Embed Size (px)
DESCRIPTION
Prevalence of transmissible infections, chronic illnesses, socio-demographic and behavioural risk factors amongst prison inmates in Mexico City: A cross-sectional study of 17,084 inmates. - PowerPoint PPT Presentation
Citation preview
Prevalence of transmissible infections, chronic illnesses, socio-demographic and behavioural risk factors amongst prison inmates in Mexico City: A cross-sectional study of 17,084 inmates
Sergio Bautista-Arredondo, Edson Serván, Fenella Beynon, Ruy López, Andrea González, Juan Sierra-Madero, Carlos Conde, Luis Juárez, Patricia Volkow
National Institute of Public HealthMexico
Health in prisons• Most people serving prison sentences come from the
poorest and most marginalized sectors of the population– Many of them in a poor state of health and with untreated
diseases– Many of them engage with higher frequency in risky activities
• The living conditions in most prisons of low- and middle-income countries are unhealthy and inadequate– Overcrowding, lack of light, fresh air and clean water, poor
food, suboptimal care and services and violence• Globally transmissible infections such as HIV, Hepatitis,
Syphilis and Tuberculosis much higher in prison
Prison health and public health
• The vast majority of people in prison eventually return to society
• Most of them receive visits while in prison • Prison staff have contact with inmates every
day• Diseases contracted in prison and conditions
that worsened during the confinement can become public health issues
Incarceration and HIV in the US
• Causal link between male incarceration rate and HIV prevalence in the US
• Incareration rates among african american population explain most of the disproportionate HIV prevalence among african american women
Mexico
• One of the biggest prison populations in LAC: incarceration rate 182 per 100,0001
• Mexico City, around 40,000 inmates (>400 per 100,000) 2
• High levels of overcrowding, poor living standard conditions, limited access to water, sanitation and medical care, drug use, corruption3
– Similar conditions have been documented in other countries in LAC 4
Objective
• Document health status of infeccious diseases, cronic conditions, sociodemographic and risk behavior characteristics in penitenciary centers in Mexico City
• Unique in size and scope
Methods• 4 penitenciary centers in Mexico City: from June to
December, 2010– Approximately 20,000 men and 2,000 women
• Voluntary and confidential participation, with informed consent1. Blood samples and antrhopometry to measure HIV, HVB
HVC, syphilis, gloucose, lypids, hipertension and obesity2. For a representative sample (10%): sociodemogrsaphics and
risk behaviors using ACASI3. All results where delivered to participants and for the
positive follow-up for treatment or referrals to health care
Results
010
2030
4050
Porc
enta
je
Menor de 30 años Entre 30 y 40 años Mayor de 40 añosGrupo de edad
Hombres Mujeres
Distribution of population by age
Men Women
Less than 30 30 to 40 More than 40
05
1015
2025
3035
4045
50
Sin estudiosPrimaria
SecundariaMedia superior
Superior Sin estudiosPrimaria
SecundariaMedia superior
Superior
Mujeres Hombres
Reclusorios Nacional
Porc
enta
je
Nivel educativo*
Schooling
Prisons General Population
MenWomen
*
0.5
11.
52
2.5
33.
54
4.5
55.
