Factors associated with death from tuberculosis and HIV/aids in prisons: integrative review

Camillo, Ana Julia Gonçalves; Ferreira, Melisane Regina Lima; Bossonario, Pedro Augusto; Andrade, Rubia Laine de Paula; Saita, Nanci Michele; Rezende, Carlos Eduardo Menezes de; Arcêncio, Ricardo Alexandre; Monroe, Aline Aparecida

doi:10.37689/acta-ape/2022AR0160666

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Review Article • Acta Paul Enferm 35 • 2022 • https://doi.org/10.37689/acta-ape/2022AR0160666 copy

Factors associated with death from tuberculosis and HIV/aids in prisons: integrative review

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

Analyze the epidemiological profile and the factors associated with death from tuberculosis and HIV/aids in the prison system.

Methods

Integrative review, conducted in July 2020, whose research question and keywords were outlined through the PEO strategy. The searches were undertaken in the MEDLINE, CINAHL, Scopus, ASP, SocINDEX, Embase and LILACS databases. Two independent reviewers selected the studies and extracted the data. To assess the methodological quality of the articles included in the review, specific tools proposed by the Joanna Briggs Institute were used.

Results

1,329 studies were retrieved, four of which were included in the review. The epidemiological profile and factors associated with death from tuberculosis in the prison system included the following variables: age ≥ 43 years, illiterate or low education level, concomitant pulmonary and extrapulmonary tuberculosis, non-performance of directly observed treatment and history of alcohol abuse. As for death from HIV and aids, males, mean age of 34 years, singles, black and Hispanic race/color, drug use and prolonged imprisonment, advanced infection and recent initiation of antiretroviral therapy stood out.

Conclusion

The epidemiological profile and the factors associated with death from tuberculosis and HIV/aids in the prison system show the need for a risk stratification with a continuous and comprehensive approach to the care provided to the population affected by these health conditions.

