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Southern Caucasus: prisoners particularly vulnerable to TB epidemic

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  • Southern Caucasus: prisoners particularly vulnerable to TB epidemic

    ICRC (press release), Switzerland
    March 23 2005

    Southern Caucasus: prisoners particularly vulnerable to TB epidemic
    Every year, three million people die of tuberculosis (TB).


    Prisoners are particularly exposed: they tend to come from society's
    poorest and hence more vulnerable sectors, and prison conditions
    foster the spread of the disease.

    Through its TB-control programme for prisons in the southern
    Caucasus, the ICRC works with the national authorities to help them
    meet their objectives, namely to reduce TB morbidity and mortality,
    to prevent the development of drug-resistant TB and to curb and
    ultimately stop TB transmission within the prison system by
    implementing the strategy recommended by the World Health
    Organization (WHO).

    In Georgia, 3,020 prisoners infected with the disease have received
    treatment since the ICRC programme was launched in 1998. In Armenia,
    where the programme started in 2002, 270 patients have been treated.
    In Azerbaijan, the programme has been running for ten years and
    treated 5,500 patients. The programme owes its success to the
    involved commitment of the medical staff who work daily to improve
    the prisoners' health.

    As a result of the programme's successful implementation, TB
    mortality in prisons in the southern Caucasus has dropped
    drastically. In another major achievement, the number of
    newly-detected infectious cases has fallen.

    This does not mean the problem has been solved, however. The
    conditions of detention are difficult: the prisons are often
    overcrowded and the prisoners lack light and proper nutrition. What
    is more, it is difficult for released prisoners to continue to have
    access to treatment. The ICRC is working to facilitate links between
    TB services in prisons and outside.

    Another major challenge is the high rate of multi-drug resistant
    (MDR) TB patients. Improper treatment in the past (treatment
    stoppages, incorrect dosage and length of treatment) has lead to the
    emergence of MDR-TB, the deadliest form of the disease. The ICRC is
    working with the authorities concerned to develop an MDR
    case-management strategy in line with international recommendations.

    Standards of health care for prisoners should be at least equivalent
    to that of the society as a whole. This is why the ICRC is helping
    the national authorities to ensure all sick prisoners have access to
    proper TB services. What is more, prisons are porous, and the
    implementation within their walls of effective TB-control programmes
    contributes to effective TB control in the wider community.
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