Disease’s structure of prisoners at some prisons in the ministry of public security in 2015

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).

Journal of military pharmaco-medicine no8-2019 DISEASE’S STRUCTURE OF PRISONERS AT SOME PRISONS IN THE MINISTRY OF PUBLIC SECURITY IN 2015 Nguyen Sy Thanh1; Pham Quang Cu1; Pham Van Thao2 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 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 - 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 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] Ministry of Public Security Vietnam Military Medical University Corresponding author: Nguyen Sy Thanh (maithanhone@gmail.com) Date received: 09/09/2019 Date accepted: 17/10/2019 140 Journal of military pharmaco-medicine no8-2019 We 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 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 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 - 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) 141 Journal of military pharmaco-medicine no8-2019 Table 1: Sample sizes at prisons in the study Number of prisons Ratio (%) Have quick release Join now Number of prisoners selected but not agreed to participate Cay Cay 2,600 40.6 607 603 04 Vinh Quang 2,100 32.8 491 487 03 Song Cai 1,700 26.6 398 395 03 Total 6,400 100 1,496 1,485 11 Prison * Data analysis: Test results and search results for records and books were entered and processed by Microsoft Excel RESULTS AND DISCUSSION General information about prisoners Table 2: General information of research subjects General information Age (mean ± SD) Song Cai (n = 395) Cay Cay (n = 603) n n % % Vinh Quang (n = 487) n % Total (n = 1,485) n % 28.9 ± 8.9 31.2 ± 8.5 33.8 ± 10.8 Illiteracy 42 10.6 64 10.6 22 4.5 128 8.6 Primary school 107 27.1 181 30.0 65 13.4 353 23.8 Secondary School 185 46.8 255 42.3 183 37.6 623 42.0 High school 48 12.2 81 13.4 175 35.9 304 20.5 Intermediate college 1.5 19 3.2 23 4.7 48 3.2 University graduate 1.8 0.5 19 3.9 29 1.9 Kinh 358 90.6 575 95.4 433 88.9 1.366 92.0 Other 37 9.4 28 4.6 54 11.1 119 8.0 Married 116 29.4 195 32.3 206 42.3 517 34.8 Alone 245 62.0 340 56.4 220 45.2 805 54.2 Separated/divorced/ widowed 34 8.6 68 11.3 61 12.5 163 11.0 < year 197 49.9 376 62.4 268 55.0 841 56.6 13 years 100 25.3 172 28.5 154 31.6 426 28.7 > years 98 24.8 55 9.1 65 13.4 218 14.7 Work at prison No 159 40.3 363 60.2 65 13.4 587 39.5 Yes 236 59.7 240 39.8 422 86.6 898 60.5 Visited by someone Yes 323 81.8 520 86.2 382 78.4 1,225 82.5 No 72 18.2 83 13.8 105 21.6 260 17.5 Education level Folk Marriage status Time at prison 142 31.5 ± 9.6 Journal of military pharmaco-medicine no8-2019 A 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 < year (56.6%), - years (14.7%), the lowest proportion of prisoners had been in the camp > 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%) Disease pattern of prisoners at 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 prisons The figure 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 143 Journal of military pharmaco-medicine no8-2019 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 144 Journal of military pharmaco-medicine no8-2019 contracted 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 The rate of HIV/AIDS, tuberculosis, hepatitis B, hepatitis C of inmates in prisons Table 3: HIV, HBV, HCV and AFB test results of prisoners in prisons Result test Song Cai (n = 395) Cay Cay Vinh Quang (n = 603) (n = 487) Total (n = 1,485) p1-2 p1-3 No % No % No % No % HCV (+) 53 13.4 121 20.1 81 16.6 253 17.0 < 0.05 > 0.05 HBV (+) 49 12.4 60 10.0 22 4.5 131 8.8 > 0.05 < 0.001 HIV (+) 1.5 41 7.0 62 12.7 111 7.5 < 0.001 < 0.001 Tuberculosis 16 4.1 33 5.5 21 4.3 70 4.7 < 0.05 > 0.05 AFB (+) 1.5 12 2.0 1.8 27 1.8 - - AFB (-) 10 2.6 21 3.5 12 2.5 43 2.9 - - Among these 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] 145 Journal of military pharmaco-medicine no8-2019 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 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 146 REFERENCES 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 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) Tran Minh Hieu Situation of HIV infection in prisoners in Dak Lak prison and detention camps 2006 - 2010 Hue Medical University 2011 Jacques B, Sandra A.B et al The disease profile of Texas prison inmates Ann Epidemiol 2000, 10 (2), pp.74-80 Doris J.J, Lauren E.G Mental health problems of prison and jail inmates Bureau of Justice Statistics, U.S Department of Justice 2006 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 Australian Institute of Health and Welfare The health of Australia’s prisoners 2009 Cat no PHE 123 Canberra: AIHW 2009 Baillargeon J et al The infectious disease profile of Texas prison inmates Preventive Medicine 2004, 38 (5), pp.607-612 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 Journal of military pharmaco-medicine no8-2019 10 Keten D The prevalence of hepatitis B and C among prisoners in Kahramanmaras, Turkey Jundishapur J Microbiol 2016, (2), e31598 11 CDC Transmission of hepatitis B virus in correctional facilities - Georgia, January 1999, June 2002 [cited 2016 28-5] Available from: http://www.cdc.gov/mmwr/preview/ 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 147 ... activities in prisons such as making handicrafts, growing, and cooking Most of the them were visited by family or someone (82.5%) Disease pattern of prisoners at prisons in 2015 In 2015, number of health... 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... 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,