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Tuberculosis in correctional institutions in Albania

Tuberculosis in correctional institutions in Albania. Hasan Hafizi, Anila Aliko, Silva Bala, Silva Tafaj. Tuberculosis in correctional institutions. The level of TB in prisons has been reported to be up to 100 times higher than that of the civilian population.

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Tuberculosis in correctional institutions in Albania

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  1. Tuberculosis in correctional institutions in Albania Hasan Hafizi, Anila Aliko, Silva Bala, Silva Tafaj

  2. Tuberculosis in correctional institutions • The level of TB in prisons has been reported to be up to 100 times higher than that of the civilian population. • Cases of TB in prisons may account for up to 25% of a country’s burden of TB. • Late diagnosis, inadequate treatment, overcrowding, poor ventilation and repeated prison transfers encourage the transmission of TB infection. • HIV infection and other pathology more common in prisons (e.g. malnutrition, substance abuse) encourage the development of active disease and further transmission of infection.

  3. Why prisons are different? • Prisoners do not represent a cross section of society but a high proportion of inmates are poorly educated and socio-economically disadvantaged. • The ministry responsible for health care in prisons is the ministry of justice and the ministry of interior. • Delayed diagnosis and substandard treatment are common.

  4. TB in correctional institutions in Albania • Data on TB in correctional institution in Albania started to be reported in 2003. • There are around 5200 imamates in Albania and more or less the same number Albanian inmates abroad (in Italy and Greece) • Few cases were reported annually and underreporting and no diagnosis was suspected

  5. OBJECTIVE • To estimate the prevalence of latent TB infection (LTBI) in the correctional institutions • To estimate the prevalence of TB

  6. METHOD • Cross sectional study. • 8 out of 25 institutional corrections randomly chosen. • 1500 inmates out of 5200 of all inmates underwent tuberculin test skin (TST), clinical and chest x-ray examination. • In suspected cases: smear examination and culture.

  7. RESULTS • Of 1500 inmates selected, evaluable TST were obtained from 1361 because 139 declined examination(9%). • The overall prevalence of LTBI for inmates taking into account the induration size of TST ≥ 5mm, was 57% (788 cases). • The most affected inmates with LTBI were young adult group belong to age group 25-34 old and people originated by higher incidence areas of the country.

  8. RESULTS • The prevalence of LTBI is much higher than general population, 57% of inmates were with LTBI compare to 12% of general population. • The number of inmates candidates for chemoprophylaxis (TST≥10mm) was 489 (36%).

  9. RESULTS • The most prevailing symptom was chronic cough - 10.2% of inmates but cough was associated with smoking as 90% of imamates were smoker. • All cases with chronic cough underwent smear and culture examination and only 1 case resulted with TB

  10. RESULTS • 1080 inmates underwent x-ray examination with portable fluoroscopy. • 1 TB pulmonary case was detected by fluoroscopy and confirmed by smear and culture • 6 cases resulted with fibrotic lesion due to previous TB.

  11. CONCLUSION • TB in correctional institutions reflects the TB epidemiological situation in Albania and doesn’t constitute a problem for the time being. • Nevertheless, considering the high rate of LTBI, strengthening of the preventive measures is recommended • Active screening is expensive and is not recommended for TB detection in correctional institutions

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