Central Prison Research Articles

Prevalence of latent tuberculosis infection and identification of associated risk factors in overcrowded Central Prison Rawalpindi, Pakistan

Purpose This paper highlights public health issues arising in prisons due to overcrowding – focusing on existence of tuberculosis (TB) and its transmission in a TB endemic country. It further addresses feasible TB management, to develop an applicable preventive intervention that will control TB transmission and development within and outside prisons. This study aims to decrease morbidity and mortality caused by TB by identifying latent tuberculosis infection (LTBI) cases. Design/methodology/approach A novel cross-sectional study conducted on male prisoners of Central Prison Rawalpindi, dividing them into three strata, i.e. under-trial (UTP), convicted (CTP) and condemned (CP) prisoners. Prevalence of latent TB infection within prisoners was methodologically calculated using multiple statistical analysis at 95% confidence interval. This research sourced an invasive skin test (Mantoux test) for primary data collection from targeted key population. Findings This research calculated existing prevalence of LTBI at 47.25%, 47.45% and 53%, respectively in UTP, CTP and CP prisoners, and 32.2% in total prison population. Overcrowding, poor health conditions and excessive smoking presented strong statistical significance to high LTBI prevalence across the prison population. Research limitations/implications Limitations included accessibility to prisons due to procedural concealment, and unannounced release of UTPs that was dealt through supplementary testing. The presented research findings highlight the disease spread across key populations, and the importance of identifying, containing and controlling them. It elaborates the crucial use of Mantoux tuberculin skin test (TST) to identify and isolate LTBI and potential TB cases in a closed population. It also facilitates policy implications that promote health and safety for prisoners, law enforcers and associated external population. Practical implications TB is one of the top 10 fatal illnesses and second highest infectious disease worldwide. For decades, TB ruled over human health and threatened their survival. Health-care professionals face challenges in locating, isolating, treating and controlling TB across the globe. Pakistan is a TB endemic country that internationally ranks fifth in nations with high TB burden. LTBI prevalence is unknown in Pakistan. Key populations are well-known to comparatively live with higher rates of infectious disease. Therefore, this research targeted a key population and has successfully calculated LTBI prevalence in overcrowded male prison population. Social implications Key populations are at high risk of contracting and transmitting communicable diseases. They not only possess higher disease incidences, but are also responsible for disease-spread within and outside their community. Targeting them will help in controlling for LTBI across prison population as well as the external population that is associated with the prisoners. TST allowed maximum screening coverage, encapsulated LTBI, spread awareness and eliminated stigmatisation. Originality/value Prevalence of TB and LTBI are unknown in Pakistan. This novel research calculated LTBI prevalence through primary data collection and targeted key populations. Authors collected primary data on case-by-case basis. This study has efficaciously located and isolated LTBI cases among the sample population following internationally standardised TST procedures.

Burden of scabies in a Ghanaian penitentiary.

There is a dearth of information concerning the epidemiology of human scabies in prisons. Therefore, we aimed to assess the burden of scabies and ascertain if prevalence was high enough to warrant mass drug administration (MDA) with ivermectin in a medium security prison in central Ghana. We conducted a cross-sectional study in December 2022 and recruited inmates at the Kumasi central prison in Ghana. Medical history and demographic information was collected using a REDCap questionnaire. A standardised skin examination of exposed regions of the body was performed on all participants and scabies was diagnosed based on the criteria of the International Alliance for the Control of Scabies (IACS). Of the 559 participants, 19 (3.4%) were female. The median (IQR) age was 36 (33-40) years. There were 368 cases (65.8%) of scabies which was mostly located on the hands, fingers and finger webs. No female inmate had scabies. Scabies severity was predominantly mild (63.3%) or moderate (30.7%). Among males, the median (IQR) number of persons per cell was 115 (56-118) and 7 (7-8) for female prisoners. 79.2% of 96 individuals previously treated in the preceding two months still demonstrated skin manifestations of scabies. Impetigo was found in 12.9% of participants. Seventeen percent of participants with scabies had impetigo compared to 5.8% in individuals without scabies [RR 2.9 (95% CI 1.6-5.5)]. A very high proportion of inmates suffered from scabies in the prison. MDA with ivermectin and health education are needed to reduce the burden of scabies in the prison. Its implementation and effectiveness should be studied.

