Guidelines for the Management of Tuberculosis Human Immunodeficiency Virus and Sexually Transmitted Infections in Correctional Centres 2013

Gu|de||nes for the management of 1ubercu|os|s, numan Immunodef|c|ency V|rus and Sexua||y-1ransm|tted Infect|ons |n Correct|ona| Centres 2013 Culdellnes for 18 and Plv ConLrol ln CorrecLlonal faclllLles ueparLmenL of PealLh |ll ubllshed by Lhe ueparLmenL of PealLh, rlvaLe 8ag x828, reLorla 0001, SouLh AfrlcaAprll 2013CopyrlghL: ueparLmenL of PealLh, 8epubllc of SouLh Afrlca 2012lor more lnformaLlon:ueparLmenL of PealLhur Llndlwe Mvusl, Lmall: MvuslL[healLh.gov.zawww.doh.gov.za Culdellnes for 18 and Plv ConLrol ln CorrecLlonal faclllLles ueparLmenL of PealLh |lll Contents ConLenLs ................................................................................................................................................. lll loreword ................................................................................................................................................. v AcknowledgemenLs ................................................................................................................................ vl AbbrevlaLlons ........................................................................................................................................ vll LxecuLlve Summary .............................................................................................................................. vlll 1.lnLroducLlon ....................................................................................................................................... 1 1.11uberculosls and Puman lmmunodeflclency vlrus ln CorrecLlonal CenLres ........................ 11 1.2aLhogenesls and 1ransmlsslon of ulsease ............................................................................ 2 1.2.1 1ransmlsslon of 1uberculosls ................................................................................................. 2 1.2.2 rogresslon from lnfecLlon Lo ulsease ................................................................................... 3 1.3CuLllne of Lhe naLlonal SLraLeglc lan on Plv, S1ls and 18 2012-2016 .................................. 3 2.Ceneral rlnclples .............................................................................................................................. 3 2.1 Ceneral rlnclples of Lhese Culdellnes ..................................................................................... 3 2.2 8oles and 8esponslblllLles ......................................................................................................... 6 2.3 CperaLlonal lssues ..................................................................................................................... 7 3.Screenlng for 1uberculosls, Plv and Sexually 1ransmlLLed lnfecLlons .............................................. 8 3.1 1uberculosls Screenlng............................................................................................................. 8 3.2 Plv Screenlng......................................................................................................................... 10 3.3 Sexually-1ransmlLLed lnfecLlon Screenlng.............................................................................. 11 3.4 Screenlng for chronlc dlseases condlLlons .............................................................................. 11 4.1reaLmenL of 1uberculosls, Plv and Sexually 1ransmlLLed lnfecLlons ............................................ 12 4.1 1uberculosls LreaLmenL ........................................................................................................... 12 4.2 Plv and S1lcare and LreaLmenL ............................................................................................. 13 4.3 Adherence SupporL ................................................................................................................. 13 4.4 CpporLunlsLlc lnfecLlons .......................................................................................................... 