THE MAIN PROBLEMS OF CONTROL OF INFECTIOUS DISEASES IN PRISONS SYSTEM OF LITHUANIA BIRUTE SEMENAITE, MEDICAL DIVISION OF THE PRISON DEPARTMENT AT THE MINISTRY OF JUSTICE OF LITHUANIA 13-14 February 2007, Oslo

LITHUANIAN PRISONS. BACKGROUND: 14 INSTITUTIONS IN LITHUANIA (ONE FOR PRISONERS WITH ACTIVE TUBERCULOSIS) AND CENTRAL HOSPITAL WITH A UNIT FOR PATIENS WITH TUBERCULOSIS AND CONSULTING-ROOM FOR HIV/AIDS PROPHYLAXIS AND TREATMENT. PRISON POPULATION ON 01-01-2006 WAS 8 137; OVERAGE NUMBER OF PRISONERS IN 2005 WAS 7 939. THE INCIDENCE OF INFECTIOUS DISEASES IN THE PENITENTIARY SYSTEM REFLECTS THE OVERAL SITUATION IN LITHUANIA.

NUMBER OF PRISONERS (1999-2006)

DRUG USE IN PRISONS SYSTEM OF LITHUANIA

NUMBER OF DRUG USERS IN PRISONS OF LITHUANIA (abs. No.)

DRUG USE IN PRISONS OF LITHUANIA (%)

Decrease of drug supply in prison Foundation of drug rehabilitation and prevention centers in all correction houses Cooperation with state institutions and NGOs Availability of education for prison staff and inmates Individual counseling of inmates

SURVEY OF HIV INFECTION IN PRISONS OF LITHUANIA

EPIDEMIOLOGY OF INFECTIONS DISEASES: DETECTION OF HIV IN PRISONS SYSTEM OF LITHUANIA

CHRONOLOGY OF HIV AND MEASURES TAKEN IN PRISONS OF LITHUANIA 2003 May – HIV/AIDS Counseling Center established in Central Prison Hospital 2003 – Local Zone cancelled 2002 – HIV outbreak in Alytus 1998 - opening of the Local Zone 1997 – several persons with HIV positive. Problem of their accommodation during their term of imprisonment 1992 – the first HIV infected person

EPIDEMIOLOGY OF INFECTIONS DISEASES: NUMBER OF HIV INFECTED PRISONERS About 66 per cent HIV infected persons served their term in prison

1 May 2003 Establishment of HIV/AIDS Prophylaxis and Treatment Center in Central Prison Hospital Its functions: Health care of persons with HIV/AIDS Counseling before and after testing for HIV Educational activities Implementation of prevention measures in prison Follow-up care of HIV infected and persons with AIDS

Prospects growing number of persons with HIV growing number of persons with AIDS growing expenditures for personal healthcare of these patients growing expenditures for treatment of diseases accompanying AIDS expenditures for treatment of AIDS increase of mortality in prison

SURVEY OF TUBERCULOSIS IN PRISONS OF LITHUANIA

EPIDEMIOLOGY OF INFECTIONS DISEASES: NUMBER OF NEW CASES OF TUBERCULOSIS REGISTERED IN PRISONS OF LITHUANIA BY YEAR

RATE OF INCIDENCE OF TUBERCULOSIS AMONG DETAINEES AND CONVICTS (%)

INCIDENCE OF PULMONARY TUBERCULOSIS IN PRISONS OF LITHUANIA (new cases, abs.n.)

PRIMARY DRUG RESISTANCE (% )

RESULTS OF TREATMENT OF PULMONARY TUBERCULOSIS IN PENITENTIARY INSTITUTIONS OF LITHUANIA IN 2004

CONCLUSIONS (1) THE INCIDENCE OF TUBERCULOSIS IN PRISONS OF LITHUANIA WAS STABILIZED AND THERE IS A TENDENCY OF DECREASE IN THE LAST YEAR. THOUGH THE PROBLEM IS STILL VERY ACCUTE. THE RATE OF INCIDENCE OF TUBERCULOSIS IN PRISONS IS A REFLECTION OF TUBERCULOSIS INCIDENCE RATE WITHIN THE COMMUNITY OUTSIDE PRISON. THE BEST PREVENTION OF TUBERCULOSIS IS EARLY DETECTION OF CASES AND PROPER TREATMENT ACCORDING TO DOTS.

CONCLUSION (2) IT IS NECESSARY TO ESTABLISH CLOSER RELATIONSHIP BETWEEN PRISONS AND THE PUBLIC HEALTH SYSTEM IN ORDER TO ACHIEVE BETTER RESULTS IN THE TUBERCULOSIS TREATMENT AND TO DECREASE THE INCIDENCE OF TUBERCULOSIS ASWELL AS THE SECONDARY DRUG RESISTANCE IN THE CASES OF THE INTERRUPTED TREATMENT

CONCLUSIONS (3) TUBERCULOSIS CONTROL IN THE FACE OF THE SPREADING OF HIV INFECTION REQUIRES THE FOLLOWING RESPONSE: - IMPROVEMENT OF CO-ORDINATION AND COOPERATION BETWEEN TUBERCULOSIS CONTROL SERVICES AND HIV/AIDS SERVICES - STRENGTHENING OF TUBERCULOSIS CONTROL SERVICES:THE NEED TO FOCUS ON THE IDENTIFICATION AND CURE OF INFECTIOUS TUBERCULOSIS PATIENTS.

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