Effectiveness of Systematic Screening and Treatment of Tuberculosis in Prison in Thailand.

The global incidence of tuberculosis (TB) in prison is 5 to 70 times greater than that in the general population. The systematic screening and treatment of TB in prison benefit TB control and treatment outcomes. However, no study has supported this in Thailand. Here, we evaluated the effectiveness of long-term, continuous, systematic screening for TB control. We conducted a retrospective study in Suratthani Central Prison, Thailand, using annual TB screening from 2016 to 2020. A positive TB screening was defined as having any TB symptoms or chest radiography abnormality. We collected sputum smear and Xpert® Mycobacterium tuberculosis/rifampicin (MTB/RIF) results from those inmates with positive screening results. Bacteriologically confirmed TB was defined as a positive sputum smear or M. tuberculosis detected by Xpert assay. Inmates with clinically diagnosed TB were also eligible for this study. Those inmates diagnosed with active TB were sent to an isolation zone in prison and received anti-TB medicine using directly observed therapy and were monitored by pulmonologists during the treatment course via telemedicine. Of 18,965 TB screening events, 175 patients were diagnosed with TB. The 5-year prevalence was 922 per 100,000 inmates. The relative reduction in TB prevalence was 60.5% from 2016 to 2020. Overall, 94.3% of TB patients were successfully treated (sum of patients cured and treatment completed). Three TB patients died during the 5-year study period. All occurred in 2016. The systematic screening and treatment of TB in inmates effectively reduced the prevalence and mortality in Suratthani Central Prison. The success rate of treatment in this prison has been consistently high.

New admissions and asymptomatic TB cases seem to fuel TB epidemic in prisons, a cross sectional survey in Tanzania.

There is an increased risk for tuberculosis (TB) infection and disease progression in prison settings. TB prevalence in prisons in low- and middle-income countries have been measured to be up to 50 -times higher than in the general population. The aim of the study was to perform active TB screening and estimate the burden of TB in central prisons in Tanzania mainland. We performed TB active case finding in five central prisons, Keko, Segerea, Ukonga, Butimba and Ruanda prison in Tanzania, using the Xpert on early morning or spot sputum sample from inmates and new entries between April 2014 and July 2015. A questionnaire that asked about the symptoms and risk factors for TB was administered before a sputum sample was collected. Out of 13,868 incarcerated individuals tested, 13,763 had valid results. TB prevalence among tested was 1550 per 100,000 population (214/13,763); new admissions contributed to the majority (61.68%) of TB cases, but prevalence was higher among inmates (1.75%) compared to new admissions (1.45%). Ukonga, an urban prison which incarcerates long-term convicted inmates had the highest prevalence of 4.02%. Male gender (OR = 2.51, p<0.001), repeated incarcerations (OR = 2.85, p<0.001), history of TB treatment (OR = 1.78, p = 0.002), TB symptoms (OR = 2.78, p = 0.006) and HIV infection (OR = 2.86, p = 0.002) were associated with positive TB results. New admissions could be the driving force of the TB epidemic in the penitentiary system. However, prison environments remain a major risk factor for developing active TB disease.

Exploring the relationship between the built environment of prisons and the mental health of inmates

PurposeAround the world, prison complexes have always been fundamentally taxing environments. The strained atmosphere within these prisons often contributes to the deterioration of mental health, mostly those who may already be psychologically vulnerable. This paper aims to understand whether there exists a relationship between the built environment of prisons, particularly the central prisons of India and its effects on the mental health of inmates.Design/methodology/approachBy means of literature reviews, the study parameters were found to be connectivity to nature, lighting, acoustics, colour, air quality and thermal comfort. The data collected through interviews and email correspondences with identified experts were analysed thematically using a deductive approach to derive a set of practical recommendations, which could be implemented in Indian prisons.FindingsThe built environment of prisons impacts the prison population by further contributing to depressive symptoms. The effects of the built space persist regardless of social factors. A well-designed environment is healthy for its occupants and would yield positive changes. However, it is not the sole contributor to depression; social interactions, prison management, societal acceptance and meaningful activities are equally relevant factors. The sole focus of this paper is the relationship between the built environment and the mental health of inmates.Originality/valueThere is a paucity of research into the intersection between prison architecture and the mental health of inmates in the Indian subcontinent. This paper that addresses the gap may have significant consequences on how criminal reform is perceived, and also encourage further research in this field.

