Departments of Preventive Medicine, Biostatistics and Pediatrics, Vanderbilt University Institute for Global Health, 2215 Garland Ave., Nashville, TN 37232-0242, USA.
Int J Infect Dis. 2010 Sep;14 Suppl 3:e60-6. doi: 10.1016/j.ijid.2009.11.012. Epub 2010 Mar 1.
The objective of this study was to evaluate the burden of sexual- and injection drug use-related infections in male prisoners in Karachi, Pakistan.
We administered a structured questionnaire in a cross-sectional survey of 365 randomly selected imprisoned men. We analyzed blood for the human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) by ELISA, and for syphilis by rapid plasma reagin with Treponema pallidum hemagglutination assay confirmation. Subjects with possible tuberculosis (World Health Organization criteria) provided sputum samples for an acid-fast bacillus smear and culture.
The prevalence of tuberculosis was 2.2% (95% CI 0.71-3.8%). Of 357 of the randomly selected prisoners (eight refused to give blood), 2.0% (95% CI 0.6-3.4) were HIV-infected; syphilis was confirmed in 8.9% (95% CI 6.0-11.8%), HBV in 5.9% (95% CI 3.5-8.3%), and HCV in 15.2% (95% CI 11.7-18.8). By self-report, 59.2% had used any illicit drugs, among whom 11.8% (95% CI 8.5-15.0) had injected drugs. The median length of stay in the prison had been 3.2 (range 1-72) months.
All four infections were prevalent among the prisoners in Pakistan. Prisons are excellent venues for infectious disease screening and intervention given the conditions of poverty and drug addiction. Collaboration with community-based health providers is vital for post-discharge planning.
本研究旨在评估巴基斯坦卡拉奇男性囚犯中与性行为和注射毒品使用相关的感染负担。
我们对 365 名随机选择的囚犯进行了横断面调查，使用结构化问卷进行调查。我们通过酶联免疫吸附试验（ELISA）分析血液中的人类免疫缺陷病毒（HIV）、乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV），并通过快速血浆反应素与梅毒螺旋体血凝试验确证梅毒。疑似患有结核病（世界卫生组织标准）的患者提供痰液样本进行抗酸杆菌涂片和培养。
结核病的患病率为 2.2%（95%可信区间为 0.71-3.8%）。在随机选择的 357 名囚犯中（8 人拒绝采血），2.0%（95%可信区间为 0.6-3.4%）感染了 HIV；8.9%（95%可信区间为 6.0-11.8%）确诊患有梅毒，5.9%（95%可信区间为 3.5-8.3%）感染了 HBV，15.2%（95%可信区间为 11.7-18.8%）感染了 HCV。据自我报告，59.2%的囚犯使用过任何非法药物，其中 11.8%（95%可信区间为 8.5-15.0%）曾注射毒品。囚犯在监狱中的平均停留时间为 3.2 个月（范围为 1-72 个月）。
所有四种感染在巴基斯坦囚犯中均普遍存在。鉴于贫困和吸毒成瘾的情况，监狱是进行传染病筛查和干预的绝佳场所。与社区卫生提供者合作对于出院后的规划至关重要。
