Browsing by Author "Telisinghe L"

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HIV and tuberculosis in prisons in sub-Saharan Africa.
(2016-Sep-17) Telisinghe L; Charalambous S; Topp SM; Herce ME; Hoffmann CJ; Barron P; Schouten EJ; Jahn A; Zachariah R; Harries AD; Beyrer C; Amon JJ; School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.; Department of HIV and AIDS, Ministry of Health, Lilongwe, Malawi; International Training and Education Center for Health, Department of Global Health, University of Washington, Seattle, WA, USA.; Management Sciences for Health, Lilongwe, Malawi.; The Aurum Institute, Johannesburg, South Africa; School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.; Johns Hopkins University School of Medicine, Baltimore, MD, USA.; Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia; University of North Carolina School of Medicine, Chapel Hill, NC, USA.; Field Epidemiology Services, Public Health England, Bristol, UK; University of Bristol, Bristol, UK. Electronic address: lily.telisinghe@phe.gov.uk.; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Health and Human Rights Division, Human Rights Watch, New York, NY, USA.; Médecins Sans Frontières, Brussels Operational Centre, Operational Research Unit, Luxembourg City, Luxembourg.; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.; International Union Against Tuberculosis and Lung Disease, Paris, France; London School of Hygiene & Tropical Medicine, London, UK.; College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia; Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia.
Given the dual epidemics of HIV and tuberculosis in sub-Saharan Africa and evidence suggesting a disproportionate burden of these diseases among detainees in the region, we aimed to investigate the epidemiology of HIV and tuberculosis in prison populations, describe services available and challenges to service delivery, and identify priority areas for programmatically relevant research in sub-Saharan African prisons. To this end, we reviewed literature on HIV and tuberculosis in sub-Saharan African prisons published between 2011 and 2015, and identified data from only 24 of the 49 countries in the region. Where data were available, they were frequently of poor quality and rarely nationally representative. Prevalence of HIV infection ranged from 2·3% to 34·9%, and of tuberculosis from 0·4 to 16·3%; detainees nearly always had a higher prevalence of both diseases than did the non-incarcerated population in the same country. We identified barriers to prevention, treatment, and care services in published work and through five case studies of prison health policies and services in Zambia, South Africa, Malawi, Nigeria, and Benin. These barriers included severe financial and human-resource limitations and fragmented referral systems that prevent continuity of care when detainees cycle into and out of prison, or move between prisons. These challenges are set against the backdrop of weak health and criminal-justice systems, high rates of pre-trial detention, and overcrowding. A few examples of promising practices exist, including routine voluntary testing for HIV and screening for tuberculosis upon entry to South African and the largest Zambian prisons, reforms to pre-trial detention in South Africa, integration of mental health services into a health package in selected Malawian prisons, and task sharing to include detainees in care provision through peer-educator programmes in Rwanda, Zimbabwe, Zambia, and South Africa. However, substantial additional investments are required throughout sub-Saharan Africa to develop country-level policy guidance, build human-resource capacity, and strengthen prison health systems to ensure universal access to HIV and tuberculsosis prevention, treatment, and care of a standard that meets international goals and human rights obligations.
Prioritizing persons deprived of liberty in global guidelines for tuberculosis preventive treatment.
(2023-Oct) Narayan A; Salindri AD; Keshavjee S; Muyoyeta M; Velen K; Rueda ZV; Croda J; Charalambous S; García-Basteiro AL; Shenoi SV; Gonçalves CCM; Ferreira da Silva L; Possuelo LG; Aguirre S; Estigarribia G; Sequera G; Grandjean L; Telisinghe L; Herce ME; Dockhorn F; Altice FL; Andrews JR; Implementation Division, The Aurum Institute, Johannesburg, South Africa.; Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, United States of America.; Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, United States of America.; Research Department, School of Medicine, Universidad Pontificia Bolivariana, Medellin, Colombia.; Department of Public Health, Facultad de Ciencias Médicas, Universidad Nacional de Asunción, Asunción, Paraguay.; Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.; Instituto Regional de Investigación en Salud, Caaguazú, Paraguay.; Department of Life Sciences, Santa Cruz do Sul University, Santa Cruz do Sul, Brazil.; Oswaldo Cruz Foundation, Campo Grande, Brazil.; London School of Hygiene and Tropical Medicine, London, United Kingdom.; Wits School of Public Health, Johannesburg, South Africa.; Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia.; Department of Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut, United States of America.; Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada.; ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.; School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Brazil.; National Tuberculosis Control Program, Ministry of Public Health and Social Welfare (MSPyBS), Asunción, Paraguay.; Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom.; Manhiça Health Research Center, Maputo, Mozambique.; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Barcelona, Spain.; Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States of America.; Ministry of Health, Health and Environmental Surveillance Secretariat, General Coordination for Tuberculosis, Endemic Mycoses and Non-Tuberculous Mycobacteria Surveillance, Brasília, (DF) Brazil.
In this Policy Forum piece, Aditya Narayan and colleagues discuss the challenges and opportunities for tuberculosis preventive treatment in carceral settings.
Scaling up evidence-based approaches to tuberculosis screening in prisons.
(2023-Apr) Charalambous S; Velen K; Rueda Z; Croda J; Herce ME; Shenoi SV; Altice FL; Muyoyeta M; Telisinghe L; Grandjean L; Keshavjee S; Andrews JR; Division of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, CT, USA; Section of Infectious Diseases, School of Medicine, Yale University, New Haven, CT, USA; University of Malaya, Centre of Excellence on Research in AIDS, Kuala Lumpur, Malaysia.; Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MT, Canada; School of Medicine, Universidad Pontificia Bolivariana, Medellin, Colombia.; The Aurum Institute, Johannesburg, South Africa; School of Public Health, Wits University, Johannesburg, South Africa; Division of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, CT, USA. Electronic address: scharalambous@auruminstitute.org.; The Aurum Institute, Johannesburg, South Africa.; Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, CA, USA.; Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, UK.; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Division of Global Health Equity, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.; London School of Hygiene and Tropical Medicine, London, United Kingdom.; Division of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, CT, USA; Departamento de Clínica Médica, Universidade Federal de Mato Grosso do Sul, Campo Grande, Brazil; Fiocruz Mato Grosso do Sul, Campo Grade, Brazil.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
People deprived of liberty have among the highest rates of tuberculosis globally. The incidence of tuberculosis is ten times greater than the incidence of tuberculosis in the general population. In 2021, WHO updated its guidance to strongly recommend systematic screening for tuberculosis in prisons and penitentiary systems. Which case-finding strategies should be adopted, and how to effectively implement these strategies in these settings, will be crucial questions facing ministries of health and justice. In this Viewpoint, we review the evidence base for tuberculosis screening and diagnostic strategies in prisons, highlighting promising approaches and knowledge gaps. Drawing upon past experiences of implementing active case-finding and care programmes in settings with a high tuberculosis burden, we discuss challenges and opportunities for improving the tuberculosis diagnosis and treatment cascade in these settings. We argue that improved transparency in reporting of tuberculosis notifications and outcomes in prisons and renewed focus and resourcing from WHO and other stakeholders will be crucial for building the commitment and investments needed from countries to address the continued crisis of tuberculosis in prisons.