Magnitude, associated risk factors, and trend comparisons of identified tuberculosis types among prisons in Ethiopia: A systematic review and meta-analysis

Abstract

Background and Aims: Tuberculosis (TB) remained a major public health threat, particularly in developing countries with vulnerable groups, particularly prison inmates. A systematic review and meta-analysis of individual studies with varying prevalence rates were performed to identify risk factors associated with the recent magnitude of TB among prisoners. Methods: A systematic search of research articles on the magnitude and risk factors of TB among prisoners in Ethiopia was conducted in registers, databases, and other sources. Cochran's Q, inverse variance (I2), sensitivity analysis, funnel plot, Begg's, and Egger's regression tests were used to check heterogeneity and publication bias. A random-effects model was used to calculate the pooled burden of TB among prisoners. Results: The total national prevalence of TB among prisoners was 9.84% (95% confidence interval [CI]: 7.16–12.52). According to the subgroup analysis, the highest prevalence was observed in patients infected by latent TB (51.20%), the Southern nations, nationalities and people's region (SNNPR) (29.63%), studies conducted in ≤200 (17.50%) sample sizes, and from 2017 to 2022 (11.49%) study periods. TB infection among prisoners was significantly associated with a history of contact with TB patients (adjusted odds ratio [AOR] = 2.75; 95% CI: 0.98–4.52), coughing for ≥2 weeks (AOR = 0.08; 95% CI: −0.16–0.33), being incarcerated in overcrowded cells with poor ventilation (AOR = 0.39; 95% CI: −0.01–0.78), and increasing with the duration of imprisonment (AOR = 1.29; 95% CI: −0.39–2.97]. Conclusion: Expectably high TB magnitude is found among prison inmates in Ethiopia. Duration of incarceration, coughing, ventilation of the cell, and contact with TB patients were all predictors of TB among prisoners. The management of TB requires early diagnosis, adequate medication, and the implementation of preventative and control measures suitable for prison inmates.