High prevalence of self-reported tuberculosis and associated factors in a nation-wide census among prison inmates in Peru.

Abstract

To estimate the prevalence of self-reported tuberculosis TB diagnosed at Peruvian correctional facilities (CFs), and their associated factors. Cross-sectional study based on secondary analysis of the National Census held in all Peruvian CFs in 2016. Outcome was defined as self-reported TB diagnosed by a healthcare professional intra-penitentiary. A descriptive bivariate analysis was carried out, followed by multivariate analysis using Poisson regression in order to calculate the adjusted prevalence ratios (PRa). Additionally, a mixed effects multilevel model adjusted by CFs as clusters was performed. Of 77086 prison inmates in 66 CFs participated in the original census, of which 69890 were included. Of these, 1754 self-reported TB diagnosed intra-penitentiary, yielding a prevalence of 2510/100000 PDL. In the final model, self-reported TB was associated with younger age, male gender, lower educational level, not having a stable partner, having prison readmissions and having relatives in prison. There was also strong association with HIV/AIDS (PRa 2.77; 1.84-4.18), STIs (PRa 2.13; 1.46-3.10), DM (PRa 1.99; 1.59-2.50) and recreational drugs use (PRa 1.41; 1.23-1.61). The mixed model showed significant variance for belonging to different CFs (2.13; 1.02-4.44) and CF overcrowding (3.25; 1.37-7.71). Self-reported TB prevalence found was higher than reported by other lower/lower-middle income countries. Demographic factors, individual clinical features and overcrowding increases the likelihood of self-reported TB.