S Hatwiinda1, S M Topp1,2, M Siyambango1, J B Harris1, K R Maggard1, C Chileshe3, N Kapata4, S E Reid1,5, G Henostroza1,5. 1. Centre for Infectious Disease Research in Zambia, Lusaka, Zambia. 2. College of Public Health, Medical & Veterinary Sciences, James Cook University, Townsville, Australia. 3. Zambia Ministry of Home Affairs, Lusaka, Zambia. 4. Zambia Ministry of Health, National Tuberculosis Program, Lusaka, Zambia. 5. University of Alabama at Birmingham, Birmingham, AL, USA.
Abstract
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.
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.
Authors: Stephanie M Topp; Anjali Sharma; Clement N Moonga; Chisele Chileshe; George Magwende; German Henostroza Journal: BMJ Glob Health Date: 2018-01-30
Authors: Stephanie M Topp; Anjali Sharma; Chisela Chileshe; George Magwende; German Henostroza; Clement N Moonga Journal: Int J Equity Health Date: 2018-09-24