Volume 8, Issue 6, June 2023 International Journal of Innovative Science and Research Technology

ISSN No:-2456-2165

Molecular Prevalence of Pulmonary Tuberculosis in

Prisons: Case of the Central Prison of Franceville
*Bourdettes Meye¹, Guy Roger Ndong Atome², Cedric Sima Obiang² , Hilaire Kenguele Moundounga³ , Thièry Ndong Mba²,³,
Dieudonné Nkoghe⁴ , Joseph Privat Ondo² and Louis-Clément Obame Engonga²
1
Medical analysis laboratory of Amissa Bongo Regional Hospital Center of Franceville (CHRAB), Gabon.
2
Laboratory of Research in Biochemistry (LAREBIO), University of Sciences and Techniques of Masuku (USTM) Franceville,
Gabon.
3
Laboratory of Molecular and Cellular Biology (LABMC) University of Science and Technology of Masuku (USTM),
Franceville, Gabon.
4
Ministry of health and social affairs
*Corresponding Author: Bourdettes Meye,Medical analysis laboratory of Amissa Bongo Regional Hospital Center of Franceville
(CHRAB), Gabon

Abstract:- Results: Among the 100 inmates suspected of having

Background: In Gabon, the epidemic of pulmonary tuberculosis, Mycobacterium tuberculosis was detected
tuberculosis (TB) in prisons is poorly documented. There in seven male patients (prevalence of 7%) and these
is no official data, even though these environments meet germs did not present any resistance to rifampicin, they
the perfect conditions for transmission of the disease: are of sensitive phenotype. Among the seven inmates
overcrowding, close and prolonged contact, and the diagnosed with tuberculosis, 4 (57.1%) were in their first
inexistence of a policy of screening/medical check-up of incarceration while 3 (42.9%) were in their second
inmates upon their admission to prison. The objective of incarceration after more than 5 years of liberty, thus we
this study was to conduct a prospective and cross- are dealing with imported cases of tuberculosis. These
sectional study to assess the prevalence of pulmonary prisoners complained of fever (71.4%), cough (57.1%)
tuberculosis in the prison environment of Yéné, the and chest pain (28.6%).
central prison of Franceville, capital of the Haut-Ogooué
province. Conclusion: In Yéné prison, the non-existence of
diagnostic tests for TB to newly incarcerated inmates
Methods: A preliminary clinical survey of inmates puts other inmates as well as prison officers at risk for
identified a cohort of 100 individuals suspected of having TB infection.
TB based on clinical symptoms. Subsequently, from June
9 to 13, 2022, we collected sputum samples from inmates Keywords:- Mycobacterium tuberculosis, Tuberculosis,
suspected of having TB. These samples were analyzed by GeneXpert, prison environment, Haut-Ogooué.
the molecular biology technique GeneXpert MTB/RIF.
Pakistan, Nigeria, Bangladesh and South Africa [2]. Studies
I. INTRODUCTION across the globe have shown that HIV and TB in prisons are
the leading causes of morbidity and mortality in all regions
Tuberculosis (TB) is a major public health problem of the world. The WHO strategy identifies prisoners as a key
worldwide [1]. According to the World Health Organization, population to be addressed in order to stop TB and AIDS [3,
one third of the world's population is latently 4].
(asymptotically) infected with Mycobacterium tuberculosis
(M. tuberculosis), the etiological agent of tuberculosis, while In Gabon, with an incidence of 521 cases per 100,000
5-10% of the world's population is actively population, TB is a key concern for incarcerated people [5].
(symptomatically) infected. The transmission of M.
tuberculosis is human-to-human via aerosols emitted when a Although the prisons of Libreville, Lambaréné and
sick person with advanced clinical signs coughs, the Tchibanga have benefited from TB screening campaigns in
contamination occurs when a healthy person inhales these 2018, 2020 and 2021 respectively with the financial support
aerosols [2]. of the Global Fund, unfortunately there is no information on
TB in the prison of Franceville [6]. In order to overcome this
Despite the availability of antibiotic chemotherapy, TB problem, this field study proposes to make a molecular
remains the third leading cause of death due to an infectious diagnosis of this disease in suspected prisoners in the central
germ, and death occurs when the disease is partially or not prison of Franceville with the main objective of assessing
managed with drugs. TB is unevenly distributed across the prevalence of tuberculosis in this prison and to study the
WHO health regions, with the greatest number of cases socio-demographic characteristics of suspected prisoners
occurring in the developing countries of Southeast Asia and particularly those diagnosed with tuberculosis.
(44%), Africa (25%), and the Western Pacific (18%) due to
weak health systems. In 2020, during the COVID-19
pandemic, 87% of new cases occurred in the 30 countries
with the highest TB burden. Two-thirds of these were
concentrated in India, Indonesia, China, the Philippines,

