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At least 235 records · Page 13Linked to original sources
PubMed2000

Pulmonary tuberculosis in prisons of the ex-USSR state Georgia: results of a nation-wide prevalence survey among sentenced inmates.

SETTING: The penitentiary system of the ex-USSR state of Georgia. OBJECTIVES: To measure the prevalence of active pulmonary tuberculosis and drug-resistant disease among prisoners. To identify factors associated with active tuberculosis and multidrug resistance (MDR). DESIGN: A comprehensive multiphasic screening survey for tuberculosis. RESULTS: The prevalence of smear- or culture-positive tuberculosis was 5995 per 100,000 prisoners (n = 448 cases among 7473 inmates). Of all the strains, 215 (77.9%) were resistant to at least one drug and 37 (13.0%) were MDR. Independent risk markers associated smear- or culture-positive tuberculosis with included prison stay of 2 years or more, body mass index <20 kg/m2, accommodation in a large size prison, previous anti-tuberculosis treatment, cough of 2 weeks or more and loss of appetite. Risk markers associated with MDR were a prison stay of less than 2 years and being over 25 years of age. CONCLUSIONS: In Georgia, the excess risk for tuberculosis among prisoners is unprecedented, suggesting that prisons represent a significant reservoir of tuberculosis. Only a comprehensive strategy for tuberculosis control in prisons, including prison reform, control of anti-tuberculosis drugs, and prompt and efficient diagnosis and treatment of patients can have an impact on the tuberculosis burden in the prison system.

Adult↗
PubMed2001

[Dermatological consultation behind bars: an analysis on a three-year period in a French prison].

BACKGROUND: Since 1994, health care in French prisons is managed by the public hospital system. The hospitals created ambulatory consultation units for prisons and detention centers. Skin problems rapidly became a frequent reason for consultation. This is the first systematic assessment of needs concerning dermatological consultation in prisons. MATERIAL AND METHODS: A monthly dermatology consultation was established at the Colmar detention center in May 1996. We reviewed the files of all prisoners who attended between May 1996 and May 1999. Data collected concerned motivation for the consultation, drug use and serology for HIV and hepatitic C virus. RESULTS: There were 280 consultations for 180 prisoners. All were men, mean age 30 years, who represented 16% of the total prisoner population. Most consulted for one or more benign skin conditions. The two most frequent conditions were acne (29%) and mycoses (13%). Drug use was found in 36% of the consulting prisoners (64/180). One was HIV-positive. Hepatitis C virus serology was positive in 19% of those tested (28/149), and in 39% of the drug users and 2% of the non-drug users. Motivation for consultation did not differ between drug users and non users, neither between seropositive and seronegative patients for hepatitis C virus. DISCUSSION: This survey confirms the demand for dermatology consultation in the prison population and points out the frequency of hepatitis C virus in prisoners. A monthly specialized consultation was able to meet the basic demands concerning dermatology. Adapted management of hepatitis C virus in the prison population setting remains a difficult challenge.

Adolescent↗
PubMed2003

Rapid assessment of tuberculosis in a large prison system--Botswana, 2002.

Prisons are settings in which tuberculosis (TB) transmission occurs, and TB rates in prisons are often five to 10 times higher than national rates. Data on the prevalence of TB in prisons in Africa are limited; however, studies from Malawi, Ivory Coast, and Tanzania that used active screening found TB rates > or = 10 times higher than national rates. During 1989-2001, TB rates in Botswana increased threefold, from 199 cases per 100,000 population to 620 (Botswana National TB Program, unpublished data, 2002). This increase has been associated with the human immunodeficiency virus (HIV) epidemic. In Botswana, prisoners are not screened routinely for TB. To determine the prevalence of TB and drug-resistant TB in the Botswana prison system and to improve future screening for TB among prisoners and guards, CDC, in collaboration with the Botswana Ministry of Health and the Division of Prisons and Rehabilitation, screened prisoners and guards at four prisons during April-May 2002. This report summarizes the results of the survey, which indicate a high point prevalence of TB among prisoners in Botswana of 3,797 cases per 100,000 population and support the need for improved screening.

AIDS-Related Opportunistic Infections↗
PubMed1989

Race and suicide in jails and prisons.

