PREVALENCE OF PULMONARY TUBERCULOSIS AND HUMAN IMMUNO- DEFICIENCY VIRUS AMONG INMATES IN NSAWAM MEDIUM SECURITY PRISON IN GHANA

ABSTRACT 

Introduction: Tuberculosis and Human Immuno- deficiency Virus (HIV) infections represent two of the greatest threats in African prison. They are both endemic diseases in Sub-Saharan Africa. They have been associated with poor sanitation, overcrowding, poor ventilation, sharing of sharps and other body fluids. Tuberculosis is caused by bacteria whilst HIV is caused by a virus. 

Objective: The objective of this study is to determine the prevalence of pulmonary tuberculosis (PTB) and human immuno-deficiency virus (HIV) infection among prisoners. 

Methodology: A cross sectional study design was used to assess the prevalence of PTB and HIV infection among prisoners in Nsawam Medium Security Prison. GeneXpert MTB/RIF was used for sputum analysis for PTB and first response HIV test kit was used for those who consented to VCCT for HIV. Relationship between socio-demographic variables and a positive screening test for the TB and HIV was assessed using bivariate and multivariate logistic regression models. 

Results: There were 5 (3.4%) positive TB cases out of a total of 149 (76.4%) presumptive PTB prisoners who were able to produce sputum for GeneXpert analysis. The overall PTB prevalence was 3101 per 100,000 prison population. Eleven (5.8%) out of 189 inmates were HIV positive among which 2(18.2%) had TB co-infection. The prevalence of HIV infection among TB infected inmates was 40% (2/5) and that of presumptive TB cases was 1.3% (2/149). Sex and HIV were risk factors significantly associated with HIV and TB respectively. 

Conclusion: Prevalence of TB and HIV are high in Nsawam Medium Security Prison with possible active transmission of both disease within the prison. There was also high prevalence of HIV among presumptive TB cases and therefore strong cooperation between prison authorities and the NTP and NACP is strongly recommended to develop appropriate interventions to reduce transmission of these diseases.