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II. MATERIAL & METHODS of the privacy of prisoners, according to the code of ethics in
the Gabonese Republic.
A. Setting and location of the study
This study took place in the south-east of Gabon in The information necessary for the realization of this
Franceville, in the province of Haut-Ogooué, in the only work was collected on anonymous survey forms. In
prison in the town of Franceville, the capital of the locality. addition, no information related to a patient will be
Initially built during the colonial era in the second district of disclosed, as well as the confidentiality of their information
the town, the central prison of Franceville was relocated in after approval.
2011 in the fourth district in the Yéné district because of the
dilapidation of the buildings and its capacity deemed  Preliminary steps to conduct the study
insufficient. A thick concrete wall 10 meters high surrounds The protocols for data collection and sample analysis
the prison, topped with electrified barbed wire. The prison were presented two months before the start of the study to
has several buildings, including the infirmary, which is run the senior nurse in charge of the prison infirmary. The
by a senior nurse and four assistant nurses. This health staff General Management of CHRAB wrote a letter of
provides nursing care and manages health emergencies. The correspondence to the Director of the prison. Once the
inmates are housed in a four-story building divided into administrative formalities were settled, a training on the
quarters and blocks or dormitories compartmentalized into good practices of the data collection forms was conducted
cells. The number of inmates per cell varies from 1 to 16 for with the nursing staff of the prison. They were then given
cells of 12 m². The inmate population is disparate due to the office equipment, personal protective equipment (PPE: over
diversity of charges, socio-professional diversity, penal blouse, KN95 respiratory protection mask, single-use latex
status, and nationalities. Prison guards assign tasks to fellow gloves) and tools for sampling and collecting samples
inmates, such as maintenance, cleaning, and emptying septic (spittoons).
tanks.
 Method of data collection, sample collection, and
B. Type and period of study transport of samples to CHRAB
From June 9 to 13, 2022, a prospective and cross- On collection days, in the morning, the prison nurses
sectional study was conducted in the central prison of the wore PPE and sat in pairs at two tables. A guard called the
city of Franceville. inmates selected for the study who lined up one behind the
other to form a line of 10 people. Under the supervision of
C. Study population two other guards, the detainees took turns sitting on a stool
The study population was made up of all the inmates placed in front of each nursing pair.
entering the prison from liberty or from another prison. The
study population consisted of approximately 500 inmates For each pair, the first nurse collected
and included adolescents, young adults, and adults of both sociodemographic data using the questionnaire on the pre-
sexes. Most of the inmates were single and there were a few established data collection form. The questionnaire collected
repeat offenders. personal data (age and sex), demographic data (place of
residence, date of incarceration, number of incarcerations),
D. Inclusion and exclusion criteria marital status, professional status, level of education, and
Inmates suspected of having pulmonary tuberculosis history of tuberculosis (treatment, appearance of symptoms).
with (symptomatic) or without (asymptomatic) clinical signs
of the disease, inmates undergoing treatment for tuberculosis At the end of the interview, each inmate was given a
or in relapse, treatment discontinuation, or treatment failure plastic screw-top jar on which was written in indelible
were included in this study. marker their first and last name, their registration number on
the laboratory register and the date of the day of the sample
Inmates who did not meet the above criteria, i.e., who collection. Each inmate was also given a single-use
had symptoms other than pulmonary TB and were being disposable handkerchief to wipe his or her mouth after
followed up for another condition, were not included in the sputum production. The nursing team’s master corporal,
sample. who ensured that the inmates were spitting properly, that the
amount of collection was sufficient and that the spittoons
E. Sampling were tightly closed after the exercise, supervised sputum
The sampling was exhaustive and included all collection by the inmates. The supervisor then placed the
symptomatic and asymptomatic patients suspected of having spittoons in a plastic wrapper and carefully placed them in a
pulmonary TB. Thus, of the 500 inmates in the prison, 100 refrigerated electric cooler (Campingaz) at +4°C with a
inmates met the inclusion criteria and among them, 2 volume capacity of 12 liters. At the end of each collection
inmates had been on first-line treatment for six months. session, the CHRAB ambulance driver was called by
telephone to the central prison to transport the
F. Conduct of the study biotechnologist to the analysis room with the completed data
 Study approval and ethical considerations collection forms and the cooler containing the freshly
The study was approved by the General Management of collected samples.
CHRAB and by the Director of the Franceville Central
Prison, subject to compliance with the law on the protection