Prisions; Tuberculosis; Acquired immunodeficiency syndrome; Death

Database	Search strategy
Embase^®	(prisoners:ti,ab,kw OR ‘correctional facility’:ti,ab,kw) AND (tuberculosis:ti,ab,kw OR ‘acquired immune deficiency syndrome’:ti,ab,kw OR ‘human immunodeficiency virus’:ti,ab,kw) AND (death:ti,ab,kw OR ‘treatment outcome’:ti,ab,kw)
Scopus	TITLE-ABS-KEY ( prisoners OR prisoner OR captive OR captives OR detainee OR detainees OR inmate OR inmates OR incarcerated OR “person deprived of liberty” OR “persons deprived of liberty” OR “population deprived of liberty” OR “people deprived of liberty” OR arrested OR prisons OR prisons OR “penal centers” OR “social rehabilitation centers” OR “penal institution” OR “penal institutions” OR penitentiary OR penitentiaries OR jail OR jails ) AND TITLE-ABS-KEY ( tuberculosis OR tb OR “Mycobacterium tuberculosis” OR “Koch Disease” OR “Koch’s Disease” OR “Kochs Disease” OR hiv OR “AIDS Virus” OR “AIDS Viruses” OR “Acquired Immune Deficiency Syndrome Virus” OR “Acquired Immunodeficiency Syndrome Virus” OR “Human Immunodeficiency Virus” OR “Human Immunodeficiency Viruses” OR “Acquired Immunodeficiency Syndrome” OR aids OR “Acquired Immune Deficiency Syndrome” OR “Acquired Immuno Deficiency Syndrome” OR “Acquired Immuno-Deficiency Syndrome” OR “Acquired Immuno-Deficiency Syndromes” OR “Acquired Immunodeficiency Syndromes” ) AND TITLE-ABS-KEY ( death OR “treatment outcome” OR “treatment outcomes” OR “case outcomes” OR “closure of treatment” OR “closures of treatment” OR “closure of the treatment” OR “closures of the treatment” OR “closure of case” OR “closure of case” OR “closures of the case” OR “closures of the cases” )
MEDLINE	((prisoners OR prisoner OR captive OR captives OR detainee OR detainees OR inmate OR inmates OR incarcerated OR “person deprived of liberty”[Title/Abstract] OR “persons deprived of liberty”[Title/Abstract] OR “population deprived of liberty”[Title/Abstract] OR “people deprived of liberty”[Title/Abstract] OR arrested OR prisons OR prisons OR “penal centers”[Title/Abstract] OR “social rehabilitation centers”[Title/Abstract] OR “penal institution”[Title/Abstract] OR “penal institutions”[Title/Abstract] OR penitentiary OR penitentiaries OR jail OR jails) AND (tuberculosis[Title/Abstract] OR TB[Title/Abstract] OR “Mycobacterium tuberculosis”[Title/Abstract] OR “Koch Disease”[Title/Abstract] OR “Koch’s Disease”[Title/Abstract] OR “Kochs Disease”[Title/Abstract] OR HIV[Title/Abstract] OR “AIDS Virus”[Title/Abstract] OR “AIDS Viruses”[Title/Abstract] OR “Acquired Immune Deficiency Syndrome Virus”[Title/Abstract] OR “Acquired Immunodeficiency Syndrome Virus”[Title/Abstract] OR “Human Immunodeficiency Virus”[Title/Abstract] OR “Human Immunodeficiency Viruses”[Title/Abstract] OR “Acquired Immunodeficiency Syndrome”[Title/Abstract] OR AIDS[Title/Abstract] OR “Acquired Immune Deficiency Syndrome”[Title/Abstract] OR “Acquired Immuno Deficiency Syndrome”[Title/Abstract] OR “Acquired Immuno-Deficiency Syndrome”[Title/Abstract] OR “Acquired Immuno-Deficiency Syndromes”[Title/Abstract] OR “Acquired Immunodeficiency Syndromes”[Title/Abstract])) AND (death[Title/Abstract] OR “treatment outcome”[Title/Abstract] OR “treatment outcomes”[Title/Abstract] OR “case outcomes”[Title/Abstract] OR “closure of treatment”[Title/Abstract] OR “closures of treatment”[Title/Abstract] OR “closure of the treatment”[Title/Abstract] OR “closures of the treatment”[Title/Abstract] OR “closure of case”[Title/Abstract] OR “closure of case”[Title/Abstract] OR “closures of the case”[Title/Abstract] OR “closures of the cases”[Title/Abstract])
LILACS*	(prisioneiros OR cativo OR cativos OR detento OR detentos OR encarcerado OR encarcerados OR encarcerada OR encarceradas OR “pessoa privada de liberdade” OR “pessoas privadas de liberdade” OR “população privada de liberdade” OR preso OR presos OR prisões OR “centros penais” OR “centros de readaptação social” OR cárcere OR cárceres OR “instituição penal” OR “instituições penais” OR penitenciária OR penitenciárias OR presídio OR presídios OR prisão OR “unidades prisionais” OR prisioneros OR cautivo OR cautivos OR detenido OR detenidos OR encarcelado OR encarcelados OR “persona encarcelada” OR “persona privada de libertad” OR “personas encarceladas” OR “personas privadas de libertad” OR preso OR presos OR prisionero OR prisiones OR “centros penales” OR “centros de readaptación social” OR cárceles OR “instituciones penales” OR presídios OR prisoners OR prisoner OR captive OR captives OR detainee OR detainees OR inmate OR inmates OR incarcerated OR “person deprived of liberty” OR “persons deprived of liberty” OR “population deprived of liberty” OR “people deprived of liberty” OR arrested OR prisons OR prisons OR “penal centers” OR “social rehabilitation centers” OR “penal institution” OR “penal institutions” OR penitentiary OR penitentiaries OR jail OR jails) AND (tuberculose OR TB OR “Mycobacterium Tuberculosis” OR “doença de Koch” OR HIV OR “Vírus da Imunodeficiência Humana” OR “Vírus de Imunodeficiência Humana” OR “Síndrome de Inmunodeficiencia Adquirida” OR “Síndrome da Deficiência Imunológica Adquirida” OR “Síndrome da Imunodeficiência Adquirida” OR “Síndrome de Deficiência Imunológica Adquirida” OR soropositivo OR “Infección por Mycobacterium tuberculosis” OR VIH OR “Virus de Inmunodeficiencia Humana” OR “Virus de la Inmunodeficiencia Humana” OR “Virus del SIDA” OR “Síndrome de Inmunodeficiencia Adquirida” OR SIDA OR “Síndrome de Deficiencia Inmunológica Adquirida” OR “Síndrome de la Inmunodeficiencia Adquirida” OR tuberculosis OR “Mycobacterium tuberculosis” OR “Koch Disease” OR “Koch’s Disease” OR “Kochs Disease” OR HIV OR “AIDS Virus” OR “AIDS Viruses” OR “Acquired Immune Deficiency Syndrome Virus” OR “Acquired Immunodeficiency Syndrome Virus” OR “Human Immunodeficiency Virus” OR “Human Immunodeficiency Viruses” OR AIDS OR “Acquired Immunodeficiency Syndrome” OR “Acquired Immune Deficiency Syndrome” OR “Acquired Immuno Deficiency Syndrome” OR “Acquired Immuno-Deficiency Syndrome” OR “Acquired Immuno-Deficiency Syndromes” OR “Acquired Immunodeficiency Syndromes”) AND (morte OR óbito OR falecimento OR “resultado do tratamento” OR “resultados do tratamento” OR “desfecho do tratamento” OR “desfechos do tratamento” OR “desfecho do caso” OR “desfechos do caso” OR “encerramento do tratamento” OR “encerramentos do tratamento” OR “encerramento do caso” OR “encerramentos do caso” OR muerte OR fallecimiento OR óbito OR “resultado del tratamiento” OR “resultado del tratamiento” OR “resultados del tratamiento” OR “resultados del caso” OR “cierre del tratamiento” OR “cierres del tratamiento” OR “cierres del caso” OR “cierres del caso” OR death OR “treatment outcome” OR “treatment outcomes” OR “case outcomes” OR “closure of treatment” OR “closures of treatment” OR “closure of the treatment” OR “closures of the treatment” OR “closure of case” OR “closure of case” OR “closures of the case” OR “closures of the cases”)
CINAHL, Academic Search Premier and SocINDEX	AB ( prisoners OR prisoner OR captive OR captives OR detainee OR detainees OR inmate OR inmates OR incarcerated OR “person deprived of liberty” OR “persons deprived of liberty” OR “population deprived of liberty” OR “people deprived of liberty” OR arrested OR prisons OR prisons OR “penal centers” OR “social rehabilitation centers” OR “penal institution” OR “penal institutions” OR penitentiary OR penitentiaries OR jail OR jails ) AND AB ( tuberculosis OR TB OR “Mycobacterium tuberculosis” OR “Koch Disease” OR “Koch’s Disease” OR “Kochs Disease” OR HIV OR “AIDS Virus” OR “AIDS Viruses” OR “Acquired Immune Deficiency Syndrome Virus” OR “Acquired Immunodeficiency Syndrome Virus” OR “Human Immunodeficiency Virus” OR “Human Immunodeficiency Viruses” OR “Acquired Immunodeficiency Syndrome” OR AIDS OR “Acquired Immune Deficiency Syndrome” OR “Acquired Immuno Deficiency Syndrome” OR “Acquired Immuno-Deficiency Syndrome” OR “Acquired Immuno-Deficiency Syndromes” OR “Acquired Immunodeficiency Syndromes” ) AND AB ( death OR “treatment outcome” OR “treatment outcomes” OR “case outcomes” OR “closure of treatment” OR “closures of treatment” OR “closure of the treatment” OR “closures of the treatment” OR “closure of case” OR “closure of case” OR “closures of the case” OR “closures of the cases” )

