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Co-infections TB/HIV in prison Côte d’Ivoire Case study

Ministry of Health and the fight against AIDS. Ministry of Justice,. Co-infections TB/HIV in prison Côte d’Ivoire Case study. Doctor J-M MASUMBUKO ESTHER Coordinator in Côte d’ivoire 24 July 2014 20 th IAC, Melbourne, Australia. Introduction.

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Co-infections TB/HIV in prison Côte d’Ivoire Case study

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  1. Ministry of Health and the fight against AIDS Ministry of Justice, Co-infections TB/HIV in prison Côte d’Ivoire Case study Doctor J-M MASUMBUKO ESTHER Coordinator in Côte d’ivoire 24 July 2014 20th IAC, Melbourne, Australia

  2. Introduction • Cote d’Ivoire : the most affected country in West Africa : • HIV 3,7% • MACA = 5.000 prison inmates / 50% of prison population • HIV in MACA 5,5% Men : 4,6 % Women : 14,1 % • Before 2008:Management of HIV in Prison almost non existent • PROJET MACA/CHU BORDEAUX 2008 (ESTHER) • Extension of the support 22/33 withaid of Global Fund (Subrecipient of National AIDS program)

  3. Key Features of prison situation • Limited medical care • Overpopulation (200-300%) • High mortality rate • lack of hygiene / Cholera Epidemic 2012 • Drug and alcoholdependence • Homosexuality, sexworkers • poordiet / BERI-BERI cases

  4. Strategy to fight HIV-TB in prisons (1) Provide screening to all (inmates and staff) • TB • screening atarrival • Externalise sputumanalysis • HIV • offer of testing on arrival • Biologicalassesment if HIV+

  5. Strategy to fight HIV-TB in prisons (2) Provide treatment and Care to all • TB - Isolation of TB patients and contact tracing • DOTS • HIV • initiation of treatment and follow-up according to the national protocol Adequate and sufficient food with dietary supplements

  6. Strategy to fight HIV-TB in prisons (3) • Advocate for Health and rights in Prisons: • Design a model of intervention replicable in all prisons • Respect confidentiality and rights • Contribute to the writing and validation of the first « National Recommendations for Health in Prisons »

  7. Support of TB patients in Prisons in 2013 (National Program) •22/33 prisons offered support to TB patients

  8. HIV – 2013 Results (8 prisons : MACA + 7/ Projet ESTHER/GF) 18.000 inmatesoffered HIV testing Take up rate : 76% HIV infection Rate: Men: 2,92% Women : 10%

  9. TB among HIV pts in 12 prisons 1st quarter 2014 (ESTHER/GF)

  10. TB Treatment centre within MACA • A treatment and care center and a reference center for other prisons • Shouldbereplicated in all regions • 2013 Results : • New cases of TB: 24 • TB (extra pulmonary) : 08 • TB patients tested HIV+ : 07 (22%)

  11. Key Challenges (1) • Lack of Health Services in prisons • Lack of qualifiedhealth personnel • PoorDiet • Overpopulation

  12. Key Challenges (2) • No preventiontools and policy for HIV / STI • Difficulty of patient follow up on release • Poor data on Drug-Résistance ESTHER/ANRS Study on multi-drug resistant TB (Starting Nov. 2014)

  13. Conclusions (1) • Screening TB /HIV in Prisons : a major Public healthpriority • Need for betterhealth services and qualified personnel • Comprehensive patient management critical for reduction of drugresistance and transmission

  14. Conclusions (2) • Additionalfinancialresourcesrequired • Projet ESTHER = Advocating for Health in Prisons ; Finalisation and political validation of the first National Recommendation of Health in Prisons

  15. Thanks • Ministry of Health - Cote d’Ivoire • Justice Ministry – Cote d’Ivoire • National HIV Program / Global Fund • Cote d’Ivoire/France Hospitalpartnerships • Prisons staff • Communityconsellors • NGO’sinvolved in pris on project • Prison inmates • ESTHER • Jeanne D’Arc Ouattara • Sidaction

  16. The MACA TEAM

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