Risk Factors for Pulmonary Tuberculosis Transmission Among Prisoner in Correctional Facilities in Lhokseumawe City, Aceh, Indonesia

Cut Khairunnisa; Mardiati; Anna Millizia; Sri Wahyuni; Putri Nabilah Lubis; Muhammad Ikhsan

doi:10.55489/njcm.160620254948

Authors

Cut Khairunnisa Department of Public Health, Faculty of Medicine, Universitas Malikussaleh, Aceh, Indonesia
Mardiati Department of Pediatric, Faculty of Medicine, Universitas Malikussaleh, Aceh, Indonesia
Anna Millizia Department of Anesthesiology, Faculty of Medicine, Universitas Malikussaleh, Aceh, Indonesia
Sri Wahyuni Department of Biochemistry, Faculty of Medicine, Universitas Malikussaleh, Aceh, Indonesia
Putri Nabilah Lubis Faculty of Medicine, Universitas Malikussaleh, Aceh, Indonesia
Muhammad Ikhsan Faculty of Medicine, Universitas Malikussaleh, Aceh, Indonesia

DOI:

https://doi.org/10.55489/njcm.160620254948

Keywords:

Tuberculosis, Prevalence, Risk Factors, Prisoners

Abstract

Background: TB remains a significant public health issue in prisons, facilitating its transmission and affecting both inmates and the wider community. This study aimed to develop a predictive model for TB prevalence and risk factors in prisoners, specifically in class 2A correctional institutions in Lhokseumawe City, Aceh Province, Indonesia.

Methodology: This case-control study included 100 prisoners who were selected through random sampling. Data were gathered through questionnaires and prison medical records. Bivariate analysis and multivariable logistic regression were performed, and p-values ≤ 0.05 set statistically significant.

Results: Medical records revealed 12 inmates with TB. Bivariate analysis identified marital status (odds ratio [OR], 1.2; 95% CI [1.08–1.34]; p=0.017), nutritional status (OR, 3.63; 95% CI [1.05–12.55]; p=0.033), comorbidities (OR, 4.47; 95% CI [1.28-15.56]; p=0.013), and contact with active TB patients (OR, 9.8; 95% CI [5.45-17.63]; p=0.013) as risk factors. Multivariate analysis showed that comorbidities (OR, 5.52; 95% CI [5.45-17.63]; p=0.025) and nutritional status (OR, 4.46; 95% CI [5.45-17.63]; p=0.012) were the most significant risk factors.

Conclusions: Marital status, nutritional status, comorbidities, and contact with patients with active TB were significantly associated with TB incidence of TB among prisoners. Nutritional status and comorbidities were the most significant risk factors.

References

World Health Organization. Global Tuberculosis Report 2023. World Health Organization; 2023. Available from: https://iris.who.int/handle/10665/373828

Rahmayanti D, Salomo R V. Faktor- Faktor yang memengaruhi Implementasi Kebijakan Pengendalian Tuberculosis di Lembaga Pemasyarakatan Kelas I Cipinang. PubBis : Jurnal Pemikiran dan Penelitian Administrasi Publik dan Administrasi Bisnis. 2020;4(2):126-135. DOI: https://doi.org/10.35722/PUBBIS.V4I2.275

Kemenkes RI. Program Penanggulangan Tuberkulosis Tahun 2022. Available from: https://www.tbindonesia.or.id/wp-content/uploads/2023/09/Laporan-Tahunan-Program-TBC-2022.pdf

USAID. Tuberculosis in Prisons: A Growing Public Health Challenge.; 2023. Available from: https://findtbresources.cdc.gov/view?id=342562 Accessed 27 May 2025

Setiadi A. Evaluasi Program Penanggulangan Teberkulosis Dan Determinan Kejadian Tuberkulosis Di Rumah Tahanan Negara/ Lembaga Pemasyarakatan Se Eks Karesidenan Sura-karta [dissertation on the Internet]. Universitas Sebelas Maret; 2016. [cited 2025 April 30]. Available from: https://digilib.uns.ac.id/dokumen/download/56397/MjUyODM0/Evaluasi-Program-Penanggulangan-Tuberkulosis-dan-Determinan-Kejadian-Tuberkulosis-di-Rumah-Tahanan-Negara-Lembaga-Pemasyarakatan-Se-Eks-Karesidenan-Surakarta-abstrak.pdf

