Prisoners In Malaysia Research Articles

A Mixed Method Study Protocol on Contributing Factors of Depression among Adults Inmates in a Local Prison Malaysia

Mental health is a global public health concern. Living in institutions, including imprisonment, make the inmates susceptible to depression. The objective of this research is to determine and explore the contributing factors of depression among adult prison inmates in a Malaysian local prison. The study utilizes the explanatory sequential mixed method approach. In the first phase, the quantitative hypothesis will be used to address the association between depression and biological, psychological, and social factors among the respondents. It will use a validated questionnaire from approximately 456 inmates using random sampling which was constructed based on the Biopsychosocial theory. The level of depression will be measured using the Center for Epidemiology Study Depression Scale (CES-D). In the second phase, in-depth interviews will be steered among depressed inmates recognized through purposive sampling. Univariate, bivariate and multivariate analyses will be used in quantitative statistics, meanwhile, the qualitative phase encompass a series of in-depth interviews where it will be discontinued once the saturation point is attained. The content of the interviews will be recorded and transcribe verbatim using thematic analysis. It is anticipated this study will enlighten the causative factors of depression and will gratify a novel modality to reduce depression.

Development of Spatial Distribution Model using GIS to Identify Social Support Index Among Drug-Abuse Inmates

This study was to identify the spatial distribution of Social Support Index (SSI) among drug-abuse inmates throughout Peninsular Malaysia. Factor Analysis (FA) and Discriminant Analysis (DA) were applied to analyses the level of social support (SS) among drug-abuse inmates and develop the spatial model using Geographic Information System (GIS). Five significant index categories were generated from FA: excellent, good, moderate, low and poor Quality of Life Index (QoLi) and the nine of SS variables are expected to be derived from family, friends and other social factor. DA showed each category differed from others in terms of different compositions, stepwise backward and forward modes gave 99.75% correct classification. GIS analysis show the distribution of SSI categorized on family and friends factor were moderately for where the prisoners came. Besides that, Perlis classified as low-level index and Melaka as high-level index of other social factor. The distribution model of SSI in moderately-level showed Jelebu, Sungai Petani, Pengkalan Chepa and Simpang Renggang as the better SS factor to quality of life compared to the Penor, Pahang. The procedures of FA, DA and GIS were used in this study proved the source apportionment of SS and QoLi among drug-abuse inmates in Peninsular Malaysian prisons.

Profiles of female prisoners in Malaysia

This study aims to explore the profiles of Malaysian female prisoners. Using a qualitative method through face-to-face interviews, the study was conducted in two prisons among 21 female prisoners who committed various types of crimes. The interview protocol contains open-ended questions and data obtained was analysed using Interpretative Phenomenological Analysis. The crime profiles showed that the informants committed various types of criminal offenses for the first time with different criminal motives in selected closed locations. They used various objects as weapons and committed non-individual crimes. Theirpsycho-criminogenic profiles demonstrated that negative personality traits, high level of stress, aggression and cognitive distortion as psychological factors for committing crimes.

Healthcare resources are inadequate to address the burden of illness among HIV-infected male prisoners in Malaysia.

Purpose Criminalization of drug use in Malaysia has concentrated people who inject drugs (PWID) and people living with HIV into prisons where health services are minimal and HIV-related mortality is high. Few studies have comprehensively assessed the complex health needs of this population. The paper aims to discuss these issues. Design/methodology/approach From October 2012 through March 2013, 221 sequentially selected HIV-infected male prisoners underwent a comprehensive health assessment that included a structured history, physical examination, and clinically indicated diagnostic studies. Findings Participants were mostly PWID (83.7 percent) and diagnosed with HIV while incarcerated (66.9 percent). Prevalence of hepatitis C virus (90.4 percent), untreated syphilis (8.1 percent), active (13.1 percent), and latent (81.2 percent) tuberculosis infection was several fold higher than non-prisoner Malaysian adults, as was tobacco use (71.9 percent) and heavy drinking (30.8 percent). Most (89.5 percent) were aware of their HIV status before the current incarceration, yet few had been engaged previously in HIV care, including pre-incarceration CD4 monitoring (24.7 percent) or prescribed antiretroviral therapy (ART) (16.7 percent). Despite most (73.7 percent) meeting Malaysia's criteria for ART (CD4 <350 cells/ μL), less than half (48.4 percent) ultimately received it. Nearly one-quarter (22.8 percent) of those with AIDS (<200 cells/ μL) did not receive ART. Originality/value Drug addiction and communicable disease comorbidity, which interact negatively and synergistically with HIV and pose serious public health threats, are highly prevalent in HIV-infected prisoners. Interventions to address the critical shortage of healthcare providers and large gaps in treatment for HIV and other co-morbid conditions are urgently needed to meet the health needs of HIV-infected Malaysian prisoners, most of whom will soon transition to the community.