Jails and prison populations are unique in the incidence of deliberate self-harm, but the phenomenon is not well understood. One of the few generally accepted findings about suicidal behavior among the incarcerated is that white prisoners are overrepresented among both completed and attempted suicides, whereas black prisoners are underrepresented. This article examines the explanations two books have advanced for racial differences in rate of self-injury. The article argues that the overrepresentation of white and Hispanic prisoners and the underrepresentation of black prisoners does not warrant those books' conclusion that prison brings greater pain or intolerable stress to white and Hispanic inmates. The interpretation that black free-world life prepares blacks better for prison, whereas white and Hispanic experiences render them more crisis-prone, ignores institutional and interpersonal factors that may affect inmate behavior. That interpretation also carries potentially insidious implications for the care and management of different ethnic groups in prison. The idea that white prisoners suffer more pain from imprisonment and merit more staff attention can affect recommendations for prevention and intervention approaches to prisoners.

Black or African American↗
PubMed1993

[AIDS patients in Italian prisons: a burning issue with no easy solution].

Some of the problems related to the detention of HIV infected subjects in Italian prisons are discussed, with particular reference to subjects with AIDS. The Italian Department of Penitentiary Administration reported, in 1991, the presence of 3030 HIV infected subjects, out of which 84 with AIDS. These subjects amount to 10% of prisoners annually detained in italian prisons. Recently Italian Government, in order to regulate the management of prisoners with HIV infection, has issued a decree-law (no. 431 of November 12th, 1992). This decree sanctions the unacceptability of detaining people with AIDS or any other severe immune deficiency. Nowadays it is impossible to predict the effects of this regulation. Many factors worsen the situation: structural peculiarities and overcrowding of prisons, prisons staff anxiety, lack of awareness about uselessness of obligatory prisoners' screening. The World Health Organization in 1987, the European Council in 1989 and the Italian Committee against AIDS in many occasions, during the last five years, gave indications for the management of seropositive prisoners and confirmed that individual counselling and confidentiality of information can help the prisoners to accept the HIV test: except for a few cases, the isolation of seropositive prisoners is not justified; prevention plays an essential role.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Prisons in transition.

The role of the prison has changed, in some ways dramatically, over the last two decades. The prison population has grown and its composition has altered. There has been an increase in the depth and weight of imprisonment, and a hardening of its emotional tone. Prisoners' voices have been silenced, outcomes have deteriorated, and yet public presentation of the prison has improved. Power has shifted upwards, as senior managers have an unprecedented grip on establishments and their 'performance'. There are new fantasies about, and constructions of, the prison's role, with little evidence to support such public and political dreams. Such sleights of hand are only possible without knowledge of the prison's interior life. Punitive prisons which treat prisoners, and possibly prison staff, unfairly and with little or no respect add to human suffering and do not address either the problem of crime or the problem of public fear.

Dehumanization↗
PubMed2002

Sex in prisons--a management guide.

Prisons are invariably unisex institutions where, besides many deprivations, heterosexual expression in its normal sense is absent. It is this characteristic that make prisons settings potentially fertile grounds for sexual aberrations. Since definite and accurate data concerning sexual activities among prison inmates are difficult to obtain, the phenomenon of sexual practices in prisons has traditionally been a topic of much speculation. However, the descriptions and explanations of most authors on the subject are often contradictory, and some of the best information are from unpublished sources. This article is an attempt to subsume many fragmented explanations about seven main types of sexual issues in prisons (i.e. consensual homosexuality, masturbation, transsexualism, prostitution, conjugal visits, sex between prisoners and prison staff, and rape among prison inmates) under more general criminological and management concepts. Suggestions for prison administrators on how to manage these complex issues in the best interests of security and inmates' health are also provided.

Family Relations↗
PubMed2006

Prevalence of human immunodeficiency virus, hepatitis B virus, hepatitis C virus and syphilis among prison inmates and officers at Nsawam and Accra, Ghana.

Although the high prevalence of blood-borne viral infections and syphilis in correctional facilities has been well documented globally, such data are sparse from Africa, and there has been no such data from Ghana. This study sought to estimate the prevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis among prison inmates and officers at prisons in Nsawan and Accra, Ghana. Prisoners and officers in 3 of the 46 prisons in Ghana were surveyed from May 2004 to May 2005. Subjects voluntarily completed a risk-factor questionnaire and provided blood specimens for unlinked anonymous testing for the presence of antibodies to HIV, HCV and Treponema pallidum, the causative agent of syphilis, and the surface antigen of hepatitis B virus (HBsAg). Almost 16% (3770) of the total of 23,980 prison inmates in Ghana were eligible, and 281 (7.5%) of those eligible took part, whilst almost 23% (1120) of the total of 4910 prison officers were eligible, and 82 (7.3%) of those eligible took part. For the 281 inmates tested, HIV seroprevalence was 19.2%, 17.4% had HBsAg, HCV seroprevalence was 19.2% and reactive syphilis serology was noted in 11%. For the 82 officers tested, HIV seroprevalence was 8.5%, 3.7% had HBsAg, HCV seroprevalence was 23.2% and reactive syphilis serology was noted in 4.9%. The data indicate a higher prevalence of HIV and HCV in correctional facilities (both prison inmates and officers) than in the general population in Ghana, suggesting their probable transmission in prisons in Ghana through intravenous drug use, unsafe sexual behaviour and tattooing as pertains to prisons worldwide.