Knowledge, practice, and infection status of prisoners toward dermatomycosis: a study in Nepal.

Dermatophytosis, commonly known as tinea, poses a significant public health concern worldwide, especially in environments with poor hygiene and overcrowding, such as prisons. Despite its prevalence and impact on quality of life, there is a lack of research on the knowledge and hygiene practices regarding dermatophytosis among prisoners, particularly in Nepal. The study aimed to assess prisoners' knowledge, hygiene practice and infection status regarding dermatophytosis in Central Prison, Nepal. A descriptive cross-sectional study with a sample size of 184 respondents was designed to collect data using a validated pre-tested questionnaire from September 2023 to January 2024. The collected data was then analyzed using IBM SPSS version 21. Knowledge and hygiene practices were measured on an eight and 11-point scale and rated as poor (≤4) and sound (>4), bad (≤6), and good (>6), respectively. Summary data were presented by descriptive, while Chi-square and logistic regression were used for inferential statistics at p < 0.05. The findings revealed moderate knowledge among prisoners regarding dermatophytosis, with significant gaps in understanding its spread and prevention. While most prisoners recognized the importance of treatment, there were misconceptions about the inevitability of contracting dermatophytosis and the role of personal hygiene. Despite good knowledge levels, adherence to recommended hygiene practices was suboptimal, highlighting the need for targeted interventions. The study underscores the importance of addressing knowledge gaps, changing attitudes, and promoting hygienic practices to mitigate the burden of dermatophytosis among prisoners.

The Knowledge Transfer Process of Mor Lam Ruang Toh Klon Khon Kaen Style to Prisoners at Khon Kaen Central Prison

The objective of this research was to convey the art of performing Mor Lam Rueang Tor Klon Khon Kaen style, by transferring the singing and performing techniques to prisoners in Khon Kaen Central Prison and evaluate research achievements. The research method included document study and fieldwork, consisting of observation and interviews with experts. The research results were presented through a performance presentation. The data was analyzed using the descriptive analysis method. The results of the study are as follows. In terms of the knowledge transfer process of the performing arts of Mor Lam Rueang Tor Klon Khon Kaen style through the process of transferring the singing and performing techniques to prisoners in Khon Kaen Central Prison, the composer included morals, ethics, and teachings into the song. Prisoners involved in the performance drew lessons from the characters they played. The activities from the research helped prisoners relieve stress. Mor Lum evolved from the palm leaf books into different types of performances, such as Mor Lum Pheun, Mor Lum Klon, Mor Lum Moo, Mor Lum Sing, and Mor Lum Phi Fah. Each type of Mor Lum is presented differently. One common element for all types of Mor Lum is the morals, ethics, teaching, beliefs, and livelihood of Isaan people ingrained within every song. Currently, the type of Mor Lum that both the older and younger generation can gain most access to is Mor Lum Tor Klon. There are many styles of Mor Lum Rueng Tor Klon in the Isaan region, such as the Ubon style, Khon Kaen Style, Kalasin Style, and Mahasarakham style. However, the style that is the most popular today is the Khon Kaen style due to its easy-listening tune, easier access, and easier to perform. Although the Khon Kaen style can be further categorized into various sangwats, or sub-styles, such as Paw Inta style, Paw Rabiab style, or Chumphae style, listeners still prefer the Khon Kaen style. Currently, 90 percent of the popular Mor Lum groups in the Isaan Region are the Mor Lum Rueng Tor Klon groups in Khon Kaen. It can be assumed that when Isaan people hear Mor Lum music, they feel joy in their hearts. Those who work in other regions miss home even more whenever they hear the Mor Lum music. However, there is another group of people who are also from Isaan but their freedom to the outside world has been taken away. We know them as “prisoners”. Prisoners are those who committed crimes and are detained by the Department of Correction. The department is the last department down that judicial line, tasked with overseeing prisoners convicted by the court and rehabilitating them to return to society as good citizens (Jirathitikarn, 2011). Khon Kaen Central Prison is a Northeastern regional prison for prisoners with skills in local performances and Luk Thung and Mor Lum music. There are workshops to provide knowledge in local Isaan music performances, which are used for improving the behaviors of prisoners to be able to adapt themselves as good citizens of society, as well as using the skill to develop their minds or generate income after they are released. From the above statement, the researchers found that whether they are prisoners in prisons or normal people living in society, they all need entertainment to soothe their sorrows. Therefore, the target group of this research consisted of prisoners detained in prison. Although they are physically detained, they should be able to receive the same type of happiness as people living on the outside. Thus, the researchers used an Isaan local performance, Mor Lum Tor Klon, as a tool that provides entertainment, while being embedded with teachings, morals, and ethics. Additionally, prisoners would receive knowledge in singing and participate in a Mor Lum Tor Klon Khon Kaen Style performance. When the prisoners are released, they can use the knowledge and skills in Mor Lum to start their careers and be accepted back into society. The researchers believe that this research will benefit the prisoners in Khon Kaen Central Prison, as well as be used as a tool in preserving the arts and culture of Mor Lum Tor Klon Khon Kaen Style in the future.

