title: Pulmonary tuberculosis and drug resistance in Dhaka central jail, the largest prison in Bangladesh.
abstract: BACKGROUND
  There are limited data on TB among prison inmates in Bangladesh. The aim of the study was to determine the prevalence of pulmonary tuberculosis (TB), its drug resistance and risk factors in Dhaka Central Jail, the largest prison in Bangladesh.
  
  
  METHODS
  Cross sectional survey with, active screening of a total number of 11,001 inmates over a period of 2 years. Sputum samples from TB suspects were taken for acid- fast bacilli (AFB) microscopy, culture and drug susceptibility testing.
  
  
  RESULTS
  Among 1,781 TB suspects 245 (13.8%) were positive for AFB on microscopy and/or culture. The prevalence rate of sputum- positive pulmonary TB was 2,227/100,000. Fifty three cases (21.6% of 245 cases) were AFB- negative on microscopy but were found positive on culture. Resistance to isoniazid, rifampicin, streptomycin and ethambutol was 11.4%, 0.8%, 22.4% and 6.5% respectively. No multidrug resistance was observed. The main risk factors of TB in prison were exposure to TB patients (adjusted odds ratio 3.16, 95% CI 2.36-4.21), previous imprisonment (1.86, 1.38-2.50), longer duration of stay in prison (17.5 months for TB cases; 1.004, 1.001-1.006) and low body mass index which is less than 18.5 kg/m(2) (5.37, 4.02-7.16).
  
  
  CONCLUSIONS
  The study results revealed a very high prevalence of TB in the prison population in Dhaka Central Jail. Entry examinations and active symptom screening among inmates are important to control TB transmission inside the prison. Identifying undiagnosed smear-negative TB cases remains a challenge to combat this deadly disease in this difficult setting.
authors.affiliation: International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh. sbanu@icddrb.org
authors.forename: Sayera
authors.initials: S
authors.lastname: Banu
authors.forename: Arman
authors.initials: A
authors.lastname: Hossain
authors.forename: Mohammad Khaja Mafij
authors.initials: MK
authors.lastname: Uddin
authors.forename: Muhammad Reaj
authors.initials: MR
authors.lastname: Uddin
authors.forename: Tahmeed
authors.initials: T
authors.lastname: Ahmed
authors.forename: Razia
authors.initials: R
authors.lastname: Khatun
authors.forename: Asif Mujtaba
authors.initials: AM
authors.lastname: Mahmud
authors.forename: Khurshid Alam
authors.initials: KA
authors.lastname: Hyder
authors.forename: Afzalunnessa Binte
authors.initials: AB
authors.lastname: Lutfor
authors.forename: Md Sirajul
authors.initials: MS
authors.lastname: Karim
authors.forename: Khalequ
authors.initials: K
authors.lastname: Zaman
authors.forename: Md Ashraful Islam
authors.initials: MA
authors.lastname: Khan
authors.forename: Pravat Chandra
authors.initials: PC
authors.lastname: Barua
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Luby
mesh_terms: D000293:Adolescent; D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D003710:Demography; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D016017:Odds Ratio; D011330:Prisons; D012307:Risk Factors; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology* / Q000382:microbiology