Poor continuity of care for TB diagnosis and treatment in Zambian prisons: a situation analysis

Hatwiinda, S., Topp, S.M., Siyambango, M., Harris, J.B., Maggard, K.R., Chileshe, C., Kapata, N., Reid, S.E., and Henostroza, G. (2018) Poor continuity of care for TB diagnosis and treatment in Zambian prisons: a situation analysis. Tropical Medicine and International Health, 23 (2). pp. 243-250.

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Objectives: Prisons act as infectious disease reservoirs. We aimed to explore the challenges of TB control and continuity of care in prisons in Zambia.

Methods: We evaluated treatment outcomes for a cohort of inmates diagnosed with TB during a TB REACH funded screening programme initiated by the Zambia Prisons Service and the Centre for Infectious Disease Research in Zambia.

Results: Between October 2010 and September 2011, 6282 inmates from six prisons were screened for TB, of whom 374 (6.0%) were diagnosed. TB treatment was initiated in 345 of 374 (92%) inmates. Of those, 66% were cured or completed treatment, 5% died and 29% were lost to follow-up. Among those lost to follow-up, 11% were released into the community and 13% were transferred to other prisons.

Conclusions: Weak health systems within the Zambian prison service currently undermines continuity of care, despite intensive TB screening and case-finding interventions. To prevent TB transmission and the development of drug resistance, we need sufficient numbers of competent staff for health care, reliable health information systems including electronic record keeping for prison facilities, and standard operating procedures to guide surveillance, case-finding and timely treatment initiation and completion.

Item ID: 52610
Item Type: Article (Research - C1)
ISSN: 1365-3156
Keywords: prisons, health systems, continuity of care, tuberculosis
Funders: TB REACH, Stop TB Program, World Health Organization (TB), United States Centers for Disease Control and Prevention (US CDCP)
Projects and Grants: TB T9-370-114ZAM, US CDCP President's emergency fund for AIDS relief, US CDCP Elizabeth Glaser Pediatric AIDS foundation
Date Deposited: 23 Feb 2018 04:43
FoR Codes: 42 HEALTH SCIENCES > 4206 Public health > 420699 Public health not elsewhere classified @ 50%
32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320211 Infectious diseases @ 50%
SEO Codes: 92 HEALTH > 9202 Health and Support Services > 920299 Health and Support Services not elsewhere classified @ 60%
92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920599 Specific Population Health (excl. Indigenous Health) not elsewhere classified @ 40%
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