Results of international approach to TB Control in Prison: Azerbaijan experience (Abstract)
17.10.2012
R. Mehdiyev, E. Gurbanova, F. Huseynov, N. Rahmanov. Main Medical Department of the Ministry of Justice, Azerbaijan
Summary:
FLD and SLD treatment in accordance to DOTS strategy for the first time in Azerbaijan has been started in penitentiary sector. The Program was launched by MoJ in 1995 with ICRC technical assistance and government consistent support. SLD treatment has been performed in penitentiary sector since 2007.
Effective mixture of international approach to TB Control in Prison Program, its adaptation to security regimes and strict infection control measures leaded to epidemiological situation improvement.
Methodology:
Azerbaijan TB Control in Prison Program e-database analysis for last five years was performed. All DR-TB patients identified in Penitentiary System were enrolled to study. DR-TB cases resistance patterns, disease severity level, co-infections, risk factors and treatment results were analyzed.
Results:
Starting from 2007 to 2011 inclusively 439 DR-TB patients were enrolled to SLD treatment. First 200 DR-TB patients’ cohort Treatment Success rate is 75%. DR-TB patients with destruction in both lungs number considerably decreased from 64% to 19%. MDR-TB among new SS+ cases reduced from 12% to 5%. DR-TB patients’ sensitivity to every anti-TB drug was separately examined and revealed the following:
· Stabile high resistance rate to H/R and decreasing rate to S/E/Z/PTO among new cases;
· Decreasing resistance rate to all anti-TB drugs among retreatment cases.
69% of DR-TB patients are re-imprisoned and this figure stays constant in each annual cohort.
Increasing TB/HIV co-infection rate from 3% to 12%, TB/HIV/Hepatitis C from 3% to 10%, steady high TB/Hepatitis C rate on average 63% of DR-TB patients cause significant concerns.
Conclusion:
Effective TB Control in Prison activities resulted with:
· Decrease of cases on disease’s severe stage;
· Lighten of DR-TB patients resistance burden;
· Decrease of MDR-TB among new SS+ cases;
· High DR-TB treatment success rate.
Re-imprisonment is DR-TB development risk factor. Increasing TB/HIV level, high TB/Hepatitis C and TB/HIV/Hepatitis C level is an alarming fact requiring investigations and emergency measures implementation.