Tuberculosis control in prisons: current situation and research gaps

Dara, Masoud; Acosta, Colleen; Melchers, Natalie V. S. Vinkeles; Al-Darraji, Haider Abdulrazzaq Abed; Chorgoliani, Dato; Reyes, Hernán M.; Centis, Rosella; Sotgiu, Giovanni; Chadha, Sarabjit; Migliori, Giovanni Battista

doi:10.1016/j.ijid.2014.12.029

Cited by 121 publications

(113 citation statements)

References 49 publications

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“…Many low- and middle-income countries [83] have severely limited prison health facilities, and prisoners with symptoms suggestive of TB may go undiagnosed. In addition, access to appropriate chemoprophylaxis in prisons can be problematic due to reasons such as affordability, circulation of suboptimal drugs and the low priority given to prison healthcare by policymakers [84,85]. In addition, the movement of prisoners, both within and out of the prison system, exacerbates the rate of treatment default.…”

Section: Resultsmentioning

confidence: 99%

Prisoners co‐infected with tuberculosis and HIV: a systematic review

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King

Dolan

et al. 2016

Journal of the International AIDS Society

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IntroductionAlmost from the beginning of the HIV epidemic in 1981, an association with tuberculosis (TB) was recognized. This association between HIV and TB co-infection has been particularly evident amongst prisoners. However, despite this, few studies of TB in prisons have stratified results by HIV status. Given the high prevalence of HIV-positive persons and TB-infected persons in prisons and the documented risk of TB in those infected with HIV, it is of interest to determine how co-infection varies amongst prison populations worldwide. For this reason we have undertaken a systematic review of studies of co-infected prisoners to determine the incidence and/or prevalence of HIV/TB co-infection in prisons, as well as outcomes in this group, measured as treatment success or death.MethodsA literature search was undertaken using the online databases PubMed, Embase, IBSS, Scopus, Web of Science, Global Health and CINAHL Plus. No restrictions were set on language or publication date for article retrieval, with articles included if indexed up to 18 October 2015. A total of 1975 non-duplicate papers were identified. For treatment and outcome data all eligible papers were appraised for inclusion; for incidence/prevalence estimates papers published prior to 2000 were excluded from full text review. After full text appraisal, 46 papers were selected for inclusion in the review, 41 for incidence/prevalence estimates and nine for outcomes data, with four papers providing evidence for both outcomes and prevalence/incidence.ResultsVery few studies estimated the incidence of TB in HIV positive prisoners, with most simply reporting prevalence of co-infection. Co-infection is rarely explicitly measured, with studies simply reporting HIV status in prisoners with TB, or a cross-sectional survey of TB prevalence amongst prisoners with HIV. Estimates of co-infection prevalence ranged from 2.4 to 73.1% and relative risks for one, given the other, ranged from 2.0 to 10.75, although some studies reported no significant association between HIV and TB. Few studies provided a comparison with the risk of co-infection in the general population.ConclusionsPrisoners infected with HIV are at high risk of developing TB. However, the magnitude of risk varies between different prisons and countries. There is little evidence on treatment outcomes in co-infected prisoners, and the existing evidence is conflicting in regards to HIV status influence on prisoner treatment outcomes.PROSPERO Number: CRD42016034068

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Section: Resultsmentioning

confidence: 99%

Prisoners co‐infected with tuberculosis and HIV: a systematic review

Edge

King

Dolan

et al. 2016

Journal of the International AIDS Society

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“…An estimated 60–70% of prisoners testing positive for TB in Eastern Europe are not referred to any care in the community upon release. 260 Dara and colleagues also note that prisons in many countries have not invested in laboratory capacity to use the GeneXpert assay that WHO recommends for diagnosis but rather rely on less accurate tools. 260 Collaboration between TB and HIV authorities and integration of interventions in the two areas is crucial for TB control in prisons but lacking in many places.…”