Peranan Program Keagamaan Terhadap Pemulihan Konsep Kendiri Banduan Wanita di Malaysia

According to the statistics of Malaysian Prisons Department (MPD), women offender population is increasing from year to year (in 2011; 8,230 people, in 2012; 8,774 people, in 2013; 11,221 people). Some studies showed, the tendency to take action deviating is associated with an individual self-concept. In the meantime, the MPD has developed a recovery module to prisoners. Among the major modules implemented are modules religious. Consequently, the study was conducted to identify the current state of the self-concept of women offenders and identify the role of religious programs on the recovery of their self-concept. Basic Scale Questionnaire Religious Values ​​Devian (BRVSD) was used to determine the extent of respondents religiosity and Six Factor Self Concept Scale (SFSCS) was used to determine the state of their self-concept. A total of 141 women offenders involved in the study. The results showed a recovery program through religious approach be able to influence self-concept of women offenders. Accordingly, high religious understandingand &nbsp;&nbsp;strength of faith as well as great implementation of worship and shari`ah can develop more positive self-concept of women offenders.

Undiagnosed pulmonary tuberculosis among prisoners in Malaysia: an overlooked risk for tuberculosis in the community.

To investigate the prevalence of previously undiagnosed active tuberculosis (TB) cases among prisoners in Malaysia's largest prison using an intensified TB case-finding strategy. From October 2012 to May 2013, prisoners housed in two distinct units (HIV-negative and HIV-positive) were approached to participate in the TB screening study. Consenting prisoners submitted two sputum samples that were examined using GeneXpert MTB/RIF, smear microscopy and liquid culture. Socio-demographic and clinical information was collected and correlates of active TB, defined as having either a positive GeneXpert MTB/RIF or culture results, were assessed using regression analyses. Among the total of 559 prisoners, 442 (79.1%) had complete data; 28.7% were HIV-infected, 80.8% were men and the average age was 36.4 (SD 9.8) years. Overall, 34 (7.7%) had previously undiagnosed active TB, of whom 64.7% were unable to complete their TB treatment in prison due to insufficient time (<6 months) remaining in prison. Previously undiagnosed active TB was independently associated with older age groups (AOR 11.44 and 6.06 for age ≥ 50 and age 40-49 years, respectively) and with higher levels of immunosuppression (CD4 < 200 cells/ml) in HIV-infected prisoners (AOR 3.07, 95% CI 1.03-9.17). The high prevalence of previously undiagnosed active TB in this prison highlights the inadequate performance of internationally recommended case-finding strategies and suggests that passive case-finding policies should be abandoned, especially in prison settings where HIV infection is prevalent. Moreover, partnerships between criminal justice and public health treatment systems are crucial to continue TB treatment after release.

Confronting the HIV, Tuberculosis, Addiction, and Incarceration Syndemic in Southeast Asia: Lessons Learned from Malaysia.

