Smear positive pulmonary tuberculosis in a prison setting: experience in the penal camp of Bouaké, Ivory Coast.

Abstract

Bouaké prison camp, Ivory Coast. To determine the clinical, radiographic and therapeutic characteristics of smear-positive pulmonary tuberculosis in the prison camp of Bouaké. The study included 108 cases of smear positive pulmonary tuberculosis who had never been treated previously. Triple chemotherapy of 6 months' duration was recommended for all of the patients. The incidence of smear positive tuberculosis in the prison population under study was very high (5.8%). In the majority of cases tuberculosis infection is associated with other conditions: here they were malnutrition (75%), anaemia (70%) and dermatoses (64%). Human immunodeficiency virus (HIV) infection was observed in 30% of the cases, and alcohol and tobacco dependence in 50%. Radiographic lesions were extensive in 70% of the cases. The 6-month treatment regimen is still effective: 80 of the 108 (74.1%) were cured, i.e. 97.6% of those who completed their treatment. The death rate, however, was alarming at 24% (one patient in four). The main reason for incarceration was theft (73%). Other epidemiological studies are needed urgently in order to pin-point those factors that favour the progression from tuberculous infection to disease in this very specific setting, and to improve socio-sanitary conditions for prison inmates.