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 Molecular analysis of samples III. RESULTS
Upon arrival at the CHRAB bacteriology unit, the
samples were taken out of the refrigerated cooler and plastic A. Sociodemographic characteristics of the inmates selected
packaging and placed on a clean bench. The number of data for the study
collection sheets was compared with the number of samples 100 inmates were recruited for this study, 94 were male.
on the bench, and the samples were stored in batches of 50 The average age of the inmates was 36.5 years, with a range
in a LIEBHERR refrigerator at +4°C. of 15 to 58 years. The majority of the detainees were of
Gabonese nationality (92%) and the rest were of Congolese
The pre-analytical phase consisted of ensuring the nationality (4%), with Chadian, Cameroonian, Nigerian and
conformity of the sample (correct identification, quality and Equatorial Guinean nationalities accounting for 1% of the
quantity of sputum, appropriate container, absence of food frequencies respectively.
debris, ...), then the recording of the patients' data in the
central activity register of the NTP (serial number, date of The detainees were arrested in various localities in the
receipt of the sample, name and surname, sex, age, address, province of Haut-Ogooué, 70% in Franceville, the
nature of the sample, HIV infection, previous anti- remaining 30% of the detainees came from the surrounding
tuberculosis treatment, diagnosis, examination results and towns: Moanda, 18%; Okondja, 4%; Mounana, 3%;
observation). Bongoville, Leconi, Ngouoni, Bakoumba each represented
1% of the frequencies. One inmate was from Libreville, the
The GeneXpert MTB/RIF procedure consisted of national capital of Gabon (1%). The largest number of
mixing the GeneXpert reagent (Sample Reagent, SR) and inmates (63%) were first-time offenders, while repeat
the sputum sample in a 2:1 ratio (2 ml SR to 1 ml sample). offenders accounted for 37%.
The resulting mixture was vigorously shaken 10 to 20 times
and then left to stand on the bench at room temperature for The number of inmates in the cells varied: 81% of the
15 minutes. The mixture was again vigorously shaken and cohabitations had between 11 and 16 individuals per cell,
allowed to stand at room temperature for 5 minutes. 18% of the cohabitations had less than or equal to 10
Following this and using a graduated plastic Pasteur pipette, inmates and 1% were in isolation.
2 ml of the mixture obtained was gently transferred into an
Xpert cartridge previously identified with the identifiers of Regarding the education of the inmates, 2% were
each of the inmates. The finished cartridge was inserted into university graduates, 60% had secondary education, 36%
a module of the GeneXpert MTB/RIF analyzer after the had primary education, and illiterates accounted for 2%.
preliminary steps of setting up the analyzer. Concerning the professions, 77% had no activity, 5% were
employed in car mechanics, 4% were cab drivers (clando
man) or bricklayers, 2% were shopkeepers and 1% of the
inmates were respectively animators, welders, scrap
metalworkers, electricians and elementary school teachers.
In terms of drug use, 41% drank alcohol, 38% smoked
tobacco and 21% smoked cannabis (Table 1).

