Министерство Юстиции
Азербайджанской Республики

20 years of ТВ control in the penitentiary system of Azerbaijan: achievements and challenges

E Gurbanova,' R Mekhdiyev,1 F Huseynov,1 О Baghirov,2 R Tahirli3
'Main Medical Department of the Ministry of Justice, Baku, Specialized Treatment Institution for Detainees with Tuberculosis, Baku, laboratory of the Specialized Treatment Institution for Detainees with Tuberculosis, Baku, Azerbaijan,
e-mail: e.gurbanova@prisonhealth.az

Source: Abstract book, 46thWorld Conference on Lung Health of the International Union Against Tuberculosis and Lung Disease   

Background: The Main Medical Department (MMD) of Azerbaijan Ministry of Justice provides healthcare including ТВ services to 24 penitentiary institutions with 16 000 population.

Design and methods: Following political commitment, а ТВ Control Program has been successfully developing in accordance with WHO recommendations over 20 years. It includes early ТВ case finding, qualitative and rapid diagnostics, standard­ized ТВ treatment, strict compliance to DOT and infection control (1С) protocols as well as uninterrupted supply with certified drugs. Quality assured ТВ labora­tory is equipped with phenotypic and genotypic diag­nostic tools for precise ТВ diagnostics. Both drug- susceptible (DS) and drug-resistant (DR.) ТВtreatment is centralized at the Specialized Treatment Institution (STI) with approximately 900 bed-places. IС include administrative (patient segregation in accordance with infectiousness, drug sensitivity profile, treatment phase and detention regimen) environmental (input and extract ventilation, UV lamps) and individual. Patients are offered permanent support of adherence via additional food and hygienic packages as well as psychological support to overcome stress related to disease and imprisonment. Uncompleted ТВ treatment, initiated within the PS, proceeds after release. Having ensured appropriate juridical basis MMD has been collaborating with MoH and NGO to provide support and follow-up of ТВpatients in civilian sector.
Results: Comparing with1995 in 2014 mortality from ТВ among Azerbaijan prison population decreased >65 times. The Programme achieved significant treatment success rate both for new smear positive DS- TB and MDR-TB cases equal 91% and 80% respectively. 100% of inmates pass through ТВ screening in pre-trial isolators and 95% of the prisoners pass through annual mass screening for ТВ including questionnaire, X-ray, and sputum investigation. Special attention is paid to identification and prevention of ТВamong HIV-infected. Training Center functioning since 2012 at the STI was declared WHO CC on ТВprevention and control in prisons and trained >700 medical and non-medical staff of PS. Moreover, delegations from >15 countries visited the Program to get acquainted with the practice. Operational researches are performed on the Pro­gramme's theoretical and practical basis.

Conclusions: Today Azerbaijan ТВ Control in prison Programme is internationally recognized model for penitentiaries in and beyond the European Region.