Intensified tuberculosis and HIV surveillance in a prison in Northeast India: Implementation research

PLoS One. 2019 Jul 29;14(7):e0219988. doi: 10.1371/journal.pone.0219988. eCollection 2019.

Abstract

Structural and individual level factors in prisons create challenges towards detection and management of HIV/tuberculosis. WHO and India's HIV/tuberculosis control programs recommend intensified case finding in prisons. Low HIV and tuberculosis detection rates suggest poor implementation of existing surveillance strategies within the prison healthcare system in Mizoram's capital city of Aizawl. We explored the operational feasibility of implementing the intensified case finding strategy in Aizawl central prison. We implemented the intensified screening through entry screening of new inmates, mass screening of resident inmates and exit screening at release. We set up digital chest radiography, sputum smear microscopy and HIV testing facilities within the prison and referral to external facility for Cartridge Based Nucleic Acid Amplification Test (CBNAAT). We screened 738 inmates (Male: 626; Female: 112). Of 53% inmates having presumptive tuberculosis symptoms, 37% underwent sputum microscopy. We detected 14 new tuberculosis cases; overall tuberculosis positivity 1.9%. We tested 65% of 657 inmates for HIV, of which 41 new cases were detected; overall HIV positivity 16.5%. Three male inmates had HIV-tuberculosis co-infection. It is feasible to implement intensified case detection for tuberculosis/HIV in the prison with inter-departmental coordination, albeit with certain challenges.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Coinfection / epidemiology*
  • Early Diagnosis
  • Female
  • HIV Infections / epidemiology*
  • Humans
  • India
  • Male
  • Mass Screening / organization & administration*
  • Middle Aged
  • Prevalence
  • Prisoners / statistics & numerical data*
  • Sputum / microbiology
  • Sputum / virology
  • Tuberculosis / epidemiology*
  • Young Adult

Grants and funding

This work was supported by the ICMR-National Institute for Research in Tuberculosis, Grant number: GF/001/IR_OR-004/2016-DSBR (www.nirt.res.in) to MS. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.