Throughout Southeast Asia, repressive drug laws have resulted in high rates of imprisonment in people who inject drugs (PWID)and people living with HIV (PLH), greatly magnifying the harm associated with HIV, tuberculosis, and addiction. We review findings from Malaysia's largest prison to describe the negative synergistic effects of HIV, tuberculosis, addiction, and incarceration that contribute to a 'perfect storm' of events challenging public and personal health and offer insights into innovative strategies to control these converging epidemics. The majority of PLH who are imprisoned in Malaysia are opioid dependentPWID. Although promoted by official policy, evidence-based addiction treatment is largely unavailable, contributing to rapid relapse and/or overdose after release. Similarly, HIV treatment in prisons and compulsory drug treatment centers is sometimes inadequate or absent. The prevalence of active tuberculosis is high, particularly in PLH, and over 80% of prisoners and prison personnel are latently infected. Mandatory HIV testing and subsequent segregation of HIV-infected prisoners increases the likelihood of tuberculosis acquisition and progression to active disease, amplifying the reservoir of infection for other prisoners. We discuss strategies to control these intersecting epidemics including screening linked to standardized treatment protocols for all three conditions, and effective transitional programs for released prisoners. For example, recently introduced evidence-based interventions in prisons like antiretroviral therapy (ART) to treat HIV, isoniazid preventive therapy to treat latent tuberculosis infection, and methadone maintenance to treat opioid dependence, have markedly improved clinical care and reduced morbidity andmortality. Since introduction of these interventions in September 2012, all-cause and HIV-related mortality have decreased by 50.0% and 75.7%, respectively. We discuss the further deployment of these interventions in Malaysian prisons.

Helping Women Cope with Life Behind Bars

Implementation of group therapy in Malaysian prison through Cognitive Behavioural Therapy (CBT) approach is deemed important to improve the psychological well-being of the inmates. Numerous studies had been conducted but most of them provide statistical data based on cross-sectional studies but findings on effect of psychological treatment is still very scarce. This preliminary study aimed to examine the impacts of group therapy on psychological well-being of women prisoners, particularly in Malaysia. Sixteen women inmates from Women Prison in Selangor, Malaysia were chosen and assigned by the prison authority to receive eight group therapy sessions. The respondents in this study were of different race/ethnic groups, different faiths, socio-economical and criminal backgrounds, aged between 27 to 56 years old. Self-report measures DASS21 was utilized to examine their psychological well-being before and after eight sessions of group therapy in a duration of four months. This study employed a pre- and post-test design study without a control group. Statistical analyses used were descriptive statistics and paired-samples t-test. The results of this study revealed that there were significant differences in psychological variables as indicated by significant decrease level of depression and stress. Although not significant, their level of anxiety has also reduced. The findings of this study the self-belief and psychological well-being of the inmates. The findings could be used to add knowledge and to better understand the inmates and the rehabilitation methods that work for them. It also give some insights if group therapy can be considered as one of the programs that can support the rehabilitation process of the inmates

Prevalence of psychiatric disorders among juvenile offenders in Malaysian prisons and association with socio-demographic and personal factors.

The number of juvenile offenders admitted to Malaysian prisons is alarming. The purpose of this paper is to determine the presence of any psychiatric disorders and their association with personal characteristics of juvenile detainees in prisons across Peninsular Malaysia. Detainees were recruited from five different prisons in Peninsular Malaysia and interviewed by a psychiatrist using the MINI-Kid and FACES-IV, relevant personal and family information was also collected. A total of 105 detainees participated in the study. Almost all of the offenders (93.3 per cent) had at least one diagnosable psychiatric disorder and more than half (76.2 per cent) had two or more psychiatric diagnoses. Conduct disorder (CD) was the commonest disorder (59.0 per cent), while substance use disorders (SUD) was the commonest co-morbidity. A significant correlation was found between presence of CD, education level and SUD. Almost all (61/62, 98.4 per cent) of the detainees with CD, had not completed schooling (OR 8.03, 95 per cent CI 1.01-71.35), and detainees with this disorder were more likely to use substances than detainees without CD (OR 4.35, 95 per cent CI 1.90-9.99). Detainees with any psychiatric diagnosis were more likely to have four or more siblings in their families (OR 5.5, 95 per cent CI 1.1-26.9). There is a high prevalence of psychiatric disorders among juvenile offenders in Malaysian prisons, detection and intervention would be important.