Table 1: Sociodemographic characteristics of inmates (n = 100)

Characteristics Frequencies Percentages (%)
Nationality Gabonese 92 92
Congolese 4 4
Chadian 1 1
Cameroonian 1 1
Nigerian 1 1
Equatorial Guinean 1 1
Gender Male 94 94
Female 6 06
Age range (years) 15 – 28 43 43
29 – 39 26 26
40 – 50 23 23
51 – 61 8 8
City of residence Franceville 70 70
Other locations 30 30
Number of co-detainees in cell 1 (isolation) 1 1
2 – 10 18 18
11 - 16 81 81
Level of education without 2 2
Primary 36 36
Secondary 60 60
University 2 2
Professional status Without 77 77

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Mechanic 5 5
Driver 4 4
Animator 1 1
Cook 3 3
Welder 1 1
Mason 4 4
Ironworker 1 1
Electrician 1 1
Shopkeeper 2 2
Teacher 1 1
Number of incarcerations 1 63 63
≥2 37 37
Drug use Alcohol 70 41
Tobacco 64 38
Cannabis 36 21

B. Clinical characteristics of the inmates selected for the Regarding TB treatment history, 3 inmates were
study. former TB cases known to the NTP and had been on TB
At the time of their entry into detention at the Yéné therapy, resulting in 2 dropouts and 1 failure. The HIV
penitentiary center, 69% of the incarcerated persons did not status of the prisoners was unknown for a good number of
present any symptoms related to tuberculosis, while 11% them (81%), nevertheless 18% tested HIV-negative and 1
reported weight loss (somewhat considerable), 9% prisoner (1%) was diagnosed HIV-positive (Table 2). In
experienced chest pain, 6% felt suffocation, and the addition, 4 individuals had a medical history of high blood
remaining 5% had a persistent cough. pressure (3 cases) and asthma (1 case).

Table 2: Clinical profile of inmates at the Franceville central prison (n = 100).

Characteristics Variables Frequency Percentage (%)
General symptoms at incarceration Persistent cough 5 5
Chest pain 9 9
Thinness 11 11
Choking 6 6
No signs 69 69
History of tuberculosis treatment Discontinuation of 2 66,7
treatment
Relapse 0 0
Treatment failure 1 33,3
Medical history high blood pressure 3 75
Asthma 1 25
HIV infection Yes 1 1
No 18 18
Unknown 81 81

C. Prevalence of tuberculosis in the Franceville while 42.9% (3/7) were repeat offenders. Among the
penitentiary recidivists, the duration of new incarceration was 3 months
Of the 100 inmates retained and screened with the and 6 months after 1 year, 4 years and 12 years of freedom.
GeneXpert automated system, the positivity rate for the The distribution of TB cases within the prison blocks is
detection of M. tuberculosis was 7% (7 positive cases). All unknown; however, TB patients were located in five
TB cases were susceptible to rifampicin, i.e. no mutations separate cells including: 1 TB patient in a cell with 16
were detected in the rpoB gene area of interest (AOI). In individuals, 2 TB patients in a cell with 14 individuals, 1 TB
contrast, 93% (93/100) of the remaining inmates were patient in a cell with 11 individuals, 1 TB patient in a cell
GeneXpert MTB/RIF negative. with 6 individuals, and 1 TB patient in a cell with 4
individuals.
Of the positive cases, all were male, 85.7% were of
Gabonese nationality and 14.3% were of Congolese The consumption of illicit products such as alcohol,
nationality. The inmates with tuberculosis were between 19 tobacco and Indian hemp are recurrent among the detainees,
and 49 years of age with an average age of 30.85 years. among the detected cases of tuberculosis 38.5% consumed
Most of them, 85.7%, had attended college while 14.3% had alcohol and tobacco, and 23% marijuana. The patients
stopped at elementary school. Before their incarceration, all presented symptoms suggestive of TB, notably fever
of them lived in Franceville and did not have a job. The (57.1%, the most frequent sign) and persistent cough
majority of them (57.1%, 4/7) had never been incarcerated (44.5%). The rate of TB-HIV/AIDS co-infection was

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Volume 8, Issue 6, June 2023 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
unknown for most of them (85.7%) and only 14.3% had (60%) and headaches (40%); digestive problems such as
been diagnosed as HIV negative (Table 3). TB inmates also epigastralgia (66.7%) and diarrhea (33.3).
presented with neurological problems such as dizziness

