Tuberculosis in prison inmates in India: a systematic review and meta-analysis

Abstract Introduction People who are incarcerated face a higher risk of developing tuberculosis (TB) and are disproportionately affected by other high-risk infections, such as HIV, hepatitis B and C, and sexually transmitted diseases. Objective The main objectives of this systematic review were to estimate the pooled prevalence of TB and presumptive-TB and assess the signs and symptoms of TB among prison inmates in India. Methods A total of six articles were selected, and the pooled prevalence of presumptive-TB and TB was estimated at a 95% confidence interval using a random effects model, assuming potential heterogeneity. Results Of the total studies, one was a pan-India study, while five were conducted in individual states and Union territories. The total sample across the six studies was 23,145 (mean (SD) = 3858 (6102), median = 1760, IQR = 970–2340). Cough (100%, n = 6) among the study participants has been reported as the most common symptom across all studies, followed by haemoptysis (83.33%, n = 5) in five studies. The pooled prevalence of TB and presumptive-TB among prison inmates was estimated at 0.01 (95% CI, 0.00–0.01) and 0.18 (95% CI, 0.08–0.31), respectively. There was considerable heterogeneity among the studies that reported the prevalence of TB ( I 2 = 76.53%) and the prevalence of presumptive TB cases ( I 2 = 99.67%) according to the random-effects model. Conclusion Prisoners need specific interventions to address the TB burden due to their typical lifestyle and its repercussions on the community. Routine TB surveillance in prisons, targeted screening, and integration with national TB programmes are key to addressing the TB burden among the prison inmates in India.