Department of Community Medicine, Government Medical College, Surat, India.
Department of Pulmonary Medicine, Government Medical College, Surat, India.
Indian J Tuberc. 2022 Apr;69(2):213-219. doi: 10.1016/j.ijtb.2021.08.001. Epub 2021 Aug 12.
In a close knit congregation such as prison, Tuberculosis (TB) and HIV can be major health problems. However, their prevalence in Indian prisons is under reported. This study aimed at adopting a camp based, active case finding approach to identify cases of TB, HIV and at risk prisoners in a central prison of South Gujarat.
A multidisciplinary team of public health experts, pulmonologists, social workers and lab technicians conducted a week-long camp to screen 1665 prisoners for TB using clinical examination, sputum smear for AFB, CBNAAT and Chest X-Ray and for HIV through Rapid Antigen Testing.
Majority of participants (1392, 84%) were under trail prisoners, having spent an average of 1.4 years in prison. About 2.9% of participants had previous history of TB, of whom only 59% had completed treatment. About 14% of participants were underweight. Weight reduction was found to be significant in first five years of imprisonment. Of all participants, 3.6% were found to have diabetic range of blood sugar. Seven new active, drug sensitive pulmonary TB cases and three new cases of HIV infection were identified. All new cases of TB, HIV and increased blood sugar levels were linked to treatment.
Camp based approach is effective in active case finding of pulmonary TB and predisposing factors such as malnourishment, Diabetes and HIV among prisoners. Routine screening of all prisoners at the time of entry and monthly thereafter in a camp based approach should be adopted to identify TB and at risk prisoners.
在监狱这样紧密的群体中，结核病 (TB) 和艾滋病病毒 (HIV) 可能是严重的健康问题。然而，它们在印度监狱中的流行情况报告不足。本研究旨在采用基于营地的主动病例发现方法，在古吉拉特邦中部的一所中央监狱中发现结核病、艾滋病病毒和高危囚犯。
一个由公共卫生专家、肺病专家、社会工作者和实验室技术人员组成的多学科团队进行了为期一周的营地活动，对 1665 名囚犯进行结核病筛查，使用临床检查、痰涂片抗酸杆菌、CBNAAT 和胸部 X 射线，以及通过快速抗原检测筛查艾滋病病毒。
大多数参与者（1392 人，占 84%）是在押囚犯，平均入狱时间为 1.4 年。约 2.9%的参与者有结核病既往史，其中只有 59%完成了治疗。约 14%的参与者体重不足。入狱头五年体重减轻明显。在所有参与者中，有 3.6%的人血糖处于糖尿病范围。发现 7 例新的活动性、药物敏感型肺结核病例和 3 例新的艾滋病病毒感染病例。所有新的结核病、艾滋病病毒和血糖升高病例都与治疗有关。
营地方法在发现监狱中囚犯的活动性肺结核和营养不良、糖尿病和艾滋病等易感因素方面是有效的。应采用营地方法在囚犯入狱时和之后每月对所有囚犯进行常规筛查，以发现结核病和高危囚犯。
