CI: 2.31-5.68)), and previous TB exposure (OR 2.43 (95% CI: 1.61-3.56)) had higher odds of pulmonary TB among inmates.

Conclusion: The prevalence of pulmonary TB among SSA prison inmates was found to be high as compared to total population. TB/HIV coinfection, BMI, incarceration duration, and TB exposure were all predictors with pulmonary tuberculosis in prison inmates. As a result, emphasizing early screening for prisoners at risk of pulmonary TB is an important point to achieving global TB commitments in resource-limited settings.

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