14 4.3 Managlng awalLlng Lrlal deLalnees......................................................................................... 16 4.6 Nutrition ..16 3.revenLlon of 1uberculosls, Plv and Sexually 1ransmlLLed lnfecLlons ............................................ 17 3.1 LducaLlon ................................................................................................................................. 17 3.2 1uberculosls revenLlon .......................................................................................................... 17 3.2.1 lsonlazld revenLlve 1herapy ln AdulL lnmaLes ................................................................... 17 Culdellnes for 18 and Plv ConLrol ln CorrecLlonal faclllLles ueparLmenL of PealLh |lv 3.2.2 lsonlazld revenLlve 1herapy ln Chlldren ............................................................................. 18 3.2.3 lnfecLlon ConLrol .................................................................................................................. 18 3.3Plv revenLlon ...................................................................................................................... 18 3.3.1 osL-exposure prophylaxls ................................................................................................... 22 5.3.2 Mens Sexual Health ............................................................................................................ 22 3.3.3 Condoms .............................................................................................................................. 22 3.3.4 Medlcal Male Clrcumclslon .................................................................................................. 23 6 Women and Chlld PealLh .............................................................................................................. 233 6.1 regnancy and 1uberculosls .................................................................................................. 233 6.2 lnfanL feedlng .......................................................................................................................... 27 7.osL release conLlnuum of care ....................................................................................................... 29 7.1 Llnkage and 8eLenLlon ln Care ................................................................................................ 29 8.8ecordlng and 8eporLlng ............................................................................................................... 321 8.1 MonlLorlng and LvaluaLlon .................................................................................................... 321 8.2 1ools for monlLorlng............................................................................................................. 331 8.3Information flow...33 8.4 Key issues on completing registers ..33 8.3 CoordlnaLlon .349.Puman 8lghLs ................................................................................................................................. 363 9.1 General rights ..35 9.2 Rights of detainees and inmates screening testing and treatment .36 9.3 Rights of detainees isolation and segregation .36 9.4 Rights of HCW and staff 37 9.5 Stigma ...37 AnnLxL 1: Puman 8lghLs rovlslons ln Lhe SouLh Afrlcan naLlonal SLraLeglc lan 2012-2016 ........... 40 AnnLxL 2: 1ools and Culdellnes for Puman 8lghLs ............................................................................. 40 AnnLxL 3: llow procedures for MMC............................................................................................... 431 ANNEXE 4: Xpert Diagnostic Algorithm .42 Culdellnes for 18 and Plv ConLrol ln CorrecLlonal faclllLles ueparLmenL of PealLh |v Ioreword 1uberculosls and Plv, AluS are Lhe ma[or causes of morbldlLy and morLallLy ln Lhe counLry. lL ls for Lhls reason LhaL our lnLervenLlons musL focus on prevenLlon of new lnfecLlons and expand access Lo LesLlng andLreaLmenLservlcesLoallSouLhAfrlcans.CorrecLlonalfaclllLlesarepoLenLlalareasforspreadof alrbornelnfecLlonsandLhedlverslLyofLhepopulaLlonlnLhesefaclllLles[usLlflesLhelmplemenLaLlon of lnLervenLlons Lo mlLlgaLe Lhe rlsk. 1hlsdocumenLprovldesLhegeneralprlnclplesforLhemanagemenLandconLrolof18,Plv,AluSand S1ls ln CorrecLlonal faclllLles. 