To describe the disease patterns of prisoners at several prisons under the management of the Ministry of Public Security in 2015. Subjects and methods: A cross-sectional descriptive study was conducted in 2015 by reviewing retrospectively the documents, reporting the results of physical examinations of prisoners and combined samples for HBsAg, HCV, HIV and tuberculosis testing on 1,485 prisoners at 03 prisons Vinh Quang (Vinhphuc province), Cay Cay (Tayninh province), Song Cai (Ninhthuan province).
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DISEASE’S STRUCTURE OF PRISONERS AT SOME PRISONS
IN THE MINISTRY OF PUBLIC SECURITY IN 2015
Nguyen Sy Thanh 1 ; Pham Quang Cu 1 ; Pham Van Thao 2
SUMMARY
Objectives: To describe the disease patterns of prisoners at several prisons under the
management of the Ministry of Public Security in 2015 Subjects and methods: A cross-sectional
descriptive study was conducted in 2015 by reviewing retrospectively the documents, reporting
the results of physical examinations of prisoners and combined samples for HBsAg, HCV, HIV
and tuberculosis testing on 1,485 prisoners at 03 prisons Vinh Quang (Vinhphuc province), Cay
Cay (Tayninh province), Song Cai (Ninhthuan province) Results: The model of disease
treatment in 3 prisoners' prisons showed that: Group of infectious diseases of the prisoners get
sick was 87%, group of non-communicable diseases was 12.6% Some popular infectious
diseases of the prisoners were flu (46.5%) and tuberculosis (25.5%) The non-infection diseases
which had the highest incidence were chronic respiratory such as COPD, asthma… (51.9%)
and heart disease such as hypertension (23.7%) Analysis results of 1,485 prisoners showed
that: the prevalence of HIV (+) was 7.5%; HBV (+) was 8.8%; HCV (+) was 17.0% and 4.7% of
cases with tuberculosis, in which 1.8% of cases had AFB (+) Conclusion: The infectious
diseases were majority in the disease patterns of prisoners in three prisons It is necessary to
build and organize the actions to control the prevalence of infectious diseases in prisons,
especial to control the incidence of HIV/AIDS, hepatitis B, hepatitis C and tuberculosis
* Keywords: Infectious disease; Non-communicable disease; Prisoners; Prison
INTRODUCTION
In the world, the researches about
disease structure of prisoners at some
prisons had been seen that chronic
diseases appear on the prisoners especial
related to quite high mental disorders,
range from 10.8 - 64% [4, 5], dyslipidemia
34.8% [6], hypertension 3 - 30.8% [4, 6],
asthma 4.6 - 16% [4, 6], musculoskeletal
disorders, arthritis range from 5.1 - 6% [4,
7], cancer has just accounted for 1% [7]
HIV, hepatitis B, C and tuberculosis most
can be found in the prisons [4, 8]
In Vietnam, the study by Nguyen Khac Thuy and Nguyen Sy Thanh (2012) at
6 prisons showed that the diseases prisoners treated at the prison were mainly tuberculosis (35.2%), bronchitis (18.6%), followed by HIV/AIDS (15.3%)
Results of clinical examination and test on
500 prisoners had to see: 59.8% of prisoners were infected, of which the number of respiratory diseases was very high (51.5%); the incidence of eyes and teeth-jaw-facial disease was low (5.4%
and 1.0%) [2]
1 Ministry of Public Security
2 Vietnam Military Medical University
Corresponding author: Nguyen Sy Thanh (maithanhone@gmail.com)
Date received: 09/09/2019
Date accepted: 17/10/2019
Trang 2We can see, the environment of the
prisons is very special Prisoners are
group of people with many risk factors
such as injecting drug use, unsafe sex or
tattoos, etc In addition, prisoners in
prisons often have to live together The
risk of these diseases is higher than in
the community Therefore, this study
provides updated descriptive data about
the patterns of prisoners' disease in
prisons in order to provide additional
scientific evidences as a basis for
proposing interventions to prevent the risk
of infection in the offender community and
reduce the risk of infection for officials
working in detention
SUBJECTS AND METHODS
1 Subjects
- Report documents, health check books
of prisoners at prisons of the detention
center
- Prisoners ≥ 18 years old, alert, able
to control themselves, not subject to
special discipline or sentence and being
renovated in 03 selected prisons
- Location: 03 prisons Vinh Quang
(Vinhphuc province), Cay Cay (Tayninh
province), Song Cai (Ninhthuan province)
under the management of the Ministry of
Public Security
- Time: in 2015
2 Methods
* Research design: Cross-sectional
description
* Sample sizes and sampling methods:
- Select the entire report book on the medical examination of prisoners at each prison’s clinic in 2015
- Select prisoners:
+ Administrating formula for calculator ratio of 1-sample size for cross-sectional study the same as that of the incidence
of the disease p = 0.355 (estimated by preliminary assessment of health situation
in prisons before the study), significance level α = 0.05 and relative accuracy
Ɛ = 0.07 So, the minimum sample size
n = 1,425 Estimated 5% rate of object loss > expected sample size was 1,496