Placeres AF, de Almeida Soares D, Delpino FM, et al. Epidemiology of TB in prisoners: a metanalysis of the prevalence of active and latent TB. BMC Infect Dis. 2023;23(1):1-19. DOI: https://doi.org/10.1186/s12879-022-07961-8 PMid:36631770 PMCid:PMC9835258

Cords O, Martinez L, Warren JL, et al. Incidence and prevalence of tuberculosis in incarcerated populations: a systematic review and meta-analysis. Lancet Public Health. 2021;6(5):e300-e308. DOI: https://doi.org/10.1016/S2468-2667(21)00025-6 PMid:33765455

Salazar‐De La Cuba AL, Ardiles‐Paredes DF, Araujo‐Castillo R V, Maguiña JL. High prevalence of self‐reported tuberculosis and associated factors in a nation‐wide census among prison inmates in Peru. Tropical Medicine & International Health. 2019;24(3):328-338. DOI: https://doi.org/10.1111/tmi.13199 PMid:30589977

Manda C, Chisompola NK. Investigating the prevalence of tuberculosis and associated risk factors among prisoners at Peter Singogo Prison in Ndola: a retrospective cross-sectional study. medRxiv. 2024. DOI: https://doi.org/10.1101/2024.05.01.24305425

Callou Filho CR, Mesquita CAM, Vieira EEA, et al. Clinical and environmental factors associated with pulmonary tuberculosis in prisoners in Northeastern Brazil. European Journal of Natural Sciences and Medicine. 2018;6(2):90-102. DOI: https://doi.org/10.26417/mf4ssz23

Adane K, Spigt M, Winkens B, Dinant GJ. Tuberculosis case detection by trained inmate peer educators in a resource-limited prison setting in Ethiopia: a cluster-randomised trial. Lancet Glob Health. 2019;7(4):e482-e491. DOI: https://doi.org/10.1016/S2214-109X(18)30477-7 PMid:30824364

Bhatnagar T, Ralte M, Ralte L, Chawnglungmuana, Sundaramoorthy L, Chhakchhuak L. Intensified tuberculosis and HIV surveillance in a prison in Northeast India: Implementation research. PLoS One. 2019;14(7):e0219988. DOI: https://doi.org/10.1371/journal.pone.0219988 PMid:31356606 PMCid:PMC6662996

Walter KS, Dos Santos PCP, Gonçalves TO, et al. The role of prisons in disseminating tuberculosis in Brazil: a genomic epidemiology study. Lancet Reg Health Am. 2022 May;9:100186. DOI: https://doi.org/10.1016/j.lana.2022.100186 PMid:35647574 PMCid:PMC9140320

UNODC. Unsentenced with Prisons Overcrowded in Half of All Countries- 2021. Available from: https://www.unodc.org/documents/data-and-analysis/statistics/DataMatters1_prison.pdf

World Health Organization (WHO). Global tuberculosis report 2023. Geneva, Switzerland: WHO; 2023.

Nations U. United Nations System Common Position on Incarceration 2021. Available from: https://www.unodc.org/res/justice-and-prison-reform/nelsonmandelarules-GoF/UN_System_Common_Position_on_Incarceration.pdf

Busatto C, Bierhals DV, Vianna JS, da Silva PEA, Possuelo LG, Ramis IB. Epidemiology and control strategies for tuberculosis in countries with the largest prison populations. Rev Soc Bras Med Trop. 2022;55. DOI: https://doi.org/10.1590/0037-8682-0060-2022 PMid:36417620 PMCid:PMC9757719

Bilmumad B, Liabsuetrakul T, Ngamtrairai N, Chongsuvivatwong V. Pulmonary tuberculosis among prisoners in Southern Thailand: prevalence and its association with imprisonment status. Int J Prison Health. 2022;18(3):233-244. DOI: https://doi.org/10.1108/IJPH-01-2021-0012 PMid:34464526 PMCid:PMC9719586

Morasert T, Worapas W, Kaewmahit R, Uphala W. Prevalence and risk factors associated with tuberculosis disease in Suratthani Central Prison, Thailand. The International Journal of Tuberculosis and Lung Disease. 2018;22(10):1203-1209. DOI: https://doi.org/10.5588/ijtld.17.0654 PMid:30236189

