Intestinal parasitic infections and predisposing factors among prison inmates in Southern Ghana: A cross-sectional study.

BACKGROUND AND AIMS: The environment within prisons, such as overcrowding, lack of access to portable water, poor sanitation, and hygiene predisposes inmates to infections, including intestinal parasitic infections (IPIs). This study therefore determined the prevalence and associated factors of IPIs among prison inmates in Southern Ghana.

METHODS: A cross-sectional study using the stratified sampling technique was employed. The study recruited 461 prison inmates across three notable prisons, with 50 inmates from Ho Central, 357 inmates from Nsawam Medium Security, and 54 inmates from Sekondi Central Prisons all in Southern Ghana. A structured closed-ended questionnaire was administered to collect data on sociodemographics, lifestyle/behavioral characteristics, and signs and symptoms of IPIs. In addition, stool samples were collected and analyzed for the presence of various stages of intestinal parasites (trophozoites, cysts, ova, and larva) using formol-ether concentration, and the modified Ziehl-Neelsen techniques.

RESULTS: The prevalence of IPIs among inmates of the three selected prisons was 38.2% (95% confidence interval [CI]: 33.72%-42.79%). The prevalence of IPIs among inmates of the three prisons, the Ho Central, Nsawam Medium Security, and Sekondi Central were 46% (95% CI: 31.82%-60.68%), 37.5% (95% CI: 32.49%-42.79%), and 35.2% (95% CI: 22.68%-49.38%), respectively. After adjusting for confounders, the following factors; handwashing after defecation (adjusted odds ratio [AOR]: 0.05 [0.00-0.67]; p  = 0.024), trimmed fingernails (AOR: 0.32 [0.13-0.76]; p  = 0.011), itchy skin (AOR [95% CI]: 5.99 [3.43-10.43]; p  < 0.001), anal itching (AOR [95% CI]: 0.35 [0.19-0.62]; p  < 0.001), nausea (AOR [95% CI]: 5.57 [3.22-9.65]; p  < 0.001), and worm expulsion (AOR [95% CI]: 3.80 [1.42-10.18]; p  = 0.008) were found to be associated with intestinal parasitic infections.

CONCLUSION: The study revealed that the prevalence of intestinal parasitic infections among prisons in Southern Ghana is high and is therefore an important public health concern. The Public Health Department of Ghana Health Service should therefore embark on health promotion and deworming exercise in all prisons in Ghana.