Adolescent↗
PubMed1996

The development of healthcare services for diabetic prisoners.

The conditions experienced by people in custody in the UK have received considerable attention recently and there has been considerable debate concerning the standards of healthcare in British prisons. The Prison Health Care Service works under great pressure and difficulties and doctors have to deal with a large and ever-changing population, often with mental and physical disorders, who are frequently manipulative. This article highlights problems encountered in delivering diabetes care in prisons. Prisoners may self-induce diabetic ketoacidosis by refusing insulin injections, in order to be transferred to an outside hospital. On the other hand, prison staff may mis-interpret the symptoms of poorly controlled diabetes as 'acting up' by prisoners and inappropriate treatment can be given. If structured diabetes care is provided in prison, however, with close liaison between the Prison Staff and the local Diabetes Care Team, the basics of modern diabetes management can be provided. Good diabetic metabolic control can be achieved in the majority of patients, probably due to the rigid dietary regime, no alcohol and compliance with treatment. Imprisonment can ensure screening for diabetic complications and reassessment of treatment regimens. The British Diabetic Association guidelines for the provision of diabetes care in British prisons are outlined in this article.

Adolescent↗
PubMed2001

An outbreak of syphilis in Alabama prisons: correctional health policy and communicable disease control.

OBJECTIVES: After syphilis outbreaks were reported at 3 Alabama State men's prisons in early 1999, we conducted an investigation to evaluate risk factors for syphilis infection and describe patterns of syphilis transmission. METHODS: We reviewed medical, patient interview, and prison transfer records and documented sexual networks. Presumptive source cases were identified. Odds of exposure to unscreened jail populations and transfer from other prisons were calculated for case patients at 1 prison. RESULTS: Thirty-nine case patients with early syphilis were identified from 3 prisons. Recent jail exposure (odds ratio [OR] = 8.0, 95% confidence interval [CI] = 0.3, 158.7, P = .14) and prison transfer (OR = 32.0, 95% CI = 1.6, 1668.1, P < .01) were associated with being a source case patient. CONCLUSIONS: Probable sources of syphilis introduction into and transmission within prisons included mixing of prisoners with unscreened jail populations, transfer of infected inmates between prisons, and multiple concurrent sexual partnerships. Reducing sexual transmission of disease in correctional settings is a public health priority and will require innovative prevention strategies.

AIDS Serodiagnosis↗
PubMed2005

Prisoner healthcare co-payment policy: a cost-cutting measure that might threaten inmates' health.

Cost-effective provision of adequate healthcare to prisoners is a core problematic issue in contemporary correctional healthcare settings. An increasingly popular policy for reducing prison healthcare costs is prisoner co-payment systems for health services. Advocates of this policy assert that it facilitates efficient healthcare delivery in prison settings. This article examines the appropriateness and consequences of prisoner healthcare co-payment systems in US prisons. In conclusion, the policy has a strong potential to compromise prisoners' access to healthcare, while not significantly reducing prison healthcare costs. Alternative approaches for improving the efficiency of prison healthcare services are suggested, and implications for Australia are considered.

Australia↗
PubMed2003

[Prisoners in security cells: a professional challenge].

BACKGROUND: Each year, some 25 to 30 inmates in Oslo prisons are transferred to forced isolation in security cells, an often traumatic and degrading experience. MATERIAL AND METHODS: 30 male prisoners who were transferred to security cells were compared to another group of 30 randomised and not secluded inmates who had been referred to the prison psychiatric service. Inmates in the security cell group who previously had been in contact with the prison psychiatric service were compared to those in the same group who had not had such contact. RESULTS: Prisoners in security cells scored higher on restrictions and previous stays in mental hospitals than did non-secluded inmates. Prisoners in security cells who had had previous contact with the prison psychiatric service, had higher negative scores than those without such a contact. Both groups had considerable drug problems. INTERPRETATION: The security cell prisoners are a professional challenge to prison officers and health personnel to who should collaborate on giving the extra attention required to meet their needs.