Table 3: Prevalence of TB among inmates (n = 7)

Characteristics Frequencies Percentages (%)
Nationality Gabonese 6 85,7
Congolese 1 14,3

Gender Male 7 100

Female 0 00
Age (years) 19 – 29 5 71,4
30 – 40 0 00
41 – 49 2 28,6
City of residence Franceville 7 100
Level of education Primary 1 14,3
Secondary 6 85,7
Number of incarcerations 1 time 4 57,1
2 times 3 42,9
Tuberculosis cases and 1 (R) among 3 inmates = 4 inmates
number of co-inmates in 1 (P) among5 inmates = 6 inmates
the cell 1 (P) among10 inmates = 11 inmates
7 100
2(R-P) among 12 inmates = 14 inmates
1 (P) among 15 inmates= 16 inmates
1 (?)
Drug Use Alcohol 5 71.4
Tobacco 5 71.4
cannabis 3 42.8
Xpert MTB/RIF test result Positive 7 100
Négative 0 00
General symptoms Asthenia 1 14,3
Fever 5 71,4
Loss of taste 1 14,3
Loss of sense of smell 1 14,3
Loss of weight 1 14,3
Nocturnal sweating 1 14,3
Respiratory symptoms Choking 1 14,3
Coughing 4 57,1
Chest pain 2 28,6
Neurological symptoms Dizziness 3 42,9
Headache 2 28,6
Digestive symptoms Epigastralgia 3 42,9
Diarrhea 1 14,3
HIV infection Unknown 6 85.7
No 1 14.3
Legend: R = recidivism; P = first incarceration; ?= number of incarcerations and co-inmates unknown.

IV. DISCUSSION overcrowding of these prisons creates favorable conditions

for TB transmission, including permanent promiscuity
The purpose of this study was to determine the throughout the period of incarceration. In fact, according to
prevalence of pulmonary TB in the prison environment of the data collected for the Yéné prison, the number of
the city of Franceville, a health region located in inmates per cell (about 12 m²) varied from 2 to 16
southeastern Gabon. individuals. Despite these extreme prison densities, the
prevalence of pulmonary TB is very low. In this study at
A. Prison occupancy rate and TB occurrence Yéné prison, the prevalence of TB was 7% (7 positive
For several African countries, prison occupancy rates cases/100 suspects). This prevalence is particularly high
(prison density) are reaching record proportions, sometimes when compared to Cameroonian prisons 3.9% (136/3423) in
exceeding 300%, well beyond the actual capacity of the 2020 [9], Nigerian prisons 0.84% (28/3324) [10] in 2021
prisons. This was the case in 2020 in Senegal (383%), and French prisons 0.24% (45/18,356) in 2019 [11]. The
Liberia (329%), Côte d'Ivoire (266%), Nigeria (137%) [7, 8] comparison of these data supports the idea that TB circulates
and in the central prison of Libreville in Gabon (583%). The much more in Gabon than in the countries mentioned above.