1he prlmary audlence ls healLh and admlnlsLraLlve sLaff ln uCS and uCP. lL ls meanL Lo provldeguldanceprevenLlon of new lnfecLlons, early deLecLlon Lhrough rouLlneLesLlng andearlyLreaLmenLofLhosewlLhLuberculoslsandhumanlmmunodeflclencyvlruslnfecLlonand dlsease. lL should be used ln con[uncLlon wlLh Lhe relevanL ueparLmenL of PealLh Culdellnes.1heLechnlcalsLaffofLheueparLmenLofCorrecLlonalServlcesaLnaLlonalandreglonallevelwlllbe responslble for ensurlng LhaLLheseguldellnes are lmplemenLed by all healLh professlonals wlLhln Lhe CorrecLlonal Servlces. 1he ueparLmenL of PealLh wlll provlde asslsLance aL Lhe dlfferenL levels Lhrough orlenLaLlon, Lralnlng and supervlslon. M|n|ster of nea|th Dr Aaron Motsoa|ed| Culdellnes for 18 and Plv ConLrol ln CorrecLlonal faclllLles ueparLmenL of PealLh |vl Acknow|edgements 1he developmenL of Lhese guldellnes has been a collaboraLlon beLween Lhe naLlonal ueparLmenL of PealLh(nuCP), Lhe ueparLmenL of CorrecLlonal Servlces (uCS) and parLners Lhe !olnL unlLed naLlons rogramme on Plv/AluS (unAluS),unlLed naLlons Cfflce on urugs and Crlme (unCuC), World PealLh CrganlsaLlon (WPC), 1he Aurum lnsLlLuLe,18 / Plv Care AssoclaLlon, 8lghL Lo Care, and Lhe unlverslLy 8esearch Co.(u8C)nuCP acknowledges Lhe wrlLlng and edlLlng Leam aL Lhe Aurum lnsLlLuLe, arkLown, SouLh Afrlca, for Lhelr lnvaluable conLrlbuLlon Lo Lhls documenL. D|rector Genera| for nea|th Ms M Matsoso Culdellnes for 18 and Plv ConLrol ln CorrecLlonal faclllLles ueparLmenL of PealLh |vll Abbrev|at|ons ACSMAdvocacy, communlcaLlon and soclal moblllzaLlon AI8Acld-Alcohol lasL 8acllll AIDSAcqulred lmmunodeflclency Syndrome Ak1AnLlreLrovlral LreaLmenL 8CG8acllleCalmeLLe-Cuerln CD4 ce||sWhlLe 1 helper cells whlch are progresslvely reduced ln AluS CMVCyLomegalovlrus CMkCoLrlmoxazole CSICerebrosplnal fluld DCSueparLmenL of CorrecLlonal Servlces DCnueparLmenL of PealLh DC1SulrecLly-observed LreaLmenL shorL-course LIALnzyme lmmunoassay L1kLlecLronlc Luberculosls reglsLer nAAk1Plghly acLlve anLlreLrovlral LreaLmenL nCWPealLh care workers nC1Plv counselllng and LesLlng nIVPuman ueflclency vlrus INnlsonlazld I1lsonlazld prevenLlve Lherapy IVlnLravenously LDnLacLaLe dehydrogenase MDk-18MulLldrug-reslsLanL Luberculosls MMCMedlcal male clrcumclslon MSMMen havlng sex wlLh men M. tubercu|os|sMycobacLerlum Luberculosls NGCnon-governmenLal organlzaLlon NnLSnaLlonal PealLh LaboraLory Servlce NSnaLlonal SLraLeglc lan on Plv, S1ls and 18 CICpporLunlsLlc lnfecLlons Ckolymerase-chaln reacLlon LosL-exposure prophylaxls IC1rovlder lnlLlaLed counselllng and LesLlng IneumocysLls [lrovecl pneumonlLls LnIVeople llvlng wlLh Plv M1C1revenLlon of moLher-Lo-chlld Lransmlsslon Nerlpheral neuropaLhy |dlour Llmes a day S1ISexually LransmlLLed lnfecLlons 181uberculosls tds1hree Llmes dally 1. gond||1oxoplasma gondll 1|er.netMonlLorlng and evaluaLlon sysLem for A81 UVGIulLravloleL germlcldal radlaLlon WnCWorld PealLh CrganlzaLlon kDk-18LxLenslvely drug-reslsLanL Luberculosls Culdellnes for 18 and Plv ConLrol ln CorrecLlonal faclllLles ueparLmenL of PealLh |vlll Lxecut|ve Summary Why we need these gu|de||nes for correct|ona| centres lnmaLescomefromcommunlLleswlLhh|ghratesoftubercu|os|s(18)andhuman |mmunodef|c|encyv|rus(nIV).1heymaybeundlagnosedoronLreaLmenL,whlchlsLhen lnLerrupLed on lncarceraLlon, causlng a h|gh r|sk of transm|ss|on of dlsease. Cvercrowd|ng,h|ghpopu|at|onturnoverandunhyg|en|ccond|t|onsconLrlbuLefurLherLoLhe spread of lnfecLlous dlseases ln correcLlonal cenLres. Inmateshavether|ghttorece|vehea|thcare,lncludlngprevenLlvemeasures,equlvalenLLoLhe care avallable ln SouLh Afrlcan communlLles. ollcles and pracLlces should be puL ln place to create a safer env|ronment and d|m|n|sh the r|sk of Lransmlsslon of 18, Plv andsexually LransmlLLed lnfecLlons (S1ls) Lo lnmaLes and sLaff allke. Screen|ng and d|agnos|s |n correct|ona| centres Vo|untary nIV counse|||ng and test|ngshould be offered Lo all lnmaLes aL enLry / exlL and upon self-presenLaLlon.1woposlLlverapldLesLsconflrmPlvlnfecLlon.lnmaLeswhoseCu4counLls330 cells/mm3 and A81 lf Cu4