Access to Tuberculosis Prevention and Treatment for Persons Deprived of Liberty in Southern Benin in 2023

Background: Access to tuberculosis (TB) preventive services in prisons is a performance indicator for disease reduction strategies in the general population. People deprived of liberty often face constraints in utilizing these services. This survey aimed to study prisoners' access to TB prevention in 2023. Methods: This was a cross-sectional analytical study, including a retrospective analysis, on a non-probabilistic sample. It was conducted at the Abomey-Calavi remand center and involved 60 people deprived of liberty. Interviews were conducted with the head nurse and their deputy, followed by a review of the curative care registers from the prison infirmary. Coverage rates for screening, awareness, and isolation during and after treatment were determined, and associations with factors were assessed at a significance threshold of p=5%. Results: Less than half (43.75%) of prisoners with a cough lasting two weeks or more were screened. Among the 60 surveyed prisoners, 38.33%, 46.67%, and 10% had access respectively to screening, awareness and isolation for TB prevention. The care pathway for prisoners includes several key steps from screening to isolation, but it faces discontinuities that compromise effective TB treatment. Factors associated with TB screening were the effectiveness of awareness-raising activities (OR= 6.21; 95% CI= [1.67; 23.05]) and perception regarding seeking TB screening and treatment (OR= 9.36; 95% CI= [1.44; 60.79]). Conclusion: The decrescendo decrease in coverage indicates the presence of several bottlenecks limiting prisoners' access to TB prevention. Their consideration by health interventions will be necessary to ensure the protection of prisoners against TB.