The prevalence of tuberculosis among the inmates of Dhaka Central Jail is about 20-fold higher than among the general population in Bangladesh, according to icddr,b.
The icddr,b investigation team in 2005 started active screening for pulmonary TB among incarcerated persons at Dhaka Central Jail, the largest correctional facility in Bangladesh, to determine the TB prevalence in order to pinpoint associated risk factors.
The result of first four-year study has been published recently in a periodical of icddr,b, the international health institution based in Dhaka.
Tuberculosis and Leprosy Research Group under the Centre for Communicable Diseases of icddr,b, conducted the study aimed at controlling and preventing TB transmission in the Dhaka Central Jail that included active screening for pulmonary TB upon entry and during incarceration in jail, use of microscopy to detect acid fast bacilli and culture to detect Mycobacterium tuberculosis, immediate isolation of persons with confirmed TB, and early initiation of treatment.
The study revealed that Dhaka Central Jail accommodates about 11,000 inmates at any time although its official capacity is only 2,600 inmates.
From October 2005 to September 2007, approximately 11,000 prisoners in the Dhaka Central Jail were actively screened for TB by the study team and the TB prevalence was found to be 2,227 per 100,000 population, which was more than 20 times higher than among the general population.
The study said the incarcerated persons often come from socioeconomic groups in which TB prevalence is high and they frequently engage in behaviours, such as alcohol and drug use, that may increase their risk for infection.
Many inmates have acquired TB before incarceration and many of the correctional facilities in the world are extremely overcrowded. Confining a high-risk population in an overcrowded setting with poor hygiene and inadequate ventilation creates an ideal environment for transmission of TB.
In January 2009, the icddr,b team in its second phase study established ongoing active screening for pulmonary TB at Dhaka Central Jail and a system to isolate and treat those inmates found to have pulmonary TB. The objective of this study was to describe findings from the first four years of the screening and intervention programme.
During the study period (January 2009 to December 2012), the icddr,b team screened 140,055 inmates and a total of 2,462 suspected TB cases were identified, of whom 298 (12 per cent) were found to have pulmonary TB.
The proportion of confirmed pulmonary TB cases among those screened was almost seven times higher among the male than female inmates.
Tuberculosis continues to be a major public health concern in low and middle income countries. Even with the encouraging progress made in controlling the spread of TB during the past two decades, the global burden of TB is still very high.
In 2011, there were an estimated 8.7 million incident cases and 1.4 million deaths from TB. Almost 60 per cent of the world’s TB cases are in the Southeast Asia and Western Pacific regions. Bangladesh is currently ranked 6th among 22 countries with a high burden of TB.
It has been estimated that approximately 10 million persons are incarcerated worldwide on any given day. Many are from marginalised and disadvantaged segments of society where the risk of TB infection is high. The presence of people at high risk for TB coupled with overcrowded conditions in jails and prisons facilitates acquisition and transmission of TB.
-With UNB/New Age input