Socio-demographic and Mechanical Profiles of Malaysian Male Murderers: a Descriptive Study

Objectives: The present study aimed to reveal the socio-demographic and mechanical profiles of Malaysian male murderers. Methodology: An observational cross-sectional methodology was applied using guided self-administered survey among Malaysian male murderers. The present study significantly differs from other studies as the information on murder was obtained from the respective murderer rather than from autopsy reports, official statistics, newspapers, or legal reports. 71 male murderers from 11 Malaysian prisons participated in this study on a voluntary basis. The murderers were queried on various mechanical variables of murder including: motives, methods of killing, weapon usage, targeted body parts, murder settings, murder concealment, relationship with victims, precipitating factors and socio-demographic variables. Results: The emerged profiles were discussed in relation to murder, criminology and victimology contexts. In addition, the Malaysian male murderers profiles were compared with murder profiles from outside of Malaysia. Conclusion: The present study achieved the aim by documenting the socio-demographic and mechanical profiles of male murderers which may be beneficial to scholars, the public and enforcement officials.

Latent tuberculosis infection in a Malaysian prison: implications for a comprehensive integrated control program in prisons

BackgroundPrisons continue to fuel tuberculosis (TB) epidemics particularly in settings where access to TB screening and prevention services is limited. Malaysia is a middle-income country with a relatively high incarceration rate of 138 per 100,000 population. Despite national TB incidence rate remaining unchanged over the past ten years, data about TB in prisons and its contribution to the overall national rates does not exist. This survey was conducted to address the prevalence of latent TB infection (LTBI) in Malaysia’s largest prison.MethodsFrom July to December 2010, all HIV-infected and a comparative group of HIV-uninfected prisoners housed separately in Kajang prison were asked to participate in the survey after explaining the study protocol. Subjects providing informed consent were interviewed using a structured questionnaire followed by the placement of tuberculin skin test (TST) with 2 TU of PPD RT-23 to subjects not being treated for active TB. TST was read after 48-72 hours and indurations of ≥ 5 mm and ≥ 10 mm were considered positive among HIV-infected and HIV-uninfected subjects, respectively. Additionally, HIV-infected inmates underwent phlebotomy for CD4 lymphocyte count assessment. A logistic regression model was explored to determine factors associated with TST positivity.ResultsOverall, 286 subjects (138 HIV-infected and 148 HIV-uninfected) had complete data and TST results. The majority were men (95.1%), less than 40 years old (median age 36.0, SD 7.87), and Malaysians (93.3%). Most (82.5%) had been previously incarcerated and more than half (53.1%) reported sharing needles just prior to their incarceration. TST was positive in 88.8% (84.7% among HIV-infected and 92.5% among HIV-uninfected subjects) and was independently associated with being HIV-uninfected (AOR = 2.97, p = 0.01) and with frequent previous incarcerations (AOR = 1.22 for every one previous incarceration, p = 0.01) after adjusting for other potential confounding factors.ConclusionsThe prevalence of LTBI was extraordinary high in this sample of Malaysian prisoners, regardless of their age or HIV status. This warrants further examination of the size of the problem of TB in other congregate settings and the establishment of an evidence-based TB control program in Malaysian prisons with integrated TB, HIV and substance abuse components.

Prevalence of tuberculosis symptoms and latent tuberculous infection among prisoners in northeastern Malaysia

There are currently no routine screening procedures for active tuberculosis (TB) or latent tuberculous infection (LTBI) in Malaysian prisons. To determine the prevalence and correlates of LTBI and active TB symptoms among Malaysian prisoners with and without human immunodeficiency virus (HIV) infection using the tuberculin skin test (TST) and the World Health Organization TB symptom-based screening instrument. A cross-sectional survey of 266 prisoners was performed in Kelantan, Malaysia. Consenting participants underwent two-step TST and were screened for active TB symptoms. Standardized cut-offs of respectively ≥5 and ≥10 mm were used to define reactive TST among prisoners with and without HIV. Clinical and behavioral data were assessed and HIV-infected prisoners were stratified by CD4 status. Overall LTBI prevalence was 87.6%, with significantly lower TST reactivity among HIV-infected than non-HIV-infected prisoners (83.6% vs. 91.5%, P < 0.05); however, TB symptoms were similar (16.9% vs. 10.1%, P = 0.105). On multivariate analysis, previous incarceration (aOR 4.61, 95%CI 1.76-12.1) was the only significant correlate of LTBI. Increasing age (aOR 1.07, 95%CI 1.01-1.13), lower body mass index (aOR 0.82, 95%CI 0.70-0.96) and TST-reactive status (aOR 3.46, 95%CI 1.20-9.97) were correlated with TB symptoms. LTBI is highly prevalent, associated with previous incarceration, and suggests the need for routine TB screening on entry to Malaysian prisons.

