Adjei Andrew A, Armah Henry B, Gbagbo Foster, Ampofo William K, Boamah Isaac, Adu-Gyamfi Clement, Asare Isaac, Hesse Ian F A, Mensah George
Department of Pathology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana.
BMC Infect Dis. 2008 Mar 7;8:33. doi: 10.1186/1471-2334-8-33.
Prisons are known to be high-risk environments for the spread of bloodborne and sexually transmitted infections. Prison officers are considered to have an intermittent exposure potential to bloodborne infectious diseases on the job, however there has been no studies on the prevalence of these infections in prison officers in Ghana.
A national multicenter cross-sectional study was undertaken on correlates of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis infections in sample of prison inmates and officers from eight of ten regional central prisons in Ghana. A total of 1366 inmates and 445 officers were enrolled between May 2004 and December 2005. Subjects completed personal risk-factor questionnaire and provided blood specimens for unlinked anonymous testing for presence of antibodies to HIV, HCV and Treponema pallidum; and surface antigen of HBV (HBsAg). These data were analyzed using both univariate and multivariate techniques.
Almost 18% (1336) of 7652 eligible inmates and 21% (445) of 2139 eligible officers in eight study prisons took part. Median ages of inmates and officers were 36.5 years (range 16-84) and 38.1 years (range 25-59), respectively. Among inmates, HIV seroprevalence was 5.9%, syphilis seroprevalence was 16.5%, and 25.5% had HBsAg. Among officers tested, HIV seroprevalence was 4.9%, HCV seroprevalence was 18.7%, syphilis seroprevalence was 7.9%, and 11.7% had HBsAg. Independent determinants for HIV, HBV and syphilis infections among inmates were age between 17-46, being unmarried, being illiterate, female gender, being incarcerated for longer than median time served of 36 months, history of homosexuality, history of intravenous drug use, history of sharing syringes and drug paraphernalia, history of participation in paid sexual activity, and history of sexually transmitted diseases. Independent determinants for HIV, HBV, HCV and syphilis infections among officers were age between 25-46, fale gender, being unmarried, being employed in prison service for longer than median duration of employment of 10 years, and history of sexually transmitted diseases.
The comparably higher prevalence of HIV, HBV, HCV and syphilis in prison inmates and officers in Ghana suggests probable occupational related transmission. The implementation of infection control practices and risk reduction programs targeted at prison inmates and officers in Ghana is urgently required to address this substantial exposure risk.
监狱是血源性和性传播感染传播的高风险环境。监狱工作人员在工作中被认为有间歇性接触血源性传染病的风险，然而，加纳尚未有关于监狱工作人员中这些感染患病率的研究。
对加纳十个地区中心监狱中的八个监狱的囚犯和工作人员样本进行了一项全国多中心横断面研究，以探讨人类免疫缺陷病毒（HIV）、乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）和梅毒感染的相关因素。2004年5月至2005年12月期间，共招募了1366名囚犯和445名工作人员。受试者完成了个人风险因素问卷，并提供血液样本进行不关联匿名检测，以检测HIV、HCV和梅毒螺旋体抗体以及HBV表面抗原（HBsAg）的存在情况。这些数据采用单变量和多变量技术进行分析。
八个研究监狱中，7652名符合条件的囚犯中有近18%（1336名）、2139名符合条件的工作人员中有21%（445名）参与了研究。囚犯和工作人员的年龄中位数分别为36.5岁（范围16 - 84岁）和38.1岁（范围25 - 59岁）。在囚犯中，HIV血清阳性率为5.9%，梅毒血清阳性率为16.5%，25.5%的人HBsAg呈阳性。在接受检测的工作人员中，HIV血清阳性率为4.9%，HCV血清阳性率为18.7%，梅毒血清阳性率为7.9%，11.7%的人HBsAg呈阳性。囚犯中HIV、HBV和梅毒感染的独立决定因素包括年龄在17 - 46岁之间、未婚、文盲、女性、被监禁时间超过36个月的中位数服刑时间、同性恋史、静脉吸毒史、共用注射器和吸毒用具史、参与有偿性活动史以及性传播疾病史。工作人员中HIV、HBV、HCV和梅毒感染的独立决定因素包括年龄在25 - 46岁之间、男性、未婚、在监狱服务工作超过10年的中位数工作时长以及性传播疾病史。
加纳监狱囚犯和工作人员中HIV、HBV、HCV和梅毒的患病率相对较高，表明可能存在职业相关传播。迫切需要在加纳针对监狱囚犯和工作人员实施感染控制措施和风险降低计划，以应对这一巨大的接触风险。
