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. 2021 Sep 10;18(18):9566.
doi: 10.3390/ijerph18189566.

Tuberculosis Notification Trends and Treatment Outcomes in Penitentiary and Civilian Health Care Sectors in the WHO European Region

Andrei Dadu  1 , Ana Ciobanu  2 , Araksya Hovhannesyan  1 , Natavan Alikhanova  3 , Oleksandr Korotych  1 , Elmira Gurbanova  4 , Rafael Mehdiyev  3 , Svetlana Doltu  5 , Ogtay Gozalov  1 , Sevim Ahmedov  6 , Masoud Dara  1
Affiliations

Tuberculosis Notification Trends and Treatment Outcomes in Penitentiary and Civilian Health Care Sectors in the WHO European Region

Andrei Dadu et al. Int J Environ Res Public Health. .

Abstract

Setting: Tuberculosis (TB) morbidity in penitentiary sectors is one of the major barriers to ending TB in the World Health Organization (WHO) European Region.

Objectives and design: a comparative analysis of TB notification rates during 2014-2018 and of treatment outcomes in the civilian and penitentiary sectors in the WHO European Region, with an assessment of risks of developing TB among people experience incarceration.

Results: in the WHO European Region, incident TB rates in inmates were 4-24 times higher than in the civilian population. In 12 eastern Europe and central Asia (EECA) countries, inmates compared to civilians had higher relative risks of developing TB (RR = 25) than in the rest of the region (RR = 11), with the highest rates reported in inmates in Azerbaijan, Kazakhstan, Kyrgyzstan, Republic of Moldova, Russian Federation, and Ukraine. The average annual change in TB notification rates between 2014 and 2018 was -7.0% in the civilian sector and -10.9% in the penitentiary sector. A total of 15 countries achieved treatment success rates of over 85% for new penitentiary sector TB patients, the target for the WHO European Region. In 10 countries, there were no significant differences in treatment outcomes between civilian and penitentiary sectors.

Conclusion: 42 out of 53 (79%) WHO European Region countries reported TB data for the selected time periods. Most countries in the region achieved a substantial decline in TB burden in prisons, which indicates the effectiveness of recent interventions in correctional institutions. Nevertheless, people who experience incarceration remain an at-risk population for acquiring infection, developing active disease and unfavourable treatment outcomes. Therefore, TB prevention and care practices in inmates need to be improved.

Keywords: WHO European Region; notification; outcomes; prisons; tuberculosis.

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Conflict of interest statement

None of the authors have conflict of interest to declare. The views and opinions expressed in this paper are those of the authors and not necessarily the views and decisions or policies of the World Health Organization, and/or the United States Agency for International Development. The designations used and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of WHO and USAID concerning the legal status of any country, territory, city or area or of its authorities, nor concerning the delimitation of its frontiers or boundaries.

Figures

Figure 1
Figure 1
Countries/states selected for case analysis based on the availability of TB reporting forms. TB: tuberculosis; WHO: World Health Organization.
Figure 2
Figure 2
Notification rate of incident TB cases in the penitentiary sector per 100,000 population, WHO European Region, 2018. TB: tuberculosis; WHO: World Health Organization.
Figure 3
Figure 3
Trends in TB notification rates in the civilian and penitentiary sectors, WHO European Region, 2014–2018. TB: tuberculosis; WHO: World Health Organization. a EECA country. Note: TB notification rate: number of new and relapse tuberculosis cases registered and reported per 100,000 population.
Figure 3
Figure 3
Trends in TB notification rates in the civilian and penitentiary sectors, WHO European Region, 2014–2018. TB: tuberculosis; WHO: World Health Organization. a EECA country. Note: TB notification rate: number of new and relapse tuberculosis cases registered and reported per 100,000 population.
Figure 4
Figure 4
Relative risks of developing TB among prisons’ inmates compared to civilian population, WHO European Region, 2014–2018. TB: tuberculosis; WHO: World Health Organization.
See this image and copyright information in PMC

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