The Diagnostic Performance of a Single GeneXpert MTB/RIF Assay in an Intensified Tuberculosis Case Finding Survey among HIV-Infected Prisoners in Malaysia

BackgroundDelays in tuberculosis (TB) diagnosis, particularly in prisons, is associated with detrimental outcomes. The new GeneXpert MTB/RIF assay (Xpert) offers accurate and rapid diagnosis of active TB, but its performance in improving case detection in high-transmission congregate settings has yet to be evaluated. We assessed the diagnostic accuracy of a single Xpert assay in an intensified case finding survey among HIV-infected prisoners in Malaysia.MethodsHIV-infected prisoners at a single site provided two early-morning sputum specimens to be examined using fluorescence smear microscopy, BACTEC MGIT 960 liquid culture and a single Xpert. The sensitivity, specificity, negative and positive predictive values of Xpert were calculated relative to gold-standard results using MGIT 960 liquid culture. Relevant clinical and demographic data were used to examine correlates of active TB disease.ResultsThe majority of enrolled subjects with complete data (N=125) were men (90.4%), age <40 years (61.6%) and had injected drugs (75.2%). Median CD4 lymphocyte count was 337 cells/µL (IQR 149-492); only 19 (15.2%) were receiving antiretroviral therapy. Of 15 culture-positive TB cases, single Xpert assay accurately detected only eight previously undiagnosed TB cases, resulting in a sensitivity, specificity, positive predictive value and negative predictive value of 53.3% (95% CI 30.12-75.2%), 100% (95% CI 96.6-100%), 100% (95% CI 67.56-100%) and 94.0% (95% CI 88.2-97.1%), respectively. Only 1 of 15 (6.7%) active TB cases was smear-positive. The prevalence (12%) of undiagnosed active pulmonary TB (15 of 125 prisoners) was high and associated with longer duration of drug use (AOR 1.14, 95% CI 1.03-1.26, for each year of drug use).ConclusionsSingle Xpert assay improved TB case detection and outperformed AFB smear microscopy, but yielded low screening sensitivity. Further examination of the impact of HIV infection on the diagnostic performance of the new assay alongside other screening methods in correctional settings is warranted.

Female Prisoners in Malaysia: An Examination of Socio demographic Characteristics

Crime rates have increased significantly over recent months and years, specifically urban crime rate. The number of females incarcerated in Malaysian prisons grew from 2909 in 1998 to 3511 in the year 2000 (15.07 rate per 100,000 inhabitants) (Malaysian Crime Index, 2002). Recent research has compared male and female trends in violent offending arrest data and found that female to male offending rate ratio for aggravated assault, robbery and simple assault have increased over time and there is a narrowing of the gender gaps (Lauritsen et al., 2009). However little is known about the females who commit crimes, the type of crimes committed and the risk factors associated with their criminal behaviour. Studies show that there are variations among female and male crime offenders concerning education, measured intelligence and marital status of parents (Silverthorn et al., 2001). As women are portrayed as the backbone of the nation, it is pertinent to understand who these women are, reasons for committing these crimes and the impact of their imprisonment on their immediate families and to outline methods to overcome this problem. The population to be researched would be the incarcerated females in a Women Prison in Malaysia. From the findings, it is hoped that concrete methods could be outlined as to how crime amongst female could be reduced.

Attitudes toward opioid substitution therapy and pre-incarceration HIV transmission behaviors among HIV-infected prisoners in Malaysia: Implications for secondary prevention