Actual sample size collected was 1,485 (reaching 99.3% sample expected)
+ Research using systematic random sampling method with distance k = N/S, of which k: The sample distance; N: The total sample size to be studied; S: The sample size allocated for each prison
Actual sample size selected in each prison was shown in table 1
- Blood samples were tested for HBsAg, anti-HCV, anti-HIV by quickly method, used test kit
- Sputum samples were AFB test
microscopy to detect Mycobacterium
tuberculosis infection on the principle of
determining Mycobacterum tuberculosis
in sputum
- Sampling, testing, storage, and analysis of tests for biological samples were carried out by health facilities that were eligible to perform this specialized technique (Provincial Preventive Medicine Center, Provincial HIV/AIDS Prevention Center)
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Table 1: Sample sizes at prisons in the study
* Data analysis: Test results and search results for records and books were entered
and processed by Microsoft Excel
RESULTS AND DISCUSSION
1 General information about prisoners
Table 2: General information of research subjects
Song Cai (n = 395)
Cay Cay (n = 603)
Vinh Quang (n = 487)
Total (n = 1,485)
General information
Education
level
Folk
Marriage
status
Separated/divorced/
Time at
prison
Work at
Visited by
prisons
Ratio (%)
Have quick
Number of prisoners selected but not agreed to participate
Trang 4A total of 1,485 prisoners were included
in the study All of them were male The
average age of prisoners was 31.5 ± 9.6
This age was similar to the age of 300
prisoners in the Asia HIV/AIDS Prevention
Project in Vietnam [1]
The educational level of the prisoners
was mainly at secondary level (42.0%)
and the primary school (23.8%) Only
3.2% of the prisoners had intermediate or
higher level education This rate was
different from the study by the HIV/AIDS
Prevention Project in Asia in Vietnam
when most of the research subjects had
secondary and high school education [1]
The majority of prisoners in the study were in prison < 1 year (56.6%), 1 - 3 years (14.7%), the lowest proportion of prisoners had been in the camp > 3 years (14.7%) There were 35.8% of the 1,485 prisoners who were married More than a half of the prisoners were single (54.2%) This result was higher than the study by the Asia HIV/AIDS Prevention Project in Vietnam (51.9%) [1]
There were 60.5% of prisoners who had engaged in activities in prisons such
as making handicrafts, growing, and cooking Most of the them were visited by family or someone (82.5%)
2 Disease pattern of prisoners at 3 prisons in 2015
In 2015, number of health check and treatment at the medical centers of prisons in Song Cai, Cay Cay, and Vinh Quang was 44,346, 272,855 and 40,275, respectively
Figure 1: Prisoner's disease situation in 2015 in 3 prisons
The figure 1 was summarized from the prison and medical records The prisoners with infectious diseases accounted for 87.4%; the ones with non-communicable diseases accounted for 12.6% The environment of the prisons is very special, so the proportion of infectious diseases was higher than that in the community
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Figure 2: Non-communicable diseases pattern of prisoners
In 2015, non-communicable diseases
in prisons were mainly cardiovascular,
cancer, diabetes and respiratory diseases
In general, among them, prisoners with
chronic respiratory diseases such as
COPD, asthma, etc accounted for the
highest proportion (51.9%), the rate of
cardiovascular diseases was 23.7% The
results were similar to some other studies
in the world, such as retrospective study from 23,031 medical records of prisoners conducted by Amy J.H et al (2010) showed the results: 18.8% of prisoners had hypertension, 5.4% of those had asthma and 4.2% of them had diabetes [9] These rates in the cross-sectional study
by Vera-Remartínez E.J et al (2014) were 17.8%; 4.6% and 5.3%, respectively [6]
Figure 3: Infectious diseases pattern of prisoners
Influenza cases accounted for the highest proportion (46.5%) in the infectious disease pattern of prisoners This was a recurrent illness, so people who have
Trang 6contracted the flu many times in a year, resulting in a higher number of reported flu cases than other infectious illnesses 25.5% of prisoners had hepatitis, 8.6%, 7.8% and 7.5% of prisoners had tuberculosis, dengue fever and HIV/AIDS, respectively
3 The rate of HIV/AIDS, tuberculosis, hepatitis B, hepatitis C of inmates in
3 prisons
Table 3: HIV, HBV, HCV and AFB test results of prisoners in 3 prisons
(n = 395)
(n = 603)
(n = 487)
Total (n = 1,485) Result test
Among these 4 diseases, the highest
rate of positive test results of the
03 prisons was the HCV (+) with 17.0%
More specifically, the highest rate of
positive HCV test result was in Cay Cay
prison (20.1%) comparing to Song Cai
with 13.4% This result was quite similar
to the research results of Keten D et al in
Turkey (2016) which showed that
17.7% of prisoners who had hepatitis C [10]
In general, the rate of HBV (+) test
