Sunday, August 24, 2008

Prison clinic beating back tuberculosis in inmates

Prison clinic beating back tuberculosis in inmates

110 prisoners cured after 6-month course

By Apiradee Treerutkuarkul

Contracting tuberculosis is a persistent threat for prison inmates, a high-risk group. One inmate, Sitthichai Daokaew, contracted tuberculosis from prisoners two years ago while being imprisoned in Khon Kaen. He wondered if he would ever get better.

However, his condition improved after being sent to Nong Khai for treatment in the provincial prison's clinic, which has been successful in treating patients with the disease.

A total of 110 prisoners infected with TB have been cured after six months of treatment.

Tuberculosis still remains a serious health threat in prisons.

Over 1,557 prisoners were found infected with TB. One-third were also HIV positive.

The rate of multi-drug resistant TB among prisoners was 6-10 per 100,000 population which is higher than 1.6 per 100,000 people in the general population, mainly due to over-crowding and inconsistent treatment.

Prisons across the country housed 168,656 prisoners last year, according to the Corrections Department.

Surasak Kosupat, a doctor responsible for TB control in Nong Khai, said provincial health authorities had worked with the department to curb TB infections and new cases in the northeastern prison.

Every month doctors and health staff check prisoners for tuberculosis. The standard DOTS treatment is available for TB-infected prisoners.

DOTS stands for Directly Observed Treatment, a short course strategy recommended by the World Health Organisation (WHO) for TB control.

Prisoners are checked for the disease every two weeks when saliva samples are sent to hospital for a lab test.

New prisoners are asked about their medical history and whether they have any TB-related symptoms.

Group discussions between TB-infected and healthy prisoners are encouraged so they can share information and learn from each other to prevent the disease spreading.

Such an integrated approach could help curb tuberculosis and other respiratory diseases, Dr Surasak said.

He said eight prisoners found infected with TB were sent to the provincial prison for treatment. Two had multi-drug resistant TB.

These TB infected prisoners would stay in a ventilated cell for two months. Each TB patient could transmit the disease to 10 people according to the WHO.

''Even though they are prisoners, we have to ensure that they can stay healthy and are able to work like anyone else when they return to society,'' Dr Surasak said.

Thailand ranks 18th on the list of countries for the prevalence of TB.

Of 91,000 new cases reported each year, more than 40,000 patients are carriers who can transmit the disease.

However, the real problem is thought to be bigger, with only 72% of potential cases diagnosed and treated.

This rate is lower than WHO's standard of 80%.

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