BackgroundPre-incarceration HIV transmission behaviors and current attitudes toward opioid substitution therapy (OST) among HIV-infected male prisoners in Malaysia have important implications for secondary HIV prevention efforts. MethodsIn June 2007, 102 HIV-infected male prisoners within 6 months of community-release were anonymously surveyed in Kota Bharu, Malaysia. ResultsNearly all subjects (95%) met criteria for opioid dependence. Overall, 66% of participants reported sharing needles, and 37% reported unprotected sex in the 30 days prior to incarceration. During this period, 77% reported injection drug use, with 71% injecting daily and 65% injecting more than one substance. Injection of buprenorphine (28%), benzodiazepines (28%) and methamphetamines (49%) was reported. Nearly all (97%) of those reporting unprotected sex did so with someone not known to be HIV-infected. While 51% believed that opioid substitution therapy (OST) would be helpful, only 33% believed they needed it to prevent relapse after prison release. Most participants (70%) expressed interest in learning more about OST. Those reporting the highest injection risks were more likely to believe OST would be helpful (p<0.05), to believe that it was needed to prevent relapse post-release (p<0.05), and to express interest in learning more about OST (p<0.01). ConclusionsSecondary HIV prevention among prisoners in Malaysia is crucial to reduce community HIV transmission after release. Effectively reducing HIV risk associated with opioid injection will require OST expansion, including social marketing to improve its acceptability and careful monitoring. Access to sterile injection equipment, particularly for non-opioid injectors, and behavioral interventions that reduce sexual risk will also be required.

Adapting an Evidence-Based Intervention Targeting HIV-Infected Prisoners in Malaysia

HIV-infected prisoners in Malaysia represent a critical target population for secondary HIV risk reduction interventions and care. We report on the process and outcome of our formative research aimed at systematically selecting and adapting an EBI designed to reduce secondary HIV risk and improve adherence to antiretroviral therapy among soon-to-be-released HIV-infected prisoners. Our formative work involved a critical examination of established EBIs and associated published reports complemented by data elicited through structured interviews and focus groups with key stakeholders, members of the target population, and their family members. Based on all information, we adapted the Holistic Health Recovery Program targeting people living with HIV (HHRP+), an EBI, to consist of eight 2-hour sessions that cover a range of specified topics so that participants may individually apply intervention content as needed to accommodate their particular substance abuse, HIV risk, and antiretroviral adherence issues. This study provides a complete example of the process of selecting and adapting an EBI—taking into account both empirical evidence and input from target organization stakeholders and target population members and their families—for use in real world prison settings where high-risk populations are concentrated.

Prevalence and correlates of community re-entry challenges faced by HIV-infected male prisoners in Malaysia

HIV-infected prisoners face an inordinate number of community re-entry challenges. In 2007, 102 HIV-infected prisoners in Malaysia were surveyed anonymously within six months prior to release to assess the prevalence and correlates of community re-entry challenges. Staying out of prison (60.8%), remaining off drugs (39.2%), finding employment (35.3%) and obtaining HIV care (32.4%) were the re-entry challenges reported most frequently. Global stigma, negative self-image and public attitudes-related stigma were independently associated with challenges to obtaining HIV care. In multivariate analyses, those with previous incarcerations (adjusted odds ratio [AOR], 3.2; 95% confidence interval [CI], 1.4-7.6), higher HIV-related symptoms (AOR, 2.0; 95% CI, 1.0-4.1) and higher public attitudes-related stigma (AOR, 2.5; 95% CI, 1.2-5.1) had a significantly higher likelihood of identifying more re-entry challenges. Targeted interventions, such as effective drug treatment, HIV care and public awareness campaigns, are crucial for stemming the HIV epidemic and improving health outcomes among HIV-infected prisoners in Malaysia.

Female Prisoners in Malaysia

This is a study on 422 female prisoners in peninsular Malaysia. More than half of the female prisoners are foreigners, mainly from Indonesia and Thailand. This study surveys the background of the respondents and identifies factors that may have influenced them to commit the offences. Female prisoners in Malaysia, particularly those who are foreigners, still fit the stereotypical image of female prisoners of the 1970s. They fit into the economic marginalisation thesis proposed by Steffensmeier and Streifel (1992) that women commit crimes because of poverty and financial problems. They also fit into Merlo's contention that poverty and drugs were major factors contributing to female criminality. Other factors that are related to re-offending or recidivism include physical abuse, alcohol abuse, drug abuse, coming from unhappy homes, having family members who have been charged with an offence previously and having family members who have been to prison. The rehabilitation programmes in the Malaysian prisons are also lacking and outdated. New rehabilitation programmes need to be implemented to help female prisoners reintegrate into the society.

Conditions in Malaysian prisons

Conditions in Malaysian prisons