Section: Drug-related Incarceration and Healthmentioning

confidence: 99%

Public health and international drug policy

et al. 2016

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Executive summary In September 2015, the member states of the United Nations endorsed sustainable development goals (SDG) for 2030 that aspire to human rights-centered approaches to ensuring the health and well-being of all people. The SDGs embody both the UN Charter values of rights and justice for all and the responsibility of states to rely on the best scientific evidence as they seek to better humankind. In April 2016, these same states will consider control of illicit drugs, an area of social policy that has been fraught with controversy, seen as inconsistent with human rights norms, and for which scientific evidence and public health approaches have arguably played too limited a role. The previous UN General Assembly Special Session (UNGASS) on drugs in 1998 – convened under the theme “a drug-free world, we can do it!” – endorsed drug control policies based on the goal of prohibiting all use, possession, production, and trafficking of illicit drugs. This goal is enshrined in national law in many countries. In pronouncing drugs a “grave threat to the health and well-being of all mankind,” the 1998 UNGASS echoed the foundational 1961 convention of the international drug control regime, which justified eliminating the “evil” of drugs in the name of “the health and welfare of mankind.” But neither of these international agreements refers to the ways in which pursuing drug prohibition itself might affect public health. The “war on drugs” and “zero-tolerance” policies that grew out of the prohibitionist consensus are now being challenged on multiple fronts, including their health, human rights, and development impact. The Johns Hopkins – Lancet Commission on Drug Policy and Health has sought to examine the emerging scientific evidence on public health issues arising from drug control policy and to inform and encourage a central focus on public health evidence and outcomes in drug policy debates, such as the important deliberations of the 2016 UNGASS on drugs. The Johns Hopkins-Lancet Commission is concerned that drug policies are often colored by ideas about drug use and drug dependence that are not scientifically grounded. The 1998 UNGASS declaration, for example, like the UN drug conventions and many national drug laws, does not distinguish between drug use and drug abuse. A 2015 report by the UN High Commissioner for Human Rights, by contrast, found it important to emphasize that “[d]rug use is neither a medical condition nor does it necessarily lead to drug dependence.” The idea that all drug use is dangerous and evil has led to enforcement-heavy policies and has made it difficult to see potentially dangerous drugs in the same light as potentially dangerous foods, tobacco, alcohol for which the goal of social policy is to reduce potential harms. Health impact of drug policy based on enforcement of prohibition The pursuit of drug prohibition has generated a parallel economy run by criminal networks. Both these networks, which resort to violence to protect their markets, and the police and sometimes military ...

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“…79 Diagnostic services are often provided by external laboratories, which can lead to delays in diagnosis. 83 Bacteriological services that are run in-house, such as sputum smear microscopy, often lack quality control; the diagnostic microscopes in prisons are often poorly maintained, and staff might have insuffcient training in the use of these diagnostic tools. 84,85 In low-income and middle-income countries, improved laboratory services and biosafety measures are crucial to increase detection and treatment of tuberculosis in prisons.…”

Section: Tuberculosis In Prisonsmentioning

confidence: 99%

“…79,83,91 Both legislation and international guidelines that address these key areas should be implemented to curb transmission and facilitate tuberculosis control in prisons.…”

Section: Tuberculosis In Prisonsmentioning

confidence: 99%

Clinical care of incarcerated people with HIV, viral hepatitis, or tuberculosis

et al. 2016

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The burden of HIV/AIDS and other transmissible diseases is higher in prison and jail settings than in the non-incarcerated communities that surround them. In this comprehensive review, we discuss available literature on the topic of clinical management of people infected with HIV, hepatitis B and C viruses, and tuberculosis in incarcerated settings in addition to co-occurrence of one or more of these infections. Methods such as screening practices and provision of treatment during detainment periods are reviewed to identify the effect of community-based treatment when returning inmates into the general population. Where data are available, we describe differences in the provision of medical care in the prison and jail settings of low-income and middle-income countries compared with high-income countries. Structural barriers impede the optimal delivery of clinical care for prisoners, and substance use, mental illness, and infectious disease further complicate the delivery of care. For prison health care to reach the standards of community-based health care, political will and financial investment are required from governmental, medical, and humanitarian organisations worldwide. In this review, we highlight challenges, gaps in knowledge, and priorities for future research to improve health-care in institutions for prisoners.

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Tuberculosis control in prisons: current situation and research gaps

Abstract: 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.

Cited by 121 publications

References 49 publications

Prisoners co‐infected with tuberculosis and HIV: a systematic review

Prisoners co‐infected with tuberculosis and HIV: a systematic review

Public health and international drug policy

Clinical care of incarcerated people with HIV, viral hepatitis, or tuberculosis

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