Ministry of Justice
of the Azerbaijan Republic

Early case-finding and its impact on the TB burden in prisons of Azerbaijan, Abstract

E Gurbanova1,2 , R Mehdiyev1, K Blondal3, A Altraja4,5

1 Ministry of Justice, Main Medical Department, Baku, Azerbaijan;
2 University of Tartu,Department of Pulmonary Medicine,Tartu,Estonia;
3Reykjavik Health Care Services, Department of Communicable Disease Prevention and Control, Reykjavik, Iceland;
4Univeristy of Tartu, Department of Pulmonary Medicine, Tartu,
5Tartu University Hospital, Lung Clinic,Tartu,Estonia.
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Source: Abstract Book, 47th World International Conference on Lung Health of the International Union Against Tuberculosis and Lung Disease

Background: Early case finding is the cornerstone for tuberculosis (TB) transmission reduction and treatment success. The Main Medical Department (MMD) of the Ministry of Justice (MoJ) of Azerbaijan has provided health care to inmates for more than 20 years, and is a WHO Collaborating Center for prevention and control of TB in prisons. We assessed the impact of improved systematic screening to TB burden in penitentiary system (PS) of Azerbaijan.
Methods: During 2009–2011 case finding strategy in Azerbaijan PS included the mass screening and incom- plete passive case finding. During the period 2009-2011, the cases with presumable TB identified based on symptoms did not have access to initial diagnostic test resulted with only patients on advanced stages of TB disease were transferred to Prison TB Hospital for diagnosis and further treatment. Mass screening was implemented annually via standard questionnaire and chestx-ray with further smear microscopy and/or culture on  solid media  as an initial  diagnostic  test. In 2012, weekly transportation of sputum samples from clinically identified presumable TB cases for Xpertw MTB/RIF testing was introduced in all prisons ensuring early TB case finding, complimentary to the annual massscreening. Since 2012, entry screening with standard questionnaire,chestx-ray and Xpert testing was introduced in the general prison hospital.All identified cases were treated with WHO-recommended treatment regimens.
Results: Number and proportion of identified smear positive TB cases, rifampicin resistant TB cases andcases with BMI,18.5kg/m2  decreased significantly in PS of Azerbaijan after introduction of enhanced case finding strategy. Treatment success with first-line drugs among new bacteriologically confirmed TB cases increased significantly.
Conclusion: Early case finding through systematically applied enhanced screening algorithm significantly de- creases the TB/RR-TB burden and improves treatment outcomes in PS.