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From: PlusNews <[email protected]>
Date: Tue, Jun 19, 2012 at 9:08 PM
Subject: SOUTH AFRICA: Overcrowding fuels TB in prisons
To: Elisabeth Janaina <[email protected]>


SOUTH AFRICA: Overcrowding fuels TB in prisons

DURBAN, 19 June 2012 (PLUSNEWS) - Tuberculosis (TB) rates in South
Africa's prisons could be cut by up to 94 percent if the country
reduced overcrowded conditions in cells and implemented active TB case
finding, according to research presented at the recent South African
TB Conference.

Overcrowding and poor living conditions have driven TB in prisons for
centuries, but a recent court case has finally given South African
researchers at the Desmond Tutu HIV Centre at the University of Cape
Town enough information on conditions in one of the country's prisons
to mathematically model TB transmission risks.

Using witness testimonies to deduce TB risk factors for inmates,
researchers found that overcrowding - more so than poor ventilation or
a lack of access to outside yards - was the main driver of TB in a
prison environment.

Reducing overcrowding by conforming to South Africa's own national
guidelines would lower the risk of TB infection for inmates by almost
a third, and bringing the country's prisons in line with international
standards would halve the risk. However, researchers found that
implementing international standards as well as active case finding
could bring down the risk by 94 percent.

"Having communal cells with more than 20 prisoners per cell in a
country like ours is a total disaster," said Prof Robin Wood of the
Desmond Tutu HIV Centre, who called prison conditions a human rights
abuse.

South Africa is ranked at 17 among the 22 countries that account for
80 percent of all TB cases globally, according to the World Health
Organization (WHO). South Africa diagnoses about 400,000 cases
annually.

Although many people carry TB, only 10 percent will ever develop the
active disease. But people with compromised immune systems, such as
those living with HIV, are up to 37 times more likely to develop
active TB.

In 2011 a former inmate of Cape Town's Pollsmoor prison, Dudley Lee,
took the Department of Correctional Services to court, arguing that
the conditions he was forced to live in for almost five years as an
awaiting-trial prisoner caused him to develop active TB.

Pollsmoor was built to house 1,800 inmates but now has about 4,200,
Wood said. South Africa's 240 correctional facilities hold about
160,000 prisoners, about a third more than the facilities were built
to accommodate, according to the Institute for Security Studies, a
South African think-tank.

Lee's legal team argued that although the Department of Correctional
Service was aware of the elevated TB risk associated with overcrowding
and poor ventilation, it failed to respond to prisoner requests for
adequate TB prevention and treatment. The department could also have
reduced the risk by segregating prisoners with active TB during the
period they were infectious.

A judge initially ruled in favour of Lee, who sought about US$46,600
in compensation from the state, but the ruling was later overturned.

llg/kn/he[END]

This report online: http://www.plusnews.org/report.aspx?reportID=95684



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