Kyrgyzstan has got significant achievements in fighting tuberculosis in prisons, ICRC Health Delegate

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The World TB Day is marked in Kyrgyzstan last week and a monthly campaign is declared in the country from March 1 till April 1 to fight tuberculosis.

Kyrgyzstan achieved significant achievements in fighting tuberculosis, Dr. Ghirmai Yiehdego, Health Delegate of the International Committee of the Red Cross (ICRC) in Kyrgyzstan told in his interview to Kabar Agency.

“What is achieved in Kyrgyzstan is quite significant, because I would say its kind of model to many other countries. The system that is existing for TB control in penitentiary sector now in its ideal situation because patients have access to all diagnostic and treatment facilities. There are rapid diagnostic facilities, and standard bacteriology laboratory diagnostic services, which are very important in TB control,” Dr. Yiehdego said.

He also named improved the infection control model in Kyrgyzstan.

“Recently there were some visits from other countries to see the achievements here and also to learn experience and use in their respective countries. That is a great work because the State Service for Punishments Execution (GSIN) of Kyrgyzstan and ICRC worked together to make this happen. I think it is a great achievement that helped minimize tuberculosis transmission in prisons. The bulk of work has been done, the remaining the decline of incidence of tuberculosis might be very positive development,” the health delegate said.

Further Dr. Yiehdego told about TB situation in prisons of Kyrgyzstan and the importance of TB control.

“Prisoners usually live in congregated settings. If one TB patient comes to the prison, he could easily transmit the disease to other inmates. On average it is estimated that one TB patient, if not treated, transmit the disease on overage 15-20 people per year. This is in the general public. But this number goes much higher when in prison. Because there is overcrowding in prison with poor ventilation, poor air exchange. If tuberculosis transmission continues than it will come the risk to the community,” he said.

The ICRC representative stressed that TB control in prison is very important. “I would like to stress also the need for stronger TB control in prisons because TB control in prisons is very important to control tuberculosis in the community,” he said.

Dr. Yiehdego also said that several measures have taken in TB control.

“Mainly our engagement has been on infection control. Because TB is a communicable disease and it is transmitted from sick person or from someone who have coughing to a healthy person. Preventing the transmission through early detection and treatment of patients with TB has been our main activity. So for this we have been engaged in infection control activities working with penitentiary system. ICRC has supported infrastructural activities to build or to renovate buildings to make sure that TB patients are separated depending on their infectiousness, so those are likely to transmit the disease to others are separated so that the risk of contracting tuberculosis to others was minimized. On top of these we supported the prison authorities in improving diagnostic services, improving treatment and care of TB patients, because TB patients need support. And we support in treatment and care providing psychological and social support when needed,” Ghirmai Yiehdego said.

He also said that ICRC works with penitentiary authorities to improve the human resources on TB in terms of providing trainings within and outside the country.

Dr. Yiehdego said that the treatment of TB in prison and civilian sector is the same, but there are some specific challenges for TB control in prisons. “Mainly population in prisons they are not as general public, there are a lot of drug users, also other prevalence of HIV is higher, and prevalence of other infectious diseases is also higher. Most of the time majority of the prisoners they come from marginalized society as in many other countries. So it makes more challenging to cure TB patients,” he said and added that despite all these challenges the outcome of treatment is encouraging and it is gradually improving quite well.

Lieutenant colonel Elena Stepanova, deputy head of the colony#31 for medical and preventive work, head of the tuberculosis-pulmonary hospital, which was reconstructed by the ICRC confirmed Ghirmai Yiehdego’s words. She said that 75 % of prisoners cured in their facility, that is a little bit higher than in civilian sector. However, many patients after the release from prison give up the treatment at home, she said.

Besides, Stepanova added that the number of prisoners decreased from13 thousand in 2009 to 7 thousand now. “At present we have about 200-230 TB patients,” she said.

ICRC Health Delegate Dr. Yiehdego also added that doctors need to be attentive to the patients also. “Because some patients develop side effects and health personnel need to detect these side effects early and address it and support the patient not to interrupt the treatment. It needs a joint engagement both from health worker’s side and also from the patient’s side to ensure continuity of treatment and prevent drug resistance. Interruption of treatment is a main cause of drug resistance,” he said.

In conclusion Dr. Yiehdego expressed hope to have less problems in coming years as the number of TB patients is decreasing year to year.

According to data of the Health Ministry of Kyrgyzstan the incidence of tuberculosis is declining gradually. 5,653 newly diagnosed TB patients were registered in 2017, that is 94.8 cases per 100,000 people, compared to 5,853 in 2015 or 98.2 per 100,000 people (including prisoners).

The indicator of the level of mortality from tuberculosis in the republic in recent years also tends to gradually decrease. In 2016, the death rate in the republic was 5.8 cases per 100,000 people compared to 6.3 per 100 thousand in 2015.

Nurzhan Kasmalieva

Kabar News Agency

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