TB control in Dutch prisons Ministry of Justice: J. Bastiani, MPH GGD Nederland: J. Doosje, MPH.

TB control in Dutch prisons

Ministry of Justice: J. Bastiani, MPHGGD Nederland: J. Doosje, MPH

TB screening in Dutch prisons: September 17, 2007

overview• Introduction• Medical Care in prisons• TB control in the Netherlands• TB screening programme in prisons

1994-2005• Conclusions, future perspective• Acknowledgements

DJI organisation

DJI is an agency of Min. of Justice DJI is the implementing agency Daily 16.000 persons detained Sectors: GW (prisons, house of detention)

TBS (detention ‘in her Majesty’s pleasure’)

DBV ( detention centres for illegals en refugees)

JJI (youth detention)All with their own director and management

Medical Care in prison

At 80 locations medical services Professionals: plm 450 nurses and 80 physiciens. Psychologist, psychiatrist, dentist and

paramedics

Populatie kenmerken

Tabel 1Formele capaciteit ultimo 2002-2005

(excl. politiecellen)

1.264

2.346

13.478

783

17.871

1.303

2.399

14.771

1565

20.038

1.401

2.566

16.255

1865

22.087

1.637

2.571

16.499

1258

21.965

TBS-inrichtingen

Jeugd-inrichtingen

Penitentiaireinrichtingen

detentie- enuitzetcentra TDBV

totaal

2005

2004

2003

2002

Populatiekenmerken

Tabel 2

Nationaliteit gedetineerden 31 december 2005(incl. detentiecentra/incl. extramuraal)

4,4%

1,7%

2,3%

2,6%

2,8%

3,2%

5,0%

7,1%

7,3%

63,6%

0,0%

totaal 16684

Onbekend of statenloos 741

Amerika + Oceanië 283

Suriname 384

Turkije 432

Overig N,W,Z-Europa 469

Oost Europa 526

Marokko 831

Azië 1180

Overig Afrika 1217

Australië en Nieuw Zeeland 3

Nederland + Ned. Antillen 10618

Populatiekenmerken

Tabel 3geslacht gedetineerden 31 december 2005

(incl. detentiecentra/incl. extramuraal)

93,6%

6,4%

mannen 15622

vrouwen 1062

Populatiekenmerken

Tabel 4

Leeftijd gedetineerden 31 december 2005(incl. detentiecentra/incl. extramuraal)

1,4%

5,8%

7,4%

12,1%

16,6%

17,1%

16,8%

18,2%

3,8%

0,6%

0,2%

totaal 16684

60 en ouder 238

50 t/m 59 976

45 t/m 49 1231

40 t/m 44 2021

35 t/m 39 2763

30 t/m 34 2860

25 t/m 29 2800

20 t/m 24 3035

18 en 19 634

jonger dan 18 98

onbekend 28

Health characteristics

Risk group for STD’s, hepatitis,

Endemic risk areas

> 40 % detained has serious addiction related problems

> 50 % detained has one or more psychiatric disorders

TB screening in Dutch prisons: September 17, 2007

TB screening in Dutch prisons: September 17, 2007

TB incidence in Dutch population 1972 – 2005*

• 1972: 2458 = 18/100.000• 1987: 1192 = 8/100.000• 1994: 1811 = 12/100.000• 1996: 10.7/100.000• 2005: 8.2/100.000

* Referentie.: Tuberculose in Nederland 2005, surveillance rapport over de tuberculosesituatie in Nederland, KNCV Tuberculosefonds, 2007

TB screening in Dutch prisons: September 17, 2007

*Referentie: Jaarverslag Tuberculose-onderzoek in Penitentiaire inrichtingen, 2007, GGD Flevoland en GGD Hart voor Brabant, W. Haddad

TB screening in Dutch prisons: September 17, 2007

TB prevalence in Dutch prisons 1994 – 2005*

• Number of PI’s included in programme: 57• 277.000 screenings in 10 years, • 240 TB cases • In average 25 new cases per year• Mean: prevalence 89/100.000 over the last

10 years• Prevalence 52/100.000 in 2005*Referentie: Jaarverslag Tuberculose-onderzoek in Penitentiaire inrichtingen, 2007, GGD

Flevoland en GGD Hart voor Brabant, W. Haddad

TB screening in Dutch prisons: September 17, 2007

Number of TB cases in Dutch prisons in 2005

TB screening in Dutch prisons: September 17, 2007

ZN smear +/- direct versus culture

TB screening in Dutch prisons: September 17, 2007

Division by age in 2005

TB screening in Dutch prisons: September 17, 2007

TB screening in Dutch prisons: September 17, 2007

TB screening in Dutch prisons: September 17, 2007

Conclusions• Decreasing incidence rate in the Netherlands • Low prevalence of TB in prisons after 10 years• Mobile Rontgen Units proven to be effective as

screening instrument• Continuing screening in following years Future perspective• Improving screening instrument:

– Efficiency: better data exchange and data match (adjusting of prevalence rate) ICT – national data base

• Set up research to define risk groups within prisons

TB screening in Dutch prisons: September 17, 2007

Optimise TB Control by using Mobile Röntgen Units!

TB screening in Dutch prisons: September 17, 2007

Acknowledgements• GGD Hart voor Brabant, Wallid Haddad

• GGD Flevoland, Rene Jonker, Dick Fleury

• KNCV Tuberculosefonds• DJI• GGD Nederland