Examining the Impact of Social Workers on Overcoming Rehabilitation Challenges for Individuals Undergoing Community Service Sentences in Butimba Central Prison, Tanzania

Globally, there is an increasing outcry on the congestion of prisoners on their welfare and human rights. To deal with such congestion, the government of Tanzania introduced the community service, intending to reduce the number of prisoners and, ultimately, the congestion of prisoners. This study aimed to examine the Impact of Social Workers on Overcoming Rehabilitation Challenges for Individuals Undergoing Community Service Sentences in Butimba Central Prison, Tanzania," The specific objectives were to investigate the specific rehabilitation challenges faced by individuals undergoing community service sentences in Butimba Central Prison, Tanzania, and to explore how social workers address these challenges. Social cognitive theory guides the study, and the study design is qualitative. Data was collected using interviews with 20 participants, observations, and document analysis. Findings highlighted pervasive stigma, discrimination, reintegration struggles, and employment difficulties among individuals in community service sentences. Social workers' interventions included counselling, family mediation, advocacy for societal acceptance, successful reintegration, reduced recidivism rates, and a more inclusive environment not adequately addressed. Social workers' challenges, including limited resources, community resistance, and legal barriers, hindered rehabilitation programs' effectiveness. The study recommended developing targeted training programs, enhancing stakeholder collaboration, and implementing evidence-based practices. The conclusion emphasised ongoing support, policy reforms, and holistic interventions in correctional settings for positive outcomes during the transition to community life

Seroepidemiological Investigation of Hepatitis B and C Prevalence and Associated Factors Among People in Custody at Zahedan Central Prison.

On a global scale, approximately 350 million are affected by hepatitis B, and 71 million by hepatitis C. People in custody face elevated risks for these infections. The prevalence and risk factors in Iranian prisons are insufficiently documented. The principal objective of this study was to ascertain the prevalence of hepatitis B and C, coupled with the identification of pertinent influencing factors, within the confines of Zahedan central prison, situated in the southeastern region of Iran. In 2019, we conducted an analytical cross-sectional study involving 407 people in custody, using stratified random sampling. To definitively diagnose hepatitis C virus (HCV) infection (P<0.05), a checklist developed by the researchers, along with enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) techniques, were employed. This study comprised 406 participants (96.3% male) with a median age of 32 years (27-38). Approximately 62% were married, and a substantial proportion of the participants had low education levels (47%), unemployment (64%), and belonged to the Baloch ethnicity (64%). The overall prevalence of hepatitis C and B infections was 2.7% and 10.6%, respectively. Tattooing (adjusted odds ratio [AOR]: 2.07, 95% CI: 1.9-4.5) and marriage (AOR: 1.78, 95% CI: 1.05-3.04) were identified as risk factors for hepatitis B. Moreover, hepatitis C showed a statistically significant association with a family history of hepatitis B and C (AOR: 3.31, 95% CI: 3.93-24.64) and intravenous (IV) drug use (AOR: 7.01, 95% CI: 1.52-32.78) according to the multivariable logistic regression analysis. The prevalence of hepatitis B and C was higher among people in custody in Zahedan central prison. Consequently, targeted interventions are vital to address and reduce viral hepatitis burden in custodial settings.

