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Date [ 2014-06-13, 04:42 ]

Currently, this is at a high rate.

Prisoner showing positive for TB

(Kuala Lumpur=Koreanpress)  Nancy Joseph = A team from University Malaya (UM) has revealed high levels of previously undiagnosed active tuberculosis (TB) among HIV infected prisoners.  

Globally, TB is a leading cause of morbidity and mortality among the incarcerated population, particularly in low and middle-income countries, where access to timely healthcare services is limited. Additionally prisons contribute to the TB burden among the general population and prison staff through released inmates.

Recognizing the gap of information in this area in Malaysia, the University of Malaya’s Centre of Excellence for Research in AIDS (CERiA) with support from the High Impact Research Grant launched a series of research studies to define the size of the TB problem in Malaysian prisons and to determine appropriate interventions to control the spread of TB in Malaysia’s correctional system.

The research was led by Professor Dr. Adeeba Kamarulzaman, the Dean of the University of Malaya’s Faculty of Medicine and the Director of CERiA and Dr. Haider Al-Darraji, a visiting research fellow in CERiA, in collaboration with Academic Icon, Professor Frederick Altice from Yale University, USA.

The study was launched with a series of standardized tuberculin (Mantoux) surveys in both the Kajang prison in Selangor and Pengkalan Chepa prison in Kelantan, involving representative samples of prisoners and prison officers. Both sites revealed an extraordinarily high prevalence of tuberculin reactivity (inactive TB) amongst prisoners and prison staff alike, showing 88.8% in Kajang prisoners and 87.6%, in Pengkalan Chepa prisoners. The staff of both prisons showed around 80.95%.

These figures are the highest ever reported figures of tuberculin positivity in prison settings and highlight the high likelihood of ongoing transmission of TB in Malaysian prisons.

The research team also recently introduced the latest diagnostic technology for diagnosis of active TB, namely GeneXpert MTB/RIF into Malaysia following the strong endorsement by the World Health Organization (WHO) for the use of this technology in diagnosing active TB.

The utilization of this new technology which allows for rapid diagnosis of TB (within 2 hours) and the gold-standard TB culture in a cross-sectional study in Kajang Prison revealed a very high prevalence of active TB disease amongst HIV-infected and uninfected prisoners (12% and 6%, respectively).

The overall prevalence of previously undiagnosed active TB disease was 7.7%, which is 77 times higher than that of the Malaysian general population.

Since July 2013, the research team has established an intensified TB screening unit upon entry to Kajang prison, focusing not only on HIV-infected, but also targeting symptomatic HIV-uninfected prisoners. Preliminary data from this study also revealed high levels of previously undiagnosed active TB especially amongst HIV infected prisoners.

This research established by CERiA has provided for the first time a standardized empiric data about the high burden of TB in the Malaysian prison system. It also has improved timely access to proper TB-related prevention and treatment to this marginalized population, and has contributed to improvement in the overall survival in the targeted prison of Kajang.

Reducing the rate of TB in the prison system through this intensified case finding and prevention and treatment programme will contribute towards the overall control of TB in Malaysia which in recent years has shown an increase in the number of new reported cases after many decades of being under strong control.

abc@koreanpress.net

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