Prevalence and factors associated with mycobacterium tuberculosis infection among adult male prisoners in NWFP Pakistan

Date of Award


Document Type


Degree Name

Master of Science in Epidemiology & Biostatistics (MSc Epidemiology & Biostats)


Community Health Sciences


Tuberculosis (TB) is a chronic and infectious disease caused by Mycobacterium tuberculosis. When a person inhales air-containing particles expelled by an infectious Person, Mycobacterium tuberculosis multiplies in the alveolar macrophages. Approximately in 57o of the persons with newly acquired Mycobacterium tuberculosis infection, the disease develops within first two years. In another 5Vo the disease develops later in life when their immune system is weakened. The remaining 90Vo stay infected with Mycobacterium tuberculosis but free from the disease for the rest of their lives. In different prison settings the prevalence of infection was New York (20%), Arkansas (26%), California (30%), Lebanon (45%), and Barcelona (56%). This study assesses the prevalence of Mycobacterium tuberculosis infection in the prisoners in NWFP and evaluates factors associated with Mycobacterium tuberculosis infection in the prisons. A cross sectional study design was used to estimate the prevalence and factors associated of Mycobacterium tuberculosis in adult prisoners in NWFP. This study was conducted in the five central prisons of NWFP: Peshawar (2581), Dera Ismail Khan (1390), Haripur (1297), Kohat (839), and Mardan (500) prisoners. Due to administrative problems, prisoners who were imprisoned for less then three months from the date of interview, who were in death cells, or in solitary custody were excluded. There were 6607 prisoners of whom 425 prisoners were interviewed and tuberculin skin test was performed- The prevalence of Mycobacterium tuberculosis infection among prisoners was 48vo (204/425).In the final multivariable model the independent effects of: age- education, current smoking status, duration of incarceration and overcrowding in the prisons were found to be associated with Mycobacterium tuberculosis infection. The high prevalence of Mycobacterium tuberculosis infection in the present study indicates that immediate steps should be taken to identify and confirm the clinical status among prisoners. Preventive efforts against transmission of infection should be focused m the control of overcrowding and smoking of the prisoners. Prisoners should be educated about the harmful effects of smoking. New prisons should be constructed. Primary level intervention and monitoring of high-risk group like smokers should be a priority of the health staff working in the prisons.

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