Intestinal parasitic infections and predisposing factors among prison inmates in Southern Ghana: A cross-sectional study.

The environment within prisons, such as overcrowding, lack of access to portable water, poor sanitation, and hygiene predisposes inmates to infections, including intestinal parasitic infections (IPIs). This study therefore determined the prevalence and associated factors of IPIs among prison inmates in Southern Ghana. A cross-sectional study using the stratified sampling technique was employed. The study recruited 461 prison inmates across three notable prisons, with 50 inmates from Ho Central, 357 inmates from Nsawam Medium Security, and 54 inmates from Sekondi Central Prisons all in Southern Ghana. A structured closed-ended questionnaire was administered to collect data on sociodemographics, lifestyle/behavioral characteristics, and signs and symptoms of IPIs. In addition, stool samples were collected and analyzed for the presence of various stages of intestinal parasites (trophozoites, cysts, ova, and larva) using formol-ether concentration, and the modified Ziehl-Neelsen techniques. The prevalence of IPIs among inmates of the three selected prisons was 38.2% (95% confidence interval [CI]: 33.72%-42.79%). The prevalence of IPIs among inmates of the three prisons, the Ho Central, Nsawam Medium Security, and Sekondi Central were 46% (95% CI: 31.82%-60.68%), 37.5% (95% CI: 32.49%-42.79%), and 35.2% (95% CI: 22.68%-49.38%), respectively. After adjusting for confounders, the following factors; handwashing after defecation (adjusted odds ratio [AOR]: 0.05 [0.00-0.67]; p = 0.024), trimmed fingernails (AOR: 0.32 [0.13-0.76]; p = 0.011), itchy skin (AOR [95% CI]: 5.99 [3.43-10.43]; p < 0.001), anal itching (AOR [95% CI]: 0.35 [0.19-0.62]; p < 0.001), nausea (AOR [95% CI]: 5.57 [3.22-9.65]; p < 0.001), and worm expulsion (AOR [95% CI]: 3.80 [1.42-10.18]; p = 0.008) were found to be associated with intestinal parasitic infections. The study revealed that the prevalence of intestinal parasitic infections among prisons in Southern Ghana is high and is therefore an important public health concern. The Public Health Department of Ghana Health Service should therefore embark on health promotion and deworming exercise in all prisons in Ghana.

Patterns of Skin Disease among Prisoners in Central Prison in Nepal: A Descriptive Cross-sectional Study.

Skin diseases pose a significant health challenge globally, especially within prison settings where overcrowding and inadequate sanitation create a breeding ground for infections. Prisons, as part of society, exist in a dynamic equilibrium, serving as potential sources of infections that can spread beyond their confines. Despite facing similar challenges, there is a dearth of research focusing on skin diseases among inmates in Nepal. This study aims to assess patterns of skin diseases among prisoners. This was a descriptive cross-sectional study at the central prison, Kathmandu from December 2023 to March 2024. All patients with skin disease visiting the consultant Dermatologist and giving consent were included in this study. Ethical approval was obtained from the Nepal Health Research Council. Data were entered in Microsoft Excel 2010 and analysis was done by the Statistical Package for the Social Sciences software. Data were presented in the form of frequency and percentage. A total of 253 patients visited the consultant Dermatologist for skin conditions. Out of which, eczema was 67 (26.50%), fungal infections 57 (22.50%), and bacterial infections 51 (20.10%). The mean age of the respondents was 34.21±12 years. The fungal and bacterial infections were common among the prisoners.

