Drug resistance pulmonary tuberculosis among prisoners in Ethiopia: A systematic review and meta-analysis

Background: Tuberculosis (TB) is a severe public health issue in prison inmates in Ethiopia since there is no routine screening for TB during prison admission. Also, drug-resistant tuberculosis (DR-TB) is a significant public health problem. Prisons are the most important permissive environments for TB transmission. However, less attention has been given to this segment of the population. Ethiopia’s condition is worse because of poor living circumstances and inefficient health care in the prisons. Objective: The study determined the pooled prevalence of DR-TB among prisoners in Ethiopia. Methods: A systematic search was conducted to retrieve records from databases such as PubMed/MEDLINE, ScienceDirect, Cochrane Library, and Google Scholar. The search did not entail a lower time limit, and articles published up until January 2024 were considered. This study was conducted in accordance with the PRISMA guidelines. The data were extracted using a standardized data extraction format. Meta-analysis was computed using STATA version 16 software. Heterogeneity was assessed by the I^2 and publication bias through a funnel plot. The random-effects meta-analysis model was computed to estimate the pooled prevalence of pulmonary tuberculosis (PTB) and DR-TB among prisoners. Results: Out of 338 records, six cross-sectional studies with 3277 study participants were included in this systematic review and meta-analysis. Of the 3277 study participants included in this study, 5.2% (169) were confirmed positive for PTB. Among 169 PTB cases the pooled prevalence of any DR-TB was 5.0% (95% CI: 2–9%), isoniazid (INH) resistance was 3.0% (95% CI: 0–6%), rifampin (RIF) resistance was 4.0% (95% CI: 0–8%), Multidrug-resistant tuberculosis (MDR-TB) was 3.0% (95% CI 0–6%). Conclusion: This systematic review and meta-analysis study has shown DR-TB in Ethiopian prisoners. These findings suggest the need for attention in prisons to the control of DR-TB in prisoners in Ethiopia.