Maggard Katie R, Hatwiinda Sisa, Harris Jennifer B, Phiri Winifreda, Krüüner Annika, Kaunda Kaunda, Topp Stephanie M, Kapata Nathan, Ayles Helen, Chileshe Chisela, Henostroza German, Reid Stewart E
Centre for Infectious Disease Research in Zambia, 5032 Great North Road, PO Box 34681, Lusaka, 10101, Zambia .
University of Alabama at Birmingham, Birmingham, United States of America .
Bull World Health Organ. 2015 Feb 1;93(2):93-101. doi: 10.2471/BLT.14.135285.
To improve the Zambia Prisons Service's implementation of tuberculosis screening and human immunodeficiency virus (HIV) testing.
For both tuberculosis and HIV, we implemented mass screening of inmates and community-based screening of those residing in encampments adjacent to prisons. We also established routine systems – with inmates as peer educators – for the screening of newly entered or symptomatic inmates. We improved infection control measures, increased diagnostic capacity and promoted awareness of tuberculosis in Zambia's prisons.
In a period of 9 months, we screened 7638 individuals and diagnosed 409 new patients with tuberculosis. We tested 4879 individuals for HIV and diagnosed 564 cases of infection. An additional 625 individuals had previously been found to be HIV-positive. Including those already on tuberculosis treatment at the time of screening, the prevalence of tuberculosis recorded in the prisons and adjacent encampments – 6.4% (6428/100,000) – is 18 times the national prevalence estimate of 0.35%. Overall, 22.9% of the inmates and 13.8% of the encampment residents were HIV-positive.
Both tuberculosis and HIV infection are common within Zambian prisons. We enhanced tuberculosis screening and improved the detection of tuberculosis and HIV in this setting. Our observations should be useful in the development of prison-based programmes for tuberculosis and HIV elsewhere.
改善赞比亚监狱管理局对结核病筛查和人类免疫缺陷病毒（HIV）检测的实施情况。
对于结核病和HIV，我们对囚犯进行了大规模筛查，并对居住在监狱附近营地的人员进行了社区筛查。我们还建立了常规系统——让囚犯担任同伴教育者——对新入狱或有症状的囚犯进行筛查。我们改进了感染控制措施，提高了诊断能力，并提高了赞比亚监狱对结核病的认识。
在9个月的时间里，我们筛查了7638人，诊断出409例新的结核病患者。我们对4879人进行了HIV检测，诊断出564例感染病例。另外有625人此前被发现HIV呈阳性。包括筛查时已在接受结核病治疗的人员在内，监狱及附近营地记录的结核病患病率为6.4%（6428/100,000），是全国估计患病率0.35%的18倍。总体而言，22.9%的囚犯和13.8%的营地居民HIV呈阳性。
结核病和HIV感染在赞比亚监狱中都很常见。我们加强了结核病筛查，改善了在这种情况下对结核病和HIV的检测。我们的观察结果应有助于其他地方制定基于监狱的结核病和HIV项目。