Analysis of Drug-Alcohol Crime Nexus: A Case Study in Ghana

Background Crimes recorded by law enforcement agencies may be directly or indirectly related to drugs. There is growing concern about the increasing illicit drug use in Ghana, especially among younger people, which is perceived by many as contributing to the increase in criminal activities. The main objective of this research is to explore the role of illicit drugs and alcohol use in relation to crime among prison inmates. The study was carried out at the Kumasi Central Prison to investigate drug use among inmates through empirical interviews and drug tests. A semi-structured interview questionnaire was used to collect qualitative and quantitative demographic data from the prison inmates and the police officers. The inmates were tested for illicit drug use by rapid immune assay test and High performance liquid chromatography. Results The study revealed that the majority of the inmates had used one type of illicit substance or the other, even though only 6% of the inmates tested positive for cannabis. About 40% of respondents were incarcerated as a result of drug related crimes. 85% of persons previously arrested for drug crimes still had their current incarceration resulting from drugs. 82% of the respondents admitted that illicit substance use had both behavioural and psychological effects on the user and influenced crime commission. Conclusions Illicit substance use has a strong correlation to criminal activities. State institutions should prioritise the rehabilitation of drug convicts in order to minimise the reoccurrence of crimes. It is recommended that steps be taken to reduce the continuous traffic of drugs into prisons.

Prevalence of pulmonary tuberculosis and HIV infections and risk factors associated to tuberculosis in detained persons in Antananarivo, Madagascar

The incidence rate of tuberculosis in prisons is estimated to be 8 times greater than that in the general population in Madagascar. Our objectives were to estimate the prevalence of pulmonary tuberculosis and HIV infection among prisoners and to identify risk factors associated with tuberculosis. We conducted a cross-sectional study at the central prison of Antananarivo from March to July 2021. Individual male and female inmates aged ≥ 13 years who had lived in the prison for at least three months prior to the study period were included as participants. Acid-fast bacilli detection by microscopy and/or culture, an intradermal tuberculin test, a chest X-ray, and a rapid diagnostic orientation test for HIV were performed. Among 748 participants, 4 (0.5%) were confirmed to have pulmonary tuberculosis. Overall, 14 (1.9%) patients had “confirmed” or “probable” tuberculosis [0.90–2.84, 95% CI]. The proportion of participants with latent tuberculosis infection was 69.6% (517/743) based on a positive tuberculin test without clinical symptoms or radiography images indicating tuberculosis. Out of 745 HIV screening tests, three showed reactive results (0.4%). Age (OR = 4.4, 95% CI [1.4–14.0]) and prior tuberculosis treatment (or episodes) were found to be associated with confirmed and probable tuberculosis.

Prevalence and determinants of impetigo in Ghana: a cross-sectional study

IntroductionSkin diseases such as impetigo pose a significant public health challenge in low resource settings. Despite this, there is a dearth of epidemiological data on the prevalence of this condition in Ghana.MethodsWe conducted a cross sectional study in three settings in Ghana: community members in East Mamprusi district in the North East region, a secondary school in Sekyere East district, and inmates of the Kumasi central prisons both in the Ashanti region. Following a period of training, we performed a standardised skin examination on each participant to assess for scabies and impetigo. We calculated the prevalence of each skin condition and investigated determinants of impetigo.Results/ findingsOf the 1327 participants [males 64.1% and median age 22 (16–29) years], 746 (56.2%) had scabies and 186 (14%) had impetigo which was usually very mild or mild in severity. Most participants with impetigo also had scabies (161/186, 86.6%). Having an itch [RR 6.05 (95% CI 2.53–14.47)], presence of scabies burrows [RR 1.99 (95% CI 1.54–2.59)], clinical scabies [RR 3.15 (2.11–4.72)] or being in preschool [RR 4.56 (1.78–11.67)] increased the risk for impetigo. A combination of the presence of clinical scabies, age, sex and itch most accurately predicted the odds of having impetigo.ConclusionsThere is substantial burden of impetigo and scabies in Ghana. There is a need to institute measures to improve detection and control of these common dermatoses as part of Universal Health Coverage package to reduce the scourge of the diseases in this setting.

Perceived anxiety and depression and associated factors among women inmates with a long-term sentence in Thailand.