Kalonji GMP, Connick G De, Ngongo LO, et al. Prevalence of tuberculosis and associated risk factors in the central prison of Mbuji-Mayi, DEmocratic republic of Congo. Trop Med Health 44, 2016: 30. DOI: https://doi.org/10.1186/s41182-016-0030-9 PMCid:PMC5028938

Mansoori N, Pahlavanzadeh B, Atarjalali M. Risk factors associated with multidrug-resistant tuberculosis in areas with a moderate tuberculosis burden. Int Health. Published online 2024:1-9. DOI: https://doi.org/10.1093/inthealth/ihae039 PMid:38873833 PMCid:PMC11879555

Wijayanto T, Solikhah S, Sulistyawati S. Relationship Nutritional Status and Pulmonary Tuberculosis: Literature Review. Disease Prevention and Public Health Journal. 2024;18(1):11-16. DOI: https://doi.org/10.12928/dpphj.v18i1.9430

Ockenga J, Fuhse K, Chatterjee S, et al. Tuberculosis and Malnutrition: The European Perspective. Clinical Nutrition. 2023;42(4):486-492. DOI: https://doi.org/10.1016/j.clnu.2023.01.016

Busatto C, Mespaque J, Schwarzbold P, et al. Tuberculosis in prison inmates in Southern Brazil: investigating the epidemiological and operational indicators. Rev Soc Bras Med Trop. 2022;55:e0052-2022. DOI: https://doi.org/10.1590/0037-8682-0052-2022 PMCid:PMC9592108

Wondimu M, Siyoum A, Ketema I, et al. Undernutrition and Associated Factors Among Adult Prisoners in Fiche Town, Central Ethiopia: a Facility-Based Cross-Sectional Study. Front Nutr. 2023;10(July):1-9. DOI: https://doi.org/10.3389/fnut.2023.1144654 PMCid:PMC10353482

Mera HB, Wagnew F, Akelew Y, et al. Prevalence and predictors of pulmonary tuberculosis among prison inmates in Sub‐Saharan Africa: a systematic review and meta‐analysis. Tuberc Res Treat. 2023;2023(1):6226200. DOI: https://doi.org/10.1155/2023/6226200 PMid:37260437 PMCid:PMC10228229

Walter KS, Martinez L, Arakaki-Sanchez D, et al. The Escalating Tuberculosis Crisis in Central and South American Prisons. The Lancet. 2021;397(10284):1591-1596. DOI: https://doi.org/10.1016/S0140-6736(20)32578-2 PMid:33838724

Walter KS, Pereira dos Santos PC, Gonçalves TO, et al. The Role of Prisons in Disseminating Tuberculosis in Brazil: A Genomic Epidemiology Study. The Lancet Regional Health - Americas. 2022;9:1-11. DOI: https://doi.org/10.1016/j.lana.2022.100186 PMid:35647574 PMCid:PMC9140320

Nunemo MH, Gidebo KD, Woticha EW, Lemu YK. Predictors of Tuberculosis and Non-Communicable Disease Comorbidities Among Newly Enrolled Tuberculosis Patients, Southern Ethiopia. Integr Blood Press Control. 2023;16(November):95-109. DOI: https://doi.org/10.2147/IBPC.S432251 PMid:38023691

Amede PO, Adedire E, Usman A, et al. Treatment outcomes of drug-susceptible tuberculosis and its predictors among male prison inmates in Bauchi State, Nigeria, 2014-2018. Published online 2020. DOI: https://doi.org/10.21203/rs.2.17443/v2

Fachrizal I, Djafri D, Syafrawati S. Determinan Kesehatan dan Faktor Risiko Komorbiditas Terhadap Penderita Tuberkulosis (TB) COVID-19. Jik Jurnal Ilmu Kesehatan. 2023;7(2):440. DOI: https://doi.org/10.33757/jik.v7i2.954

Yanti B, Firdausa S, Dhiyauddin A, et al. Type 2 Diabetes Mellitus as an Independent Risk Factor of Pulmonary Tuberculosis: A Hospital Based Cross-Sectional Study. Indonesian Journal of Medicine and Health. 2024;15(2):212-220. DOI: https://doi.org/10.20885/JKKI.Vol15.Iss2.art9

Seegert AB, Patsche CB, Sifna A, et al. Hypertension is Associated with Increased Mortality in Patients with Tuberculosis in Guinea-Bissau. International Journal of Infectious Diseases. 2021;109:123-128. DOI: https://doi.org/10.1016/j.ijid.2021.06.062