Active case finding of pulmonary tuberculosis and HIV infection among prisoners of South Gujarat: A cross sectional study

Abstract

Background: In a close knit congregation such as prison, Tuberculosis (TB) and HIV can be major health problems. However, their prevalence in Indian prisons is under reported. This study aimed at adopting a camp based, active case finding approach to identify cases of TB, HIV and at risk prisoners in a central prison of South Gujarat.

Methods: A multidisciplinary team of public health experts, pulmonologists, social workers and lab technicians conducted a week-long camp to screen 1665 prisoners for TB using clinical examination, sputum smear for AFB, CBNAAT and Chest X-Ray and for HIV through Rapid Antigen Testing.

Results: Majority of participants (1392, 84%) were under trail prisoners, having spent an average of 1.4 years in prison. About 2.9% of participants had previous history of TB, of whom only 59% had completed treatment. About 14% of participants were underweight. Weight reduction was found to be significant in first five years of imprisonment. Of all participants, 3.6% were found to have diabetic range of blood sugar. Seven new active, drug sensitive pulmonary TB cases and three new cases of HIV infection were identified. All new cases of TB, HIV and increased blood sugar levels were linked to treatment.

Conclusion: Camp based approach is effective in active case finding of pulmonary TB and predisposing factors such as malnourishment, Diabetes and HIV among prisoners. Routine screening of all prisoners at the time of entry and monthly thereafter in a camp based approach should be adopted to identify TB and at risk prisoners.

Keywords: Active case finding; CBNAAT; Drug sensitive tuberculosis; Malnutrition.