The Open Infectious
Infections in Prison in Low and Middle Income Countries:
Prevalence and Prevention Strategies
Oscar O. Simooya Pp 33-37
Prisoners throughout the world are at a greater risk of infectious
diseases compared to communities outside. Hepatitis C (HCV), human
immunodeficiency virus (HIV) and tuberculosis (TB) have attracted
great attention because of their potential to cause great morbidity
and mortality in prison populations.
However, prisons are not closed worlds. Many people enter and leave
prisons every day and many prisoners themselves stay only a short
period in prison and return to their families. Giving prisoners
adequate treatment for infectious diseases is good medical practice
and provides public health benefits to the community.
There are several factors that may fuel the highly infectious environment
in prisons and include: 1) poor health services; 2) overcrowding
and congestion; 3) high risk behaviors; 4) security vs
public health concerns and 5) lack of public empathy for prisoners.
This paper looks at the challenge of infectious diseases in prisons
in low and middle income
Three percent of the world’s population is infected with HCV
but in prisons the prevalence appears to be much higher ranging
from 4% in Indian prisons to 12.3% in prisoners in Nigeria. A review
of HIV prevalence in 152 LMICs found information on HIV prevalence
in only 75 (50%) of these countries. HIV prevalence was greater
than 10% in prisons in 20 countries. TB infection rates in prison
are equally high and may be up to 100 times those outside prison.
Overcrowding is a major problem and non-custodial sentences must
be considered in order to decongest prisons. Furthermore, standard
medical treatment and prevention measures for HCV, HIV and TB must
be provided to prisoners in order to reduce the burden of infections
in prisons. Linkages between prison health and national health services
would go a long way in addressing the threat of infections to prison
Prisoners go to jail to be punished for offending society and not
to get infectious diseases. Health care equivalent to that found
outside prison must be provided to these individuals.