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El VIH y la tuberculosis en las prisiones del África subsahariana
Lilanganee Telisinghe1, Salome Charalambous2, Stephanie M Topp3
1Field Epidemiology Services, Public Health England, Bristol, UK; University of Bristol, Bristol, UK.
Lancet (London, England)
|July 19, 2016
Resumen
Las prisiones de África subsahariana muestran tasas más altas de VIH y tuberculosis que la población general. Los recursos limitados y la fragmentación de la atención dificultan la prevención y el tratamiento eficaces, lo que requiere una mayor inversión y una reforma de las políticas.
Área de la Ciencia:
- Salud pública
- Enfermedades infecciosas
- Epidemiología
Sus antecedentes:
- El África subsahariana se enfrenta a una doble epidemia de VIH y tuberculosis.
- Las poblaciones carcelarias de la región sufren una carga desproporcionada de estas enfermedades.
- Los datos existentes sobre el VIH y la tuberculosis en las prisiones suelen ser limitados y de mala calidad.
Objetivo del estudio:
- Investigar la epidemiología del VIH y la tuberculosis en las prisiones del África subsahariana.
- Describir los servicios de salud disponibles e identificar los desafíos en la prestación de servicios.
- Para determinar las prioridades de investigación para mejorar los programas de salud de las prisiones.
Principales métodos:
- Revisión de la literatura de los estudios publicados entre 2011 y 2015 sobre el VIH y la tuberculosis en las prisiones de África subsahariana.
- Análisis de datos de 24 países, teniendo en cuenta cuestiones de calidad y representatividad de los datos.
- Incluye cinco estudios de caso sobre políticas y servicios de salud en las prisiones de Zambia, Sudáfrica, Malawi, Nigeria y Benin.
Principales resultados:
- La prevalencia de VIH osciló entre el 2,3% y el 34,9%; la prevalencia de tuberculosis osciló entre el 0,4% y el 16,3%.
- Las poblaciones de prisioneros mostraron una mayor prevalencia de VIH y tuberculosis en comparación con la población general.
- Las principales barreras identificadas incluyen limitaciones de recursos financieros y humanos, sistemas de derivación fragmentados, sistemas de salud débiles, detención preventiva y hacinamiento.
Conclusiones:
- Se necesitan inversiones sustanciales para reforzar los sistemas penitenciarios de salud en el África subsahariana.
- El desarrollo de orientaciones políticas a nivel nacional y la creación de capacidades de recursos humanos son fundamentales.
- Garantizar el acceso universal a la prevención, el tratamiento y la atención del VIH y la tuberculosis en las prisiones es esencial para cumplir los objetivos internacionales y las obligaciones en materia de derechos humanos.
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