サハラ以南のアフリカの刑務所におけるHIVと結核
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
まとめ
サハラ以南のアフリカの刑務所は 一般人よりもHIVと結核の 高い割合を示しています 限られた資源と分散したケアが 効果的な予防と治療を阻害し 投資と政策改革の必要性を高めています
科学分野:
- 公衆衛生
- 感染症
- 流行病学
背景:
- サハラ以南のアフリカは HIVと結核の二重の流行に直面しています
- この地域の刑務所の収容者は これらの病気の不釣り合いの負担を 抱えています
- 刑務所でのHIVと結核に関するデータは 限られていて 質が悪いことが多いのです
研究 の 目的:
- サハラ以南のアフリカの刑務所でのHIVと結核の流行を調査する.
- 提供可能な保健サービスを説明し,サービス提供における課題を特定する.
- 刑務所の医療プログラムを 改善するための研究優先事項を 特定するためです
主な方法:
- サハラ以南のアフリカの刑務所でのHIVと結核に関する2011年から2015年の間に発表された研究の文献レビュー
- 24か国のデータを分析し,データ品質と代表性の問題を指摘した.
- ザンビア,南アフリカ,マラウィ,ナイジェリア,ベニンの刑務所の健康政策とサービスに関する5つのケーススタディを掲載.
主要な成果:
- HIVの罹患率は2. 3%から34. 9%,結核の罹患率は0. 4%から16. 3%であった.
- 囚人の集団ではHIVと結核の罹患率が 一般人群に比べて高かったのです
- 特定された主な障壁は,財政的および人事資源の制限,分散した紹介システム,弱い保健システム,審前拘禁,過密化です.
結論:
- サハラ以南のアフリカでは 刑務所の保健システムを強化するために 大規模な投資が必要である.
- 国のレベルでの政策指針の制定と人材能力の構築は極めて重要です.
- 刑務所でのHIVと結核の予防,治療,ケアへの普遍的なアクセスを確保することは,国際的目標と人権義務を達成するために不可欠です.
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