Adult↗
PubMed1994

HIV epidemiology and risk behavior promoting HIV transmission in Austrian prisons.

In 1989, 1990 and 1992, 19%, 15% and 10%, respectively, of all prisoners newly admitted to prisons and penitentiary institutions in Austria underwent HIV antibody tests. Based on the HIV test outcome in prisons in which more than 80% of the newly admitted inmates were tested, annual HIV prevalences among prison inmates in Austria were determined. These were 0.5% (11/2,223), 1.3% (19/1,466) and 0.9% (14/1,509) in 1989, 1990 and 1992, respectively. The prevalence rates among prison inmates in Austria are thus 5 times higher than those in the general Austrian population. About 5% of all inmates belong to the high-risk group of intravenous drug users. Inquiries into HIV risk behavior among prison inmates showed that, in Austrian prisons just like in those of many other countries, intravenous drug use and sexual contacts are common practices. As disposable needles and condoms are not available to prison inmates, these practices carry a particularly high risk of HIV transmission. The data collected can be taken as a basis for developing strategies which are designed to reduce the risk of HIV transmission in prisons and which have a major bearing on the development of the HIV pandemic.

Austria↗
PubMedDate not supplied

Prevalence and characteristics of trauma and posttraumatic stress disorder in female prisoners in China.

OBJECTIVE: Posttraumatic stress disorder (PTSD) and its relationship with a range of traumatic events have previously been documented within various traumatized groups in Western countries. In the present study, the authors investigated the relationship between the frequency and type of traumatic events and the prevalence of PTSD among female prisoners in China. METHOD: A structured psychiatric interview, the self-report Traumatic Life Events Questionnaire, and Symptom Checklist-90-Revised were administered to a subset of 471 female members who were randomly selected from Hunan female prison, China. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnoses were assigned by consensus after the interviews were evaluated by independent raters. RESULTS: The prevalences of lifetime and current PTSD were 15.9% (n = 75) and 10.6% (n = 50), and 82% (n = 386) of the subjects had experienced at least 1 traumatic event. The whole sample was divided into 2 groups according to age: the younger group (age < or =25 years) and the older group (age >25 years) . The most predictive factor for lifetime PTSD among the younger age group was the experience of sudden death of a close friend or a loved one, childhood physical abuse, intimate partner abuse, and sexual abuse before the age of 13 years by someone at least 5 years older. For the older group, the most predictive factors were a history of motor traffic accident, sudden death of a close friend or a loved one, severe assault by acquaintance or stranger, witness to family violence, having experienced more than 5 traumatic events, intimate partner abuse, and sexual abuse before the age of 13 years by someone at least 5 years older. Those females with PTSD tended to demonstrate higher levels of anger/hostility or interpersonal sensitivity than those without either partial or full diagnosis. CONCLUSIONS: In this sample of female prisoners in China, although exposure to traumatic events was common and the rate is nearly as high as that in western countries, the prevalences of lifetime and current PTSD were relatively lower. Moreover, the prevalence of current PTSD among younger prisoners was significantly higher than that among older prisoners. The risk of developing lifetime PTSD was significantly greater only for older prisoners with a history of more than 5 traumatic events, whereas the types of specific traumatic events with the risk of developing lifetime PTSD among younger prisoners were similar to that among older prisoners. Administering specialized treatments for anger dyscontrol and interpersonal sensitivity may be useful for rehabilitation and reform of female prisoners.

Adolescent↗
PubMed2006

Value for money in drug treatment: economic evaluation of prison methadone.

BACKGROUND: Although methadone maintenance treatment in community settings is known to reduce heroin use, HIV infection and mortality among injecting drug users (IDU), little is known about prison methadone programs. One reason for this is the complexity of undertaking evaluations in the prison setting. This paper estimates the cost-effectiveness of the New South Wales (NSW) prison methadone program. METHODS: Information from the NSW prison methadone program was used to construct a model of the costs of the program. The information was combined with data from a randomised controlled trial of provision of prison methadone in NSW. The total program cost was estimated from the perspective of the treatment provider/funder. The cost per heroin free day, compared with no prison methadone, was estimated. Assumptions regarding resource use were tested through sensitivity analysis. RESULTS: The annual cost of providing prison methadone in NSW was estimated to be 2.9 million Australian dollars (or 3,234 Australian dollars per inmate per year). The incremental cost effectiveness ratio is 38 Australian dollars per additional heroin free day. CONCLUSIONS: From a treatment perspective, prison methadone is no more costly than community methadone, and provides benefits in terms of reduced heroin use in prisons, with associated reduction in morbidity and mortality.