Authors / Journal / Year / Country	Type of study/ MQA (main limitations)	Objective	Study population (n)	Synthesis of results
Culbert GJ et al.⁽¹⁶⁾ / Research Reports in Tropical Medicine / 2017 / Indonesia	Cohort 09/11 (confounding variables and strategies to minimize them were not identified)	Identify predictors of mortality and causes of death during imprisonment and up to two years after release from prison of male prisoners, infected with HIV, randomly selected in Indonesia.	102	There were 15 deaths from HIV among people deprived of freedom, 10 of which occurred inside the prison and five after release. The most common probable cause of death was infectious disease attributable to HIV infection, which includes deaths caused by opportunistic infections and those classifiable as HIV-related deaths based on the symptoms. No deaths were attributed to accidental injury, poisoning, suicide, or homicide. Drug overdose was ruled out as a cause of death for all but one participant. Predictors of mortality within the prison in general were similar, and shorter overall survival was associated with belonging to a specialized “narcotic” prison for drug offenders, prolonged imprisonment and advanced HIV infection. Treatment of drug dependence was associated with longer survival, although treatment with ART or methadone was not.
Ribeiro Macedo et al.⁽¹⁷⁾ / The International Journal of Tuberculosis and Lung Disease / 2013 / Brazil	Cohort 6/11 (confounding variables and strategies to minimize them were not identified, and exposure and outcome measures may not be reliable due to the use of secondary sources)	Describe the clinical and epidemiological characteristics associated with TB treatment outcomes in the Brazilian prison population.	14,864	Of the 14,874 subjects in the study, 335 (2%) died from TB. People who died were more likely to be aged ≥ 43 years, to be illiterate, to suffer from alcoholism, to have other comorbidities, such as aids, to have pulmonary+extrapulmonary TB and not to be under the DOT regime.
Gido⁽¹⁸⁾ / The Prison Journal / 1989 / United States	Descriptive 7/9 (statistical analysis presents weaknesses)	Identify the demographic and epidemiological profile of New York inmates who died from aids between 13 November 1981 and 31 October 1987.	506	The majority of AIDS deaths occurred in state maximum security facilities; 97% of AIDS deaths were male; average age of male mortality was 34 years, against 31 years for female mortality; a relationship was identified between aids deaths and history of intravenous drug abuse (95% of male cases and 100% of female cases); 45% of aids deaths occurred in the black race/color, followed by 44% in Hispanics; 58% of cases were unmarried; and among deaths from other causes, pneumonia due to pneumocystis carinii was the most common opportunistic infection among inmates who died from aids.
Telisinghe et al.⁽¹⁹⁾ / International Journal of STD & AIDS / 2016 / South Africa	Cohort 8/11 (confounding variables and strategies to minimize them were not identified, and strategies to minimize follow-up losses were not clear)	Describe, in the prison facility, the mortality due to HIV of the ART program, retention in the program and suppression of viral load.	404	Among the 299 who started ART for the first time, 23 deaths occurred. Mortality from HIV was high among those who had recently started ART or those who were not under this treatment. There was no difference in mortality when considering CD4+ T lymphocyte counts among people who did not use ART.

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[1] Corresponding author: Rubia Laine de Paula Andrade E-mail: rubia@eerp.usp.br