High prevalence of self-reported tuberculosis and associated factors in a nation-wide census among prison inmates in Peru

Objective: To estimate the prevalence of self-reported tuberculosis TB diagnosed at Peruvian correctional facilities (CFs), and their associated factors. Methods: Cross-sectional study based on secondary analysis of the National Census held in all Peruvian CFs in 2016. Outcome was defined as self-reported TB diagnosed by a healthcare professional intra-penitentiary. A descriptive bivariate analysis was carried out, followed by multivariate analysis using Poisson regression in order to calculate the adjusted prevalence ratios (PRa). Additionally, a mixed effects multilevel model adjusted by CFs as clusters was performed. Results: Of 77 086 prison inmates in 66 CFs participated in the original census, of which 69 890 were included. Of these, 1754 self-reported TB diagnosed intra-penitentiary, yielding a prevalence of 2510/100 000 PDL. In the final model, self-reported TB was associated with younger age, male gender, lower educational level, not having a stable partner, having prison readmissions and having relatives in prison. There was also strong association with HIV/AIDS (PRa 2.77; 1.84–4.18), STIs (PRa 2.13; 1.46–3.10), DM (PRa 1.99; 1.59–2.50) and recreational drugs use (PRa 1.41; 1.23–1.61). The mixed model showed significant variance for belonging to different CFs (2.13; 1.02–4.44) and CF overcrowding (3.25; 1.37–7.71). Conclusions: Self-reported TB prevalence found was higher than reported by other lower/lower-middle income countries. Demographic factors, individual clinical features and overcrowding increases the likelihood of self-reported TB.