Costs and Cost Analysis↗
PubMed1996

Cost implications of random mandatory drugs tests in prisons.

BACKGROUND: Compulsory urine testing of prisoners for drugs, a control initiative, was introduced in eight prisons in England and Wales early in 1995. Despite no evidence of effectiveness, testing was extended to all prisons in England and Wales by March 1996. We consider the cost of testing. METHODS: We combined the costs of refusals, confirmatory tests, punishment of confirmed positives for cannabis or for class A drugs to estimate the average costs of random compulsory drugs testing. These costs were then compared to: i) the healthcare budget for a prison; and ii) the cost of putting in place a credible prisons' drugs reduction programme. We then used Scottish data on incarceration and regional prevalence of injecting drug users to estimate the extent of the injecting drug use problem that prisons face. FINDINGS: Costs per 28 days of the random mandatory drugs testing control initiative in an establishment for 500 inmates where refusal rate is a) 10% or b) nil; and 35% of urine samples test positive, one tenth of them for class A drugs were estimated at between a) 22,800 UK pounds and b) 16,000 UK pounds per 28 days [a) $US35,100 and b) $US24,600]. This cost was equivalent to twice the cost of running a credible drugs reduction and rehabilitation programme, and around half the total healthcare expenditure for a prison of 500 which averaged 41,114 UK pounds per 28 days [$US64,860]. Major cost-generating events were the punishment of refusals--over one third of cost a)--and testing positive for cannabis--over 50% of cost a). In Scotland, around 5% of injecting drug users (IDUs) are incarcerated at any time: 5% of Lothian's drugs care, treatment and prevention costs and 2.5% of its HIV/AIDS prevention budget in 1993-94 amounted to 101,300 UK pounds per annum--or 7770 UK pounds per 28 days ($US11,970)--and about 35% of monthly MDT costs. INTERPRETATION: We suggest that 5% of current resources for drugs prevention and treatment and for IDU-targetted HIV/AIDS prevention should be directed towards the prisons because in the prisons, where 5% of the clients are at any time, injectors have less access to harm reduction measures than on the outside.

Costs and Cost Analysis↗
PubMed2006

[Hepatitis C in prison settings: screening and therapy are improving. Comparative survey between 2000 and 2003].

OBJECTIVE: To determine the real frequency of hepatitis C (HCV) in French prisons. AIMS AND METHODS: To evaluate the changes in HCV screening and therapeutic practices in prisons between 2000 and 2003 by comparing results of mail surveys of prison medical units both years (* if p<0.01). RESULTS: 88 units (51%) responded to both surveys. In 2003, HCV serologic screening was routinely performed in 28% (36%* in 2000) of prisons and routinely offered in 66% (35%*). Mean HCV prevalence was 6.9% in 2003 and 6.7% in 2003. There were 534 liver biopsies in 2003 and 545 in 2003, that is, an average of 6 biopsies per unit per year both years. Treatment was provided to 297 patients in 2003 and 164 in 2000, but 29% of prisons offered no treatment in 2003, and 44% (*) in 2000. Overall 14% of HCV-infected prisoners received therapy. CONCLUSION: The prisons participating in this study and the inmates they include were representative of the French prison population. HCV prevalence in French prisons appears stable. Routinely suggested or conducted screening is widespread. The number of liver biopsies is stable but low, and the number of patients receiving treatment has increased significantly.

Biopsy↗
PubMed2006

Modelling the hepatitis B vaccination programme in prisons.

A vaccination programme offering hepatitis B (HBV) vaccine at reception into prison has been introduced into selected prisons in England and Wales. Over the coming years it is anticipated this vaccination programme will be extended. A model has been developed to assess the potential impact of the programme on the vaccination coverage of prisoners, ex-prisoners, and injecting drug users (IDUs). Under a range of coverage scenarios, the model predicts the change over time in the vaccination status of new entrants to prison, current prisoners and IDUs in the community. The model predicts that at baseline in 2012 57% of the IDU population will be vaccinated with up to 72% being vaccinated depending on the vaccination scenario implemented. These results are sensitive to the size of the IDU population in England and Wales and the average time served by an IDU during each prison visit. IDUs that do not receive HBV vaccine in the community are at increased risk from HBV infection. The HBV vaccination programme in prisons is an effective way of vaccinating this hard-to-reach population although vaccination coverage on prison reception must be increased to achieve this.

Adolescent↗