Inmates face 100 times greater TB risk than civilians
A recent mass screening for tuberculosis (TB) carried out at the New Bilibid Prison (NBP) has led to dramatic findings: Of more than 6,300 inmates screened, 318 tested positive for the infectious disease.
The screening was done at the mediumsecurity compound of the prison, evaluating 6,328 inmates for TB. The activity was launched last March 24, with the theme “Medium Security Compound ay Linisin, TB ay Hanapin” and took nearly four months to complete.
With August being “Lung Awareness Month,” it was but fitting to emphasize the need to raise public awareness about the disease, which, though completely curable, can also be deadly if not detected in time or left untreated.
It is important to improve TB awareness in prisons as it has been reported that inmates face up to 100 times greater risk of getting infected than the civilian population.
It is also noteworthy that TB cases in prisons may account for up to 25 percent of the country’s disease burden, based on a 2017 report from the World Health Organization.
In the Philippines, where many jails face extreme overcrowding, this means that a communicable disease like TB can spread like wildfire if detection mechanisms are not in place.
TB spreads through air and a person who has it can infect about 15-20 others in just one year. Hence, this issue is not restricted within the penitentiary system but is actually a serious public health concern.
The screening at the NBP ended in July and was administered with the help of one doctor, two nurses, two laboratory technicians and 10 interviewers.
Of the 318 detected cases, 26 were multi-drug resistant, which is a severe form of the disease. The numbers were much higher than estimated or anticipated.
Sustaining efforts to detect TB cases
This is not the first such screening done, though.
Over the past years, the Bureau of Corrections, in partnership with the International Committee of the Red Cross (ICRC), has been organizing these mass screening campaigns.
Considered as one of the active ways to detect TB cases, these campaigns have been implemented to cover all quadrants of the maximum security compound, the inmates from Building 14 and also the personnel working in custodial areas.
As many as 21,000 detainees and 504 personnel of the NBP have been screened to date. Of these, 817 were found to be positive for TB, including 64 for multi-drug resistant tuberculosis. All positive cases have started treatment.
Subsequent screenings over the years have ensured that those who are suffering from the disease, but were “missed, undetected or not treated” in the past for whatever reason, were now screened, tested, isolated and treated properly.
We also strengthened links with the Department of Health and the Philippine Business for Social Progress to ensure that anti-TB drugs and logistics for the program are in place.
As part of the campaign, a lengthy preparation phase began with establishing rapport through dialogues with the cell leaders, gobernadores and the mayores, which allowed better understanding and involvement among inmates.
Then, we used zumba as a crowd-puller and made these screening sessions highly entertaining and well-attended. The idea was to educate inmates and also address their fears. These screenings also united the prison employees, TB treatment unit staff and the ICRC, which has been supporting our efforts to improve TB case detection at the NBP.
Each day, several inmates underwent interviews detailing the TB symptoms, apart from physical assessments, followed by chest X-ray in order to screen the “presumptive TB.”
All inmates identified to have “presumptive TB” were asked to undergo a test for confirmation called “GeneXpert,” the result of which was released after just two hours.
Those who turned out positive for TB were immediately isolated and put on treatment.
Moving forward
Though the road toward eliminating TB in prisons is long and bumpy, several best practices and strategies can be adapted from this experience to smaller jails and prisons to aid their efforts in TB awareness and detection.
The finish line – End TB by 2035 – is very clear. All it needs is total commitment and the right strategies by all the partners.
The team at the NBP plans to continue these mass screenings in the coming years to ensure that nobody is left behind in this fight against the deadly but curable disease.