Discovering risk of TB transmission through latent tuberculosis infection prevalences among Indonesian prisoners: A cross-sectional study

Background There is well-established evidence that the incidence of confirmed tuberculosis (TB) cases is higher in prisons than in the general population. However, few studies have examined latent TB infection (LTBI) as a primary prevention strategy for TB in prisons, using a public health approach to stop the disease’s transmission. This study aims to assess the TB statuses through the relationship between LTBI and prisoner profiles including HIV in Bandung First Class Prison State, Bandung, Indonesia. Methods To ensure that the identified LTBI cases did not pose a risk of becoming possible, probable, or confirmed TB, all subjects underwent comprehensive testing. A cross-sectional design was conducted to examine the relationship between the variables using multiple logistic regression. Results The 396 tested samples consisted of 14.6% non-Mycobacterium Tuberculosis (non-MTB), 49.0% LTBI, 32.3% possible TB, 1.8% probable TB, and 2.3% confirmed TB. HIV was found in two inmates, and LTB is more prevalent in low nutritional status compared to normal nutrition, up to 51.5% compared to inmates with normal nutritional status. However, due to abnormal distribution, malnutrition status could not be analyzed with HIV. From 252 selected samples for LTBI statuses, the point prevalence of LTBI in First Class Prison State Bandung was measured at 76.9%, with confirmed TB at 2.3%. Conclusion LTBI was considered significantly associated with the length of incarceration (p-value<0.05; PR=0.947). There was also no association between LTBI and nutritional status. Prisoners with longer incarceration profiles were at higher risk than new prisoners. The high prevalence of LTBI suggests that transmission mostly occurs within the prison environment.