TB prevalence rate high in Malawi Prisons: Lack of isolation cells

The National Tuberculosis Control Program in collaboration with Malawi Prison Service (MPS) staff on Easter Holidays toured Chichiri and Zomba Maximum Security Prisons in an effort to identify challenges being faced in TB control efforts in Malawi’s Prisons.

The programmes director in the Ministry of Health Dr James Mpunga told Nyasa Times that the visit was a follow-up to the recently conducted study of 2011 by College of Medicine (CoM) which indicated that the TB prevalence among prisoners is as high as 4.4 percent.

He said there have also been reports from routinely collected information that the proportion of smear positive TB which is the infectious form of TB is as high as 60 percent in Malawi prisons.

Said Mpunga: “The TB/HIV co-infection rate among prisoners is over 90 percent which is way high compared to the national data. At the moment, TB control activities in prisons are improving tremendously although there is still a lot of work to be done.”

Mpunga on the right,  after officials from the TB Control Programme toured Chichiri and Zomba Central prisons to identify challenges being faced in TB control efforts in most prisons in the country.

Mpunga on the right, after officials from the TB Control Programme toured Chichiri and Zomba Central prisons to identify challenges being faced in TB control efforts in most prisons in the country.

Mpunga cited the use of peer educators in the sensitization of TB issues among prison in-mates as a very positive way of helping raise awareness among prisoners so that patients or those suspected to have TB are identified earlier.

“However, the disease spreads faster due to lack of proper isolation cells for prisoners with TB and those who are weak due to other disease conditions including HIV. The situation is worrisome as it encourages spread of TB among prisoners very easily.

“Review of prison records also indicate that TB patients are diagnosed with very high bacillary counts on microscopy meaning that diagnosis is delayed and therefore patients are most likely transmitting to other fellow prisoners for a long duration before they are themselves identified,” he lamented.

He added that prison cells are poorly ventilated and very congested, creating a very conducive environment for TB transmission, bemoaning lack of proper isolation cells for inmates diagnosed of TB.

“The problem is particularly worrisome given the rising numbers of multi drug resistant TB in Malawi. Spread of multi-drug resistant TB within Malawi prisons may be disastrous and this needs urgent attention,” said Mpunga.

During the visit, the officials also noted that sick prisoners like TB/ART patients are not provided with nutritious food arguing, proper well balanced nutrition plays a very important role in treatment outcomes among ART and TB patients.

He then re-assured the Prison officials that National TB Control Program will work with its partners to strengthen TB control activities within prisons in areas of care, diagnosis and treatment in order to reduce the huge TB burden in Malawi prisons.

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