Intensified pulmonary tuberculosis case finding among HIV-infected new entrants of a prison in Malaysia: implications for a holistic approach to control tuberculosis in prisons
International Journal of Prisoner Health
ISSN: 1744-9200
Article publication date: 11 January 2023
Issue publication date: 28 November 2023
Abstract
Purpose
This intensified case finding study aimed to evaluate the prevalence of tuberculosis (TB) disease among people with HIV entering the largest prison in Malaysia.
Design/methodology/approach
The study was conducted in Kajang prison, starting in July 2013 in the men’s prison and June 2015 in the women’s prison. Individuals tested positive for HIV infection, during the mandatory HIV testing at the prison entry, were consecutively recruited over five months at each prison. Consented participants were interviewed using a structured questionnaire and asked to submit two sputum samples that were assessed using GeneXpert MTB/RIF (Xpert) and culture, irrespective of clinical presentation. Factors associated with active TB (defined as a positive result on either Xpert or culture) were assessed using regression analyses.
Findings
Overall, 214 incarcerated people with HIV were recruited. Most were men (84.6%), Malaysians (84.1%) and people who inject drugs (67.8%). The mean age was 37.5 (SD 8.2) years, and median CD4 lymphocyte count was 376 cells/mL (IQR 232–526). Overall, 27 (12.6%) TB cases were identified, which was independently associated with scores of five or more on the World Health Organization clinical scoring system for prisons (ARR 2.90 [95% CI 1.48–5.68]).
Originality/value
Limited data exists about the prevalence of TB disease at prison entry, globally and none from Malaysia. The reported high prevalence of TB disease in the study adds an important and highly needed information to design comprehensive TB control programmes in prisons.
Keywords
Acknowledgements
The authors are thankful to the Prison Department in Malaysia for allowing them to conduct the study in their facility. The authors would like to extend their thankfulness to the individuals who agreed to participate in the study.
Funding: Funding for this research was provided by the University of Malaya High Impact Research Grant (HIRGA E000001-20001 for H.A. and A.K.) and from the National Institutes on Drug Abuse for Research (R01 DA025943 for F.L.A.) and career development (K24 DA017072 for F.L.A.). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist.
Citation
Al-Darraji, H., Hill, P., Sharples, K., Altice, F.L. and Kamarulzaman, A. (2023), "Intensified pulmonary tuberculosis case finding among HIV-infected new entrants of a prison in Malaysia: implications for a holistic approach to control tuberculosis in prisons", International Journal of Prisoner Health, Vol. 19 No. 4, pp. 501-511. https://doi.org/10.1108/IJPH-01-2022-0001
Publisher
:Emerald Publishing Limited
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