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Indeed, according to WHO statistics [12] Gabon is possible that these young people acquired the infection
categorized among the 30 countries worldwide with a high during their various risky social activities. The results of the
burden of TB and ranks 3rd in Africa, far ahead of study revealed that all the inmates with tuberculosis (n=7,
Cameroon and Niger. 100%) were drug addicts, 71.4% (5/7) used tobacco.
According to the World Health Organization and Zhang et
B. Number of incarcerations, length of incarceration, and al, (2007), smoking is indirectly responsible for 20% of
importation of tuberculosis tuberculosis cases worldwide [22]; both passive and active
Recidivism rates are not well known in Gabon today exposure to cigarette smoke are associated with an increased
because data on prisoners are not kept after their release. risk of M. tuberculosis infection and the development of
Each time a prisoner is re-incarcerated, he or she is assigned active tuberculosis [23]. Regular ingestion of toxic smoke is
a new prison number. Of the 7 TB cases detected, 57.1% thought to promote low production of interleukin-12 and
(4/7) were first-time offenders and 42.9% were repeat TNF-α, pro-inflammatory cytokines essential for activation
offenders (2nd incarceration) after 1, 4 and 12 years of and communication/coordination of immune cells located in
freedom. It appears that the TB cases in Yéné prison are the pulmonary alveoli. The decreased production prevents
imported TB cases because no TB inmate has stayed for granuloma formation [24; 25]. Another factor in the
more than 2 to 5 years in a row. In other words, because of development of tuberculosis is alcohol abuse. According to
their recent re-incarceration (less than 6 months), these Soh et al (China) and Lönnroth et al, chronic alcohol
people contracted the infection outside the prison during consumption is indeed a risk factor for the development of
their years of freedom. This phenomenon of importation of tuberculosis, especially among heavy drinkers [26, 27]. In
TB into the prison environment is far from trivial and this study, five of the inmates (71.4%) drank alcohol.
specific to the Yéné prison. A study conducted in 2011 in
Burkina Faso showed that 260 inmates with TB (86.7%) D. Medical characteristics of prisoners with TB
were in their first incarceration [13]. These incarcerations of Depending on the stage of infection, TB manifests itself
new inmates without hospital biological checkups run the through various symptoms ranging from non-specific
risk of transmitting tuberculosis to those already (common to most other pathologies) to more specific.
incarcerated. According to our results on the clinical symptoms of TB
inmates in Yéné prison, 71.4% (5/7) of the patients
C. Socio-demographic characteristics of tuberculosis cases complained of fever associated with coughing (57.1%, 4/7)
The ratio of men to women in prison cases is largely to and to a lesser extent with choking (14.3%, 1/7), night
the disadvantage of men, and men always constitute the sweats (14.3%, 1/7) and weight loss (14.3%, 1/7) The results
most represented prison population. In the Yéné prison, the of our study are similar to those of Sani et al, conducted in
tuberculosis patients were mainly men (100%), a somewhat 2021 in a prison setting in Niger [28] who stated that people
surprising fact, even though in certain circumstances with TB often complained of fever 92.85% and cough
andperiods, men and women may share certain rooms for 100%. As reported in the literature, cough is the most
various common activities: recreation, religious worship or frequent symptom lasting more than 2 to 3 weeks due to
maintenance of the prison. An inmate with tuberculosis is bronchial irritation. Fever is a clinical manifestation that
likely to infect any room by coughing repeatedly, and this indicates an ongoing infection. The severity of M.
room will constitute a spot of infection if the ventilation is tuberculosis infection determines the level of fever, and
practically null. This high prevalence of male tuberculosis usually fever in patients with tuberculosis is subfebrile (40-
patients has also been observed in prisons in Cameroon in 41°C) and intermittent [29; 30].
2020 with 96.6% [14], in Niger in 2021 with 100% [15], in
Ethiopia in 2018 with 97% [16], in France in 2019 with E. Limitations of the study
95.6% [17]. This trend is probably because during their The present study is far from exhaustive and therefore
periods of freedom men are led to establish many more has some limitations. The GeneXpert MTB/RIF technique is
social and (pseudo) professional connections within society only limited to the detection of mutations associated with
than women [18; 19] because of its cultural and even RIF. The use of other molecular diagnostic tools, such as
religious character as a provider of shelter and food within Hain GenoType MTBDRplus and Sanger sequencing, would
the family. This high level of interaction increases the risk have allowed the screening of mutations conferring
of contracting tuberculosis infection [20]. The role of resistance to INH and PZA in order to determine whether
women would be somewhat limited to performing domestic TB cases are susceptible or mono-resistant to INH or PZA
tasks. All of the people who tested positive for TB were with respect to these first-line antituberculosis drugs.
nationals of the city of Franceville, which is sufficient proof Moreover, due to the relatively short time available, we
that TB circulates in the Franceville community. In our were not able to genotype the strains of the TB inmates.
African societies, the male role of provider is inherent to Genotyping would have allowed us to identify the strain or
people between 30 and 45 years of age or even 50 years of strains involved.
age (productive age) [20, 21]. The minority, 28.6% (2/7) of
TB cases were productive (adults) aged 47 and 49 years
respectively while the largest number of inmates detected
with active TB were 71.4% (5/7) young individuals aged
between 19-29 years. Cases of TB transmission in young
individuals usually incriminate domestic transmissions of
parental origin, however, given the prison context; it is quite

