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

Andrei Dadu, Ana Ciobanu, Araksya Hovhannesyan, Natavan Alikhanova, Oleksandr Korotych, Elmira Gurbanova, Rafael Mehdiyev, Svetlana Doltu, Ogtay Gozalov, Sevim Ahmedov and Masoud Dara
Additional contact information
Andrei Dadu: Regional Office for Europe, World Health Organization, 2100 Copenhagen, Denmark
Ana Ciobanu: Health Primary Care Department, University of Medicine and Pharmacy ‘N. Testemitanu’, 2004 Chisinau, Moldova
Araksya Hovhannesyan: Regional Office for Europe, World Health Organization, 2100 Copenhagen, Denmark
Natavan Alikhanova: Main Medical Department of the Ministry of Justice of Azerbaijan Republic, Baku AZ1000, Azerbaijan
Oleksandr Korotych: Regional Office for Europe, World Health Organization, 2100 Copenhagen, Denmark
Elmira Gurbanova: WHO Collaborating Centre on Prevention and Control of TB in Prisons, Baku AZ1000, Azerbaijan
Rafael Mehdiyev: Main Medical Department of the Ministry of Justice of Azerbaijan Republic, Baku AZ1000, Azerbaijan
Svetlana Doltu: Council for Preventing and Eliminating Discrimination and Ensuring Equality, 2004 Chisinau, Moldova
Ogtay Gozalov: Regional Office for Europe, World Health Organization, 2100 Copenhagen, Denmark
Sevim Ahmedov: United States Agency for International Development, Arlington, VA 22202, USA
Masoud Dara: Regional Office for Europe, World Health Organization, 2100 Copenhagen, Denmark

IJERPH, 2021, vol. 18, issue 18, 1-18

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: tuberculosis; prisons; notification; outcomes; WHO European Region (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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