Assessment of Knowledge on Preventive and Control Measures of Pulmonary Tuberculosis among Inmates and Staff of Abakaliki Prisons, Nigeria: An Implication for Policy Implementation

Background: Pulmonary Tuberculosis (PTB) is one of the major diseases of public health importance especially in prisons where case-finding rate has been low. The WHO established five facts of prisons PTB spread include: Prisons receive TB, Prisons concentrate TB, Prisons disseminate TB, Prisons make TB worse, and Prisons export TB. Poor TB case finding results in annual TB transmission risks of 90%. This study assessed knowledge on preventive and control measures of pulmonary tuberculosis among inmates and staff of Nigerian Prisons, Abakaliki.

Methods: A prison-based cross-sectional descriptive study was undertaken among 307 inmates and staff selected using a systematic sampling technique. Informed consent was obtained from the staff and inmates. The respondents were interviewed using a pre-tested interviewer-administered structured questionnaire. Good knowledge of pulmonary tuberculosis was assessed by the proportion of respondents who correctly answered 60% of the knowledge questions, while sputum test was done for respondents with cough of two weeks or more. Data analysis was done using SPSS statistical software version 22. Chi-squared test was used for bivariate analysis with level of significance set at p-value of less than 0.05. Data were treated with strict confidentiality.

Results: The mean age of inmates was 34.96±5.7 years while that of staff was 38.43±3.5 years. Majority of the respondents had secondary education, while about 46% and 51% of inmates and staff respectively had good knowledge of pulmonary tuberculosis. Predictors of good knowledge were educational and employment status of inmates and staff educational attainment only.

Conclusion: Knowledge on preventive and control measures of PTB was poor among respondents. This level of knowledge especially by the inmates needs to be improved upon by intensified public health campaign. High PTB burden and poor control policies within prisons potentiate high attributable risk. Implementation of current national or international cell occupancy recommendations would reduce TB transmission by 50% and 94% respectively especially now that there is an increase in the incidence of MDR-TB.