Abstract
The study was undertaken to determine transmission of Mycobacterium tuberculosis within the prison environment. In total, 168 Aba Federal prison inmates in Nigeria were evaluated for tuberculosis (TB) by sputum-smear microscopy and sputum culture, simultaneously, and for HIV status by serology. They were subsequently followed up for one year for fresh Mycobacterium-associated infection by tuberculin skin testing or for development of TB and for HIV infection or AIDS. Ninety-one (54.2%) of the 168 prison inmates had infection due to Mycobacterium, and three (3.3%) of them were sputum-smear- and culture-positive while 41 (24.4%), including one (2.4%) with concomitant TB, were HIV-infected. In a one-year follow-up study, 11 (19.3%) of 57 tuberculin skin test (TST)- and HIV-negative inmates became TST-positive and one (1.8%) HIV-positive, eight (13.8%) of the 58 TST-positive but HIV-negative inmates developed TB, and one (1.7%) became HIV-infected: six (24.0%) of 25 TST- and HIV-positive inmates developed TB while five (33.3%) of 15 TST-negative but HIV-positive inmates became TST-positive, and one (6.7%) progressed to AIDS. The duration of imprisonment did not influence the rates of infection, and the transmission of Mycobacterium tuberculosis did not necessarily require sharing a cell with a TB case.
Highlights
INTRODUCTIONHIV infection has become an additional factor that has threatened TB programmes worldwide, and for the last two decades, the HIV
Tuberculosis (TB), one of the most important contagious diseases, is a leading cause of death due to a single pathogen worldwide
A primary infection due to Mycobacterium tuberculosis may actively develop into clinical TB, pass as inapparent infection, or remain latent in the individual for months or years depending on the various host and environmental factors
Summary
HIV infection has become an additional factor that has threatened TB programmes worldwide, and for the last two decades, the HIV. In sub-Saharan Africa where ≈70% of HIV-infected individuals of the world live, the annual rate of identification of TB cases has quadrupled since the mid-1980s [17], and over two-thirds of TB patients in the region are dually infected with HIV [18]. It is estimated that about 200,000 deaths due to TB occur among the people of sub-Saharan Africa concomitantly infected with HIV [19]. The factors influencing infection and progression to TB and even AIDS tend to prevail in crowded institutions, such as military camps, prisons, and police detention camps. The Nigerian prisons seem most favourable for the dissemination of M. tuberculosis and progression to TB and transmission of HIV and progression to AIDS given the overcrowding in cells, poor feeding, and allegations of homosexual practices and sexual abuse among the incarcerated. It was on account of these that the investigation reported here was carried out among the inmates of the Federal prisons in Aba, Nigeria
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