Screening for tuberculosis and testing for human immunodeficiency virus in Zambian prisons

Maggard, Katie R., Hatwiinda, Sisa, Harris, Jennifer B., Phiri, Winifreda, Krüüner, Annika, Kaunda, Kaunda, Topp, Stephanie M., Kapata, Nathan, Ayles, Helen, Chileshe, Chisela, Henostroza, German, and Reid, Stewart E. (2015) Screening for tuberculosis and testing for human immunodeficiency virus in Zambian prisons. Bulletin of the World Health Organization, 93. pp. 93-101.

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Objective: To improve the Zambia Prisons Service's implementation of tuberculosis screening and human immunodeficiency virus (HIV) testing.

Methods: For both tuberculosis and HIV, we implemented mass screening of inmates and community-based screening of those residing in encampments adjacent to prisons. We also established routine systems – with inmates as peer educators – for the screening of newly entered or symptomatic inmates. We improved infection control measures, increased diagnostic capacity and promoted awareness of tuberculosis in Zambia's prisons.

Findings: In a period of 9 months, we screened 7638 individuals and diagnosed 409 new patients with tuberculosis. We tested 4879 individuals for HIV and diagnosed 564 cases of infection. An additional 625 individuals had previously been found to be HIV-positive. Including those already on tuberculosis treatment at the time of screening, the prevalence of tuberculosis recorded in the prisons and adjacent encampments – 6.4% (6428/100 000) – is 18 times the national prevalence estimate of 0.35%. Overall, 22.9% of the inmates and 13.8% of the encampment residents were HIV-positive.

Conclusion: Both tuberculosis and HIV infection are common within Zambian prisons. We enhanced tuberculosis screening and improved the detection of tuberculosis and HIV in this setting. Our observations should be useful in the development of prison-based programmes for tuberculosis and HIV elsewhere.

Item ID: 39596
Item Type: Article (Research - C1)
ISSN: 1564-0604
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Funders: Stop TB Partnership (STB), Elizabeth Glaser Pediatric AIDS Foundation, Centers for Disease Control and Prevention
Projects and Grants: STB T9-370-114ZAM)
Date Deposited: 29 Jul 2015 01:35
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111799 Public Health and Health Services not elsewhere classified @ 100%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920404 Disease Distribution and Transmission (incl. Surveillance and Response) @ 50%
92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920599 Specific Population Health (excl. Indigenous Health) not elsewhere classified @ 50%
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