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V. CONCLUSION [7.] Ndione A. G., Desclaux A., Bâ I., Sow K., Ngom M.,
Diop, M. (2020). Usagers de drogues et Covid-19:
Tuberculosis is an airborne disease, and communities comment réduire la surpopulation carcérale en
or groups of people characterized by close and prolonged Afrique de l’Ouest? The Conversation, 19, 6-p.
contact are very prone to disseminate the disease among [8.] Fischer B. (2021). Interroger la promotion
their members. With occupancy rates far in excess of the internationale de l’État de droit à l’aune de la
actual capacity of the prison, inmates in African prisons détention avant jugement. L’exemple de la Côte
constitute a population group at high risk of tuberculosis, a d’Ivoire. Déviance et Société, 45(3), 417-448.
disease known to national tuberculosis control programs. [9.] Morelle M., Awondo P., Birwe H., Eyenga, G. M.
(2018). Politique de réforme et matérialité de la
The aim of the prospective cross-sectional study prison au Cameroun. Politique africaine, (2), 75-96.
conducted in the Yéné prison in Franceville from 9 to 13 [10.] Kolappan, C., Gopi, P. G., Subramani, R., &
June 2022 was to determine the prevalence of tuberculosis Narayanan, P. R. (2007). Selected biological and
in this prison. Among the 100 cases of suspected clinical behavioural risk factors associated with pulmonary
tuberculosis examined, the detection rate of tuberculosis tuberculosis. The International Journal of
with rifampicin-sensitive germs was 7%. The major finding Tuberculosis and Lung Disease, 11(9), 999-1003.
of the study was that these TB cases were imported into the [11.] Bouvier, J.C et Blisson, L. (2020). En finir avec la
prison. This unexpected characterization on our part crise permanente de la surpopulation carcérale.
highlights flaws in the health protocols and procedures at Deliberee,11 (3), 34 – 38.
Yéné prison. This sanitary flaw is of major importance [12.] Matteelli A., Centis R., D’Ambrosio L., Sotgiu G.,
because inmates as well as prison officers (guards, Tadolini M., Pontali E., Migliori G. B. (2016). WHO
administrators, doctors and nurses...) are exposed to the strategies for the programmatic management of drug-
disease. resistant tuberculosis. Expert review of
In order to prevent possible transmissions or respiratorymedicine, 10(9), 991-1002.
contaminations within Gabon's prisons, the authorities in [13.] Trop M. (2011). Prévalences et facteurs associés aux
charge of prisons should implement preventive measures to infections à Virus de l’Immunodéficience Humaine et
limit transmission/contamination in prisons. As a preventive virus de l’hépatite B, à la syphilis et à la tuberculose
measure, prisoners could be subjected to a lung X-ray and/or pulmonaire bacillifères en milieu carcéral au Burkina
TST test, and possibly to an IGRA test for latent TB, as soon Faso. Médecine tropicale, 71(5), 464-467.
as they arrive in the prison and periodically. The same [14.] Kuate A. K., Wandji A., Belinga E., Bekang F.,
applies to the prison staff. As another preventive measure, Evouna A. E., Mbassa, V. (2020). Amélioration du
an optimal ventilation system should be put in place for the diagnostic de la tuberculose dans les prisons
premises (prison blocks). In the end, adequate sensitization Camerounaises en 2018 à travers des campagnes de
of inmates and prison staff about TB is an essential part of masse de la tuberculose. Revue des Maladies
the TB control strategy. Respiratoires Actualités, 12(1), 61.
[15.] Sani K., Laouali H. A. M., Laminou A. M., Azize G.
ACKNOWLEDGMENTS A., Mamane D., Piubello A., Eric, A. (2021).
Tuberculose pulmonaire en milieu carcéral au Niger:
The authors would like to thank all the medical staff, aspects épidémiologiques, diagnostiques,
participants, and director of the hospital center for their thérapeutiques et évolutifs.
valuable contribution. The authors declared no conflicts of [16.] Adane K., Spigt M., Dinant, G. J. (2018).
interest. Tuberculosis treatment outcome and predictors in
northern Ethiopian prisons: a five-year retrospective
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