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TB control in Dutch prisons

TB control in Dutch prisons. Ministry of Justice: J. Bastiani, MPH GGD Nederland: J. Doosje, MPH. overview. Introduction Medical Care in prisons TB control in the Netherlands TB screening programme in prisons 1994-2005 Conclusions, future perspective Acknowledgements. DJI organisation.

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TB control in Dutch prisons

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  1. TB control in Dutch prisons Ministry of Justice: J. Bastiani, MPH GGD Nederland: J. Doosje, MPH

  2. overview • Introduction • Medical Care in prisons • TB control in the Netherlands • TB screening programme in prisons 1994-2005 • Conclusions, future perspective • Acknowledgements TB screening in Dutch prisons: September 17, 2007

  3. DJI organisation • DJI is an agency of Min. of Justice • DJI is the implementing agency • Daily 16.000 persons detained • Sectors: GW (prisons, house of detention) TBS (detention ‘in her Majesty’s pleasure’) DBV ( detention centres for illegals en refugees) JJI (youth detention) All with their own director and management

  4. Medical Care in prison • At 80 locations medical services • Professionals: plm 450 nurses and 80 physiciens. • Psychologist, psychiatrist, dentist and paramedics

  5. Populatie kenmerken Tabel 1

  6. Populatiekenmerken • Tabel 2

  7. Populatiekenmerken • Tabel 3

  8. Populatiekenmerken • Tabel 4

  9. Health characteristics • Risk group for STD’s, hepatitis, • Endemic risk areas • > 40 % detained has serious addiction related problems • > 50 % detained has one or more psychiatric disorders

  10. TB screening in Dutch prisons: September 17, 2007

  11. TB incidence in Dutch population 1972 – 2005* • 1972: 2458 = 18/100.000 • 1987: 1192 = 8/100.000 • 1994: 1811 = 12/100.000 • 1996: 10.7/100.000 • 2005: 8.2/100.000 * Referentie.: Tuberculose in Nederland 2005, surveillance rapport over de tuberculosesituatie in Nederland, KNCV Tuberculosefonds, 2007 TB screening in Dutch prisons: September 17, 2007

  12. *Referentie: Jaarverslag Tuberculose-onderzoek in Penitentiaire inrichtingen, 2007, GGD Flevoland en GGD Hart voor Brabant, W. Haddad TB screening in Dutch prisons: September 17, 2007

  13. TB prevalence in Dutch prisons 1994 – 2005* • Number of PI’s included in programme: 57 • 277.000 screenings in 10 years, • 240 TB cases • In average 25 new cases per year • Mean: prevalence 89/100.000 over the last 10 years • Prevalence 52/100.000 in 2005 *Referentie: Jaarverslag Tuberculose-onderzoek in Penitentiaire inrichtingen, 2007, GGD Flevoland en GGD Hart voor Brabant, W. Haddad TB screening in Dutch prisons: September 17, 2007

  14. Number of TB cases in Dutch prisons in 2005 TB screening in Dutch prisons: September 17, 2007

  15. ZN smear +/- direct versus culture TB screening in Dutch prisons: September 17, 2007

  16. Division by age in 2005 TB screening in Dutch prisons: September 17, 2007

  17. TB screening in Dutch prisons: September 17, 2007

  18. TB screening in Dutch prisons: September 17, 2007

  19. Conclusions • Decreasing incidence rate in the Netherlands • Low prevalence of TB in prisons after 10 years • Mobile Rontgen Units proven to be effective as screening instrument • Continuing screening in following years Future perspective • Improving screening instrument: • Efficiency: better data exchange and data match (adjusting of prevalence rate) ICT – national data base • Set up research to define risk groups within prisons TB screening in Dutch prisons: September 17, 2007

  20. Optimise TB Control by using Mobile Röntgen Units! TB screening in Dutch prisons: September 17, 2007

  21. Acknowledgements • GGD Hart voor Brabant, Wallid Haddad • GGD Flevoland, Rene Jonker, Dick Fleury • KNCV Tuberculosefonds • DJI • GGD Nederland TB screening in Dutch prisons: September 17, 2007

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