PREVALENCE AND ASSOCIATED RISK FACTORS OF PLUMONARY TUBERCULOSIS AMONG PRISONERS IN SHIRE, AXUM AND ADWA PRISON CENTRS

Abstract

Background: Pulmonary Tuberculosis is a contagious airborne disease caused by Mycobacterium tuberculosis and remains a significant global public health problem. Prisons, due to overcrowding, poor ventilation, and limited healthcare services, present a high-risk environment for TB transmission and progression. In the Tigray region of Ethiopia, challenges such as inadequate diagnostic capacity and insufficient data hinder effective TB control among incarcerated populations. Objective: This study was aimed to determine the prevalence of pulmonary tuberculosis and identify its associated risk factors among prisoners in Shire, Axum, and Adwa correctional facilities in Tigray, Ethiopia, over the period from December, 2024 to May, 2025. Methodology: An institutional-based cross-sectional design was employed to enroll 265 prisoners presenting with TB symptoms. Structured questionnaires were collected socio-demographic and clinical information, including HIV status, history of smoking, and incarceration-related exposures. Sputum samples were collected and analyzed using Ziehl-Neelsen staining and the Gen-expert MTB/RIF assay. Results: A total of 265 prisoners were enrolled in this study, drawn from a total incarcerated population of 3,180 inmates across the three prison centers in Shire, Axum, and Adwa, located in northern Ethiopia. The study identified 5 bacteriologically confirmed TB cases, yielding a point prevalence of 1.9% (95% CI: 0.6%–4.3%) among the study participants. Occupation prior to imprisonment was significantly related to TB status: prisoners who had been governmentemployed or self-employed had significantly lower odds of TB infection compared to those who had been daily laborers or unemployed (exact AOR = 0.119, 95% CI: 0.000–0.946, p = 0.0432). Prisoners who were HIV-negative or whose HIV status was unknown had significantly lower odds of TB compared to HIV-positive individuals (exact AOR = 0.033, 95% CI: 0.001–0.722, p = 0.0281). Conclusions and Recommendations: The prevalence of PTB was high in these prison centers. There should be an intensified implementation of TB screening among high-risk inmates, particularly those with a history of unemployment, HIV infection, smoking, or TB symptoms.