Hepatitis B and hepatitis C in correctional facilities

Abstract

The aim of the study was to investigate the prevalence and incidence of Hepatitis B and C among local inmates and to recommend public health interventions to prevent and control transmission of these viruses among other inmates, to the prison staff and community. The incidence, prevalence and turnover rates for 2000 - 2006 were calculated using routine data available at the local Correctional Facility. Incidence of Hepatitis B ranged between 1119/100000/year and 2506/100000/year, and of Hepatitis C ranged between 11494/100000/year and 27985/100000/year. Prevalence of Hepatitis B ranged between 0.8% and 2.9% and of Hepatitis C ranged between 11.4% and 20.6%. The turnover rates ranged between 116% and 153%. Information about knowledge, attitudes and beliefs on Hepatitis B and C was collected among all Correctional Officers in Malta, using a structured self-administered questionnaire. Correctional Officers were found to have limited knowledge on Hepatitis Band C regarding mode of transmission, prevention and control, irrespective of their rank and length of service. They are eager to further their education on this topic (95%), the main reason being due to fear of transmission (91.7%) of such infections to their relatives at home. Correctional Officers show sympathy (84%) with inmates who are infected with Hepatitis B and C. Structured personal interviews were conducted with four prison officers working at the local Correctional Facility. There are no written policies or guidelines regarding Hepatitis Band C infections. Correctional Officers are introduced to the subject during their introductory' course but the need for further education is greatly felt. Correctional Officers and inmates have their blood tests routinely for Hepatitis B and C. Correctional Officers are routinely vaccinated for Hepatitis B, whereas inmates are not routinely vaccinated. No health education courses are organised on the subject. Medical care is a priority, and imnates are medically examined on admission and are then referred for specialist treatment when necessary. Counselling is carried out by the medical officer within the facility. Unfortunately, continuation of medical treatment after release is rather difficult due to lack of communication between the facility and outside community care. Inmates are encouraged to participate in daily jobs and education programmes. Outreach facilities are well established. There is strong opposition towards the introduction of needle and syringe exchange programmes and making free condoms available to inmates. Inmates are informed verbally of all services and activities that are available within the facility.

Cristina Chircop Micallef