Tuberculosis in prisons in sub-Saharan Africa--a potential time bomb (original) (raw)

Guidelines for the control of tuberculosis in prisons

1998

Tuberculosis (TB) is common in many prisons worldwide and treatment is often ill-informed and inadequate. In this perspective the WHO and the International Committee of the Red Cross (ICRC) have joined forces to produce guidelines for the control of TB in prisons. This document presents the results of the collaborative effort of WHO and ICRC. The guidelines based on recent experience outline the many obstacles to effective diagnosis and treatment and it gives useful guidance as to how to overcome these obstacles. Outlined into three parts these guidelines are primarily for prison authorities policy- makers and decision-makers in relevant ministries nongovernmental organizations (NGOs) and donor agencies and National TB Program staff. Part I provides background information on TB and prisons of particular relevance to prison authorities and decision-makers in relevant ministries. Part II provides guidelines for the control of TB in prisons of particular relevance to prison health staf...

Tuberculosis control in prisons: current situation and research gaps

International Journal of Infectious Diseases, 2015

Background: Tuberculosis (TB) in penitentiary services (prisons) is a major challenge to TB control. This review article describes the challenges that prison systems encounter in TB control and provides solutions for the more efficient use of limited resources based on the three pillars of the post-2015 End TB Strategy. This paper also proposes research priorities for TB control in prisons based on current challenges. Methods: Articles (published up to 2011) included in a recent systematic review on TB control in prisons were further reviewed. In addition, relevant articles in English (published 1990 to May 2014) were identified by searching keywords in PubMed and Google Scholar. Article bibliographies and conference abstracts were also hand-searched. Results: Despite being a serious cause of morbidity and mortality among incarcerated populations, many prison systems encounter a variety of challenges that hinder TB control. These include, but are not limited to, insufficient laboratory capacity and diagnostic tools, interrupted supply of medicines, weak integration between civilian and prison TB services, inadequate infection control measures, and low policy priority for prison healthcare. Conclusions: Governmental commitment, partnerships, and sustained financing are needed in order to facilitate improvements in TB control in prisons, which will translate to the wider community.

Tuberculosis Prevention and Control in Large Jails

American Journal of Preventive Medicine, 2006

Background: This study assessed the extent to which 20 large jail systems have implemented national recommendations for tuberculosis (TB) prevention and control in correctional facilities. Methods: Data were collected through questionnaires to jail medical directors and TB control directors, observation at the jails, and abstraction of medical records of inmates with TB disease and latent TB infection. Results: Twenty percent of jail systems (4/20) had conducted an assessment of risk for TB transmission in their facilities, and 55% (11/20) monitored tuberculin skin test conversions of inmates and staff. Sixty-five percent (13/20) of jails had an aggregate recordkeeping system for tracking TB status and treatment, which was usually paper based. Forty-five percent of jails (9/20) had policies to offer HIV counseling and testing to tuberculin skin test-positive patients, and 75% (15/20) screen HIV-infected inmates with chest radiographs. Three quarters of jails (15/20) had policies to always isolate patients with suspected or confirmed pulmonary TB in an airborne infection isolation room. Half of jails with airborne infection isolation rooms (6/12) conformed to Centers for Disease Control and Prevention (CDC) guidelines for monitoring negative pressure. Conclusions: Improvements are needed in conducting TB risk assessments and evaluations to determine priorities and reduce risk of transmission. Inadequate medical information systems are impeding TB control and evaluation efforts. Although HIV infection is the greatest cofactor for development of TB disease, jails have inadequate information on patients' HIV status to make informed decisions in screening and management of TB and latent TB infection. Jails need to improve the use of environmental controls.

HIV and related infections in prisoners 5 HIV and tuberculosis in prisons in sub-Saharan Africa

2016

Given the dual epidemics of HIV and tuberculosis in sub-Saharan Africa and evidence suggesting a disproportionate burden of these diseases among detainees in the region, we aimed to investigate the epidemiology of HIV and tuberculosis in prison populations, describe services available and challenges to service delivery, and identify priority areas for programmatically relevant research in sub-Saharan African prisons. To this end, we reviewed literature on HIV and tuberculosis in sub-Saharan African prisons published between 2011 and 2015, and identifi ed data from only 24 of the 49 countries in the region. Where data were available, they were frequently of poor quality and rarely nationally representative. Prevalence of HIV infection ranged from 2·3% to 34·9%, and of tuberculosis from 0·4 to 16·3%; detainees nearly always had a higher prevalence of both diseases than did the non-incarcerated population in the same country. We identifi ed barriers to prevention, treatment, and care s...