In Thailand, the growing prevalence of mental health problems among the increasing number of adult female prisoners has emerged as a significant public health concern. However, studies on the health of women prisoners are primarily conducted in Western societies, and studies in other countries are rare. Thailand, a non-western country, is no exception to this. The objectives of this study were to assess the current levels of anxiety and depression among women drug offenders in Thailand and to identify possible associated factors. Data were collected from a sample consisting of 554 women drug offenders serving sentences of eight years or more. Stratified random sampling with proportionate stratification was employed during the data collection. The female inmates were being held in three categories of prisons: correctional institutions, central prisons, and provincial prisons. A single question was used to measure self-perceived levels of anxiety and depression: none, moderate, or substantial. Ordered logit regression was employed in the data analysis. One out of five (21.1%) of the inmates in the sample reported no perceived current anxiety and depression, 61.7% reported moderate anxiety and depression, and 17.1% reported having substantial perceived levels of anxiety and depression. It was found that chronic health conditions or disease, concerns about economic status, and feelings of shame were associated with the perceived anxiety and depression reported by the inmates. The study's findings suggest that integrated mental health services that emphasize a holistic approach that acknowledges the intersectionality of women's mental health and societal gender roles should be provided in prisons. Regular mental health screening and accessible mental health services are essential for all incarcerated women. Empowerment programs during confinement can boost self-esteem and thus lead to better post-release outcomes. The government should also implement programs to alleviate the financial burden on prisoners' households.

Extent and patterns of drug use in prison in Burkina Faso: findings from a cross-sectional study in central prison of Ouagadougou

PurposeDrug use in prisons remains a public health concern because it is often the place of drug initiation. The purpose of this study was to analyze the drug use in prison in Burkina Faso.Design/methodology/approachWe conducted cross-sectional study in the prison of Ouagadougou. The adult prisoners (male and female) incarcerated for more than one month at the largest prison of Burkina Faso were included in the study. Participants were selected using a systematic random sampling. Data were collected from October 28 to November 26, 2018. The face-to-face interviews were conducted in the prison grounds. Logistic multivariate regression was used to identify factors associated with in prison drug use. All analysis was done using Stata.FindingsA total of 379 prisoners were included in this study. Approximately one-third inmates (32.71%; n = 124) experienced illicit drug in lifetime. Nearly one-third (28.76%; n = 109) of the prisoners were drug users before incarceration and 11.87% (n = 45) used drug inside the prison, of which 33.33% (n = 15) initiated drug use in the prison. Cannabis was the first drug used by the prisoners (71.11%) followed by tramadol (62.22%), diazepam (13.33%) and cocaine (2.22%). Four prisoners (3.63%) had reported Heroin use before incarceration. Cannabis was mainly smoked. Tramadol, diazepam and amphetamines were swallowed or mixed with food. Cocaine is smoked and snorted. Case of injection of cocaine and heroin was reported before incarceration. Main factors independently associated with drug use in prison is drug use before prison and young age of inmates. Indeed, inmates who had reported drug use before prison had 4.01 time {adjusted odd ratio (AOR: 4.01 [95% CI: 1.91–8.41])} higher odds to use drug in prison.Research limitations/implicationsTo conduct the interviews in the prison grounds could be a limitation due to social desirability bias. Indeed, the prisoners may understate drug use in prison for the fear of likely additional sentence. Availability of biological tests for drug markers might help addressed this bias. Nevertheless, the findings of this study should help to plan effective drug use prevention and care programs for prisoners.Practical implicationsThe actions must include the implementation of a medical and psychological care in continuum of healthcare system in Burkina Faso. This system should include screening at entry and adequate health and psychological care in prison for drug users for an effective control of drugs use in prison.Social implicationsMost of these drug users in prison have a low level of education and are unemployed. Education activities and training on occupational activities to prepare drug users for a successful social reintegration less dependent on drugs is essential. This study can be a basis to explore more possibilities and find out what is available to help those with substance use disorder, manage these cases in prison and prevent relapse on release.Originality/valueTo the best of the authors’ knowledge, this study is the first study on drug use in prison in Burkina Faso. It indicates that the repressive strategy against drug use seems ineffective because former users continue their consumption inside and also new users are initiated to use drugs in prison.