results was 8.8% In particular, Song Cai
prison had the highest rate (12.4%),
comparing to Vinh Quang prison with
4.4% Our results were lower than that in
America (13 - 47% depending on location)
[11] A study of the Project on HIV/AIDS
Prevention in Asia in Vietnam (2014) on
the inmates showed that 13.3% of
inmates infected with hepatitis B [1]
The rate of HIV (+) test results was 7.5% More specifically, Vinh Quang prison had the highest incidence (12.7%), comparing to Song Cai prison with 1.5% HIV/AIDS was also one of the most common infectious diseases in prisoners because there were many prisoners with
a history of injection drug use Our results were lower than that in some researches worldwide, Abdul M Kazi's study on risk factors and HIV prevalence among prisoners in Pakistan (2011) showed that out of 357 randomly selected prisoners, only 2% of prisoners were infected with the HIV virus [12] However, domestic studies had shown higher results than ours Research by Tran Minh Hieu et al in the period of 2006 - 2010 at the prisons in Daklak province, Tay Nguyen on 7,926 prisoners showed that among 683 injection drug users, 19.91% of them were infected with HIV virus [3]
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The proportion of prisoners with
tuberculosis in our study was 4.7%, of
which the AFB (+) test result was 1.8%
The highest rate was in Cay Cay (5.5%),
the rate in the remaining two prisons was
lower (about 4%) These results were
same that of studies in Ethiopia with a
tuberculosis incidence of 4.9% or in Brazil
with 4.7% [13, 14]
The study showed a statistically
significant difference (p < 0.05) in the
incidence of HCV, HIV, tuberculosis
between Song Cai and Cay Cay and the
rates of HBV and HIV infection between
Song Cai and Vinh Quang The explanation
for the differences between the 3 prisons
may be due to the cultural differences in
the prisons between regions
CONCLUSION
Infectious diseases made up the majority
of prisoners' disease patterns in prisons
(87.4%), non-communicable diseases
accounted for 12.6% The most common
infectious diseases of prisoners were flu
(49.3%), followed by tuberculosis (27.9%)
Non-communicable diseases with high
rates of inmates were chronic respiratory
diseases such as COPD, bronchial asthma,
etc (51.9%), followed by cardiovascular
diseases such as hypertension (23.7%)
Out of 1,485 prisoners tested: 7.5%
had HIV (+); 8.8% had HBV (+); 17.0%
had HCV (+) and 4.7% of cases of
tuberculosis, of which 1.8% of cases had
AFB (+) The Ministry of Public Security
and prisons need to conduct interventions
to control the incidence of infectious
diseases in prisoners, especially the
groups of HIV/AIDS, hepatitis B, hepatitis C
and tuberculosis
REFERENCES
1 Ministry of Health HIV prevalence and
risk of HIV, hepatitis B and hepatitis C infection among inmates at detention centers, detention camps and practitioners at the provincial center for treatment, education - social labor and construction sites 06 Bac Kan, Hoa Binh and Tuyen Quang HIV/AIDS Prevention Project in Asia in Vietnam (HAARP) 2014
2 Nguyen Khac Thuy, Nguyen Sy Thanh
Researching disease patterns and assessing the responsiveness of prisons in medical examination and treatment for prisoners Medical Journal of Hochiminh City 2012, 16 (4)
3 Tran Minh Hieu Situation of HIV
infection in prisoners in Dak Lak prison and detention camps 2006 - 2010 Hue Medical University 2011
4 Jacques B, Sandra A.B et al The
disease profile of Texas prison inmates Ann Epidemiol 2000, 10 (2), pp.74-80
5 Doris J.J, Lauren E.G Mental health
problems of prison and jail inmates Bureau of Justice Statistics, U.S Department of Justice
2006
6 Vera-Remartínez E.J, Borraz-Fernández J.R et al Prevalence of chronic diseases and
risk factors among the Spanish prison population Rev Esp Sanid Penit 2014, 16, pp.38-47
7 Australian Institute of Health and Welfare
The health of Australia’s prisoners 2009 Cat
no PHE 123 Canberra: AIHW 2009
8 Baillargeon J et al The infectious disease
profile of Texas prison inmates Preventive Medicine 2004, 38 (5), pp.607-612
9 Amy J.H, Jacques G.B et al Prevalence
of chronic medical conditions among inmates
in the Texas prison system J Urban Health
2010, 87 (3), pp.486-503
Trang 810 Keten D The prevalence of hepatitis B
and C among prisoners in Kahramanmaras,
Turkey Jundishapur J Microbiol 2016, 9 (2),
e31598
11 CDC Transmission of hepatitis B virus
in correctional facilities - Georgia, January
1999, June 2002 [cited 2016 28-5] Available
mmwrhtml/mm5330a2.htm 2004
12 Abdul M Kazi, Shah Sharaf A et al
Risk factors and prevalence of tuberculosis,
human immunodeficiency virus, syphilis, hepatitis B virus, and hepatitis C virus among prisoners in Pakistan J Infect Dis 2010, 14 (3), pp.60-66
13 Ali S, Haileamlak A et al Prevalence of
pulmonary tuberculosis among prison inmates
in Ethiopia: A cross-sectional study PLoS One 2015, 10 (12), e0144040
14 Valenca M.S, Scaini J.L et al
Prevalence of tuberculosis in prisons: Risk factors and molecular epidemiology J Tuberc Lung Dis 2015, 19 (10), pp.1182-1187