56
VIHVHC
HBcAbHBsAg
Anti-TP+/VDRL-VDR+
VIHVHC
HBcAbHBsAg
Anti-TP+/VDRL-VDRL+
Mujeres Hombres
Reclusorio Nacional*
Porc
enta
je
Infección de transmisión
Infectious diseasesWomen Men
Prisons General Population
Syphilis, by age0
24
68
1012
1416
20-29 30-39 40-49 50-59 60-69 20-29 30-39 40-49 50-59 60-69
Anti TP + VDRL -
Mujeres Hombres
Porc
enta
je
Grupo de edadWomen Men
0
20
40
60
80
Prev
alen
ce /1
00 in
habi
tant
s
20 - 29 30 - 39 40 - 49 50 - 59 60 - 69 20 - 29 30 - 39 40 - 49 50 - 59 60 - 69
Females Males
Prison General population
Age group
Obesity Prevalence
Diabetes and hypertension previously diagnosed0
1530
4560
015
3045
600
1530
4560
20 - 29 30 - 39 40 - 49 50 - 59 60 - 69 All
All
Females
Males
Prison General population
Age group
Diabetes
Prev
alen
ce /1
00 in
habi
tant
s
20 - 29 30 - 39 40 - 49 50 - 59 60 - 69 All
All
Females
Males
Prison General population
Age group
High blood presure
Violence and sexual risk behavior before and in prison
Substance use
Drug use before and in prison (%)
Findings
• Prevalence of HIV, HVC and syphilis higher than general population
• Chronic conditions, compared with national figures:– Obesity: similar among women, lower among men– Previously diagnosis: similar to GP
• Sociodemographic and behavior: – Lower levels of education– Higher use of drugs, tobacco, unsafe tatoos– Violence, sexual risk behavior and drug use
Thank [email protected]
References
1. Dolan K, Kite B, Black E, Aceijas C, Stimson GV. HIV in prison in low-income and middle-income countries. The Lancet infectious diseases. 2007;7(1):32-41. 2. Subsecretaría de Sistema Penitenciario G de DF2010. Movimiento Diario de Población Penitenciaria, 2010. Available at: http://www.reclusorios.df.gob.mx/reclusorios/estadisticas/index.html?anio=2010&mes=6. 3. Azaola E, Bergman M. El Sistema Penitenciaro Mexicano. USMEX 2003-04 Working Paper Series. 2003.4. Salla F, Rodriguez Ballesteros P, Espinoza O, et al. Democracy, Human Rights and Prison Conditions in South America. 2009.5. WHO. Health in Prisons: A WHO guide to the essentials in prison health. 2007.6. Jürgens R, Ball A, Verster A. Interventions to reduce HIV transmission related to injecting drug use in prison. The Lancet infectious diseases. 2009;9(1):57-66. 7. Vescio MF, Longo B, Babudieri S, et al. Correlates of hepatitis C virus seropositivity in prison inmates: a meta-analysis. Journal of epidemiology and community health. 2008;62(4):305-13. 8. Weinbaum CM, Sabin KM, Santibanez SS. Hepatitis B , hepatitis C , and HIV in correctional populations : a review of epidemiology and prevention. Aids. 2005:41-46.9. de la Hoya PS, Bedia M, Murcia J, Cebriá J, Sánchez-Payá J, Portilla J. Factores predictivos de infección por el VIH, VHC y coinfección en la población reclusa de una prisión española. Enfermedades Infecciosas y Microbiología Clínica [Internet]. 2005 Feb;23(2):53–7. 10. Leddy M a, Schulkin J, Power ML. Consequences of high incarceration rate and high obesity prevalence on the prison system. Journal of correctional health care : the official journal of the National Commission on Correctional Health Care [Internet]. 2009 Oct [cited 2011 Dec 7];15(4):318–27.
References
11. Binswanger I a, Krueger PM, Steiner JF. Prevalence of chronic medical conditions among jail and prison inmates in the USA compared with the general population. Journal of epidemiology and community health . 2009 Nov [cited 2011 Dec 7];63(11):912–9. 12. Nara K, Igarashi M. Serum of Prison Life Style to Blood Pressure , Lipids and Obesity in Women Prisoners in Japan. Industrial Health. 1998;:1–7. 13. CENSIDA. (2009). El VIH/SIDA en México 2009.14. Valdespino, J., Conde-González, C., Olaiz-Fernández, G., Palma, O., & Sepúlveda, J. (2007). Prevalencia en México de la infección y el estado de portador de la hepatitis B en adultos. Salud Publica de Mexico, 49(3), 404-411.15. Valdespino, J., Conde-González, C., Olaiz-Fernández, G., Palma, O., Kershenobich, D., & Sepúlveda, J. (2007). Seroprevalencia de la hepatitis C en adultos de México:¿ un problema de salud pública emergente? Salud Publica de Mexico, 49(Supl. 3), 395-403.16. Conde-González, C. J., J. L. Valdespino, et al. (2007). "Prevalencia de anticuerpos antitreponémicos y características sociodemográficas de la población mexicana adulta en el año 2000." Salud Publica de Mexico 49(Supl. 3): S395-S403.