Effectiveness of Rehabilitation Initiatives in Reducing Recidivism in Tanzania: Evidence from Isanga and Ukonga Central Prisons

Although there have been different rehabilitation activities introduced by Tanzania Prison Services (TPS) since independence to reduce recidivism, the rate of recidivism has remained relatively high with the prevalence of reoffending and stigma on the part of ex-prisoners. Failure to effectively implement rehabilitation activities is said to be among the causes of an increase in recidivism by the ex-prisoners. With support from cognitive behavioural therapy, human capital theory, and labelling theory, this study aimed to explore the effects of rehabilitation activities on reducing recidivism in Tanzania by combining quantitative and qualitative analyses. Data were collected through surveys, interviews, discussions, and observations. Quantitative data were analysed through descriptive statistics and binary logistic regression, while qualitative data were analysed through content analysis. Findings revealed that informal rehabilitation activities were not able to reduce the reoffending behaviour of recidivists. The effective rehabilitation activities were those focused on life skills, psychosocial aspects, and educational programs. Problems such as curriculum design, financial constraints, infrastructure limitations, attendance problems, and varying literacy levels among prisoners pose obstacles to the effective rehabilitation of prisoners. Therefore, rehabilitation initiatives should focus on generating practical skills that contribute to the successful reintegration of prisoners into society. In addition, life skills, spiritual, psychological, and educational programs must be supported by authentic curricula and well-defined delivery modes. Prison management should also be sensitized to the importance of disciplinary science, aftercare services, and startup capital for enhancing reintegration, proper rehabilitation, and reducing recidivism among prisoners.

Towards The Development of A Model to Motivate Juvenile Inmates to Pursue Education at Mukati Central Prison Harare Metropolitan Province Zimbabwe

Towards The Development of A Model to Motivate Juvenile Inmates to Pursue Education at Mukati Central Prison Harare Metropolitan Province Zimbabwe

Patterns of admission in forensic units during the COVID-19 pandemic: a process analysis.

The impact of COVID-19 pandemic on forensic service practice remains matter of debate. Increased rates of anxiety, depression, and exacerbation of psychotic symptoms were reported in the early phases of the pandemic among detained persons. However, longitudinal analyses in medium-security hospitals taking into account the whole pandemic period led to mitigated results. This report examines the evolution of the type (voluntary versus involuntary) and reason of admissions, length of stay, history of outpatient care, short-term seclusion hours for aggressive behaviors, and clinical diagnoses for detainees needing acute psychiatric care during the COVID-19 pandemic in the sole secure ward located in the central prison of Geneva, Switzerland. To determine the general trend of the processes over time we applied a combination of process analysis with run chart plotting, and fractional polynomial regression. Run tests showed that the proportion of cases with personality disorders, substance use disorders (SUD), and previous outpatient care tended to increase during the COVID pandemic with subsequent decrease to reach the pre-COVID values. This was also the case for depressive symptoms as reason for admission. The proportion of involuntary admission showed a steady increase both during the COVID and post-COVID time periods. In contrast, short-term seclusion hours decreased during the COVID pandemic followed by a return to their pre-COVID values. Regression models revealed that the COVID pandemic was associated with a significant increase in the rates of inmates with personality disorders and SUD admitted for forensic care explaining 36 and 41% of their variance. These data support the idea that, in terms of acute care needs, the COVID-19 pandemic was associated with increased needs for acute forensic care that concerned detainees with personality disorders characterized by increased levels of impulsiveness, decreased tolerance to frustrations, loss of control, increased extraversion and frequent SUD comorbidity.

Effects of spirituality and religious attendance on the mental health and psychosocial wellbeing of inmates: a case study of Harare central prison, in Zimbabwe

The purpose of the study was to assess the prevalence of mental health problems at Harare Central Prison, Zimbabwe, in addition to assessing the prisoners’ levels of religiosity and spirituality, and furthermore ascertain how these affect their mental health and psychosocial wellbeing. This paper used a qualitative research design, whilst the target population constituted the inmates at Harare Central Prison with diagnosed or undiagnosed mental health conditions. Purposeful sampling was used, whilst the research instrument employed was structured interviews. Data were presented in narrative form and analyzed using thematic analysis. The major findings of this study were that religion and spirituality had beneficial effects on the mental health and psychosocial wellbeing of inmates, including working as a protective factor. It was concluded that all the various stakeholders concerned should work on promoting the functional and beneficial aspects of religion and spirituality at the prison.