Advancing Corrections Journal - Edition #12 - Innovation in Correctional Healthcare (ACJ12-A012)
Abstract
Background: This baseline study aims to characterize tuberculosis patients in Haiti’s National Penitentiary facility who did not demonstrate timely treatment completion.
Methods: Data were collected for every person in Haiti’s flagship correctional facility identified with tuberculosis disease from 2016-2018. Logistic regression was used to identify factors associated with not completing tuberculosis treatment while in prison.
Results: From 2016-2018, the in-prison treatment completion rate was 556/661 (84.1%). Extrapulmonary TB (EPTB) patients were twice as likely to not complete treatment in prison as pulmonary cases (aOR 1.96, 95% CI 1.08-3.52). Patients living with HIV were three times as likely to not complete treatment as HIV-negative patients (aOR 3.31, 95% CI 1.82-6.02). A subsequent review of records from a community transitional clinic showed that an additional 7 patients (1.1%) from the cohort completed treatment after prison.
Conclusions: Tuberculosis treatment completion of 85.2% while in custody for the period 2016-2018 exceeds Haiti’s national average of 79%, but falls short of the World Health Organization’s target of 90% for correctional services. Targeting patients with HIV and/or EPTB for closer monitoring, plus interventions to finish treatment after release, may push the overall TB treatment completion rate towards the WHO’s target. To help improve TB treatment completion, this study justified a trial of Video Direct Observed Therapy.
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