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

Aida SA, Aili HH, Manveen KS, Salwina WI, Subash KP, Ng CG, et al.

Int J Prison Health, 2014;10(2):132-43.
PMID: 25764076 DOI: 10.1108/IJPH-06-2013-0029

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

Bick J, Culbert G, Al-Darraji HA, Koh C, Pillai V, Kamarulzaman A, et al.

Int J Prison Health, 2016 12 19;12(4):253-269.
PMID: 27921633 DOI: 10.1108/IJPH-06-2016-0017

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.
Intensified pulmonary tuberculosis case finding among HIV-infected new entrants of a prison in Malaysia: implications for a holistic approach to control tuberculosis in prisons

Al-Darraji H, Hill P, Sharples K, Altice FL, Kamarulzaman A

Int J Prison Health, 2023 Jan 11.
PMID: 36622107 DOI: 10.1108/IJPH-01-2022-0001

PURPOSE: This intensified case finding study aimed to evaluate the prevalence of tuberculosis (TB) disease among people with HIV entering the largest prison in Malaysia.
DESIGN/METHODOLOGY/APPROACH: The study was conducted in Kajang prison, starting in July 2013 in the men's prison and June 2015 in the women's prison. Individuals tested positive for HIV infection, during the mandatory HIV testing at the prison entry, were consecutively recruited over five months at each prison. Consented participants were interviewed using a structured questionnaire and asked to submit two sputum samples that were assessed using GeneXpert MTB/RIF (Xpert) and culture, irrespective of clinical presentation. Factors associated with active TB (defined as a positive result on either Xpert or culture) were assessed using regression analyses.
FINDINGS: Overall, 214 incarcerated people with HIV were recruited. Most were men (84.6%), Malaysians (84.1%) and people who inject drugs (67.8%). The mean age was 37.5 (SD 8.2) years, and median CD4 lymphocyte count was 376 cells/mL (IQR 232-526). Overall, 27 (12.6%) TB cases were identified, which was independently associated with scores of five or more on the World Health Organization clinical scoring system for prisons (ARR 2.90 [95% CI 1.48-5.68]).
ORIGINALITY/VALUE: Limited data exists about the prevalence of TB disease at prison entry, globally and none from Malaysia. The reported high prevalence of TB disease in the study adds an important and highly needed information to design comprehensive TB control programmes in prisons.
Fulltext HIV/AIDS, hepatitis and tuberculosis-related mortality among incarcerated people: a global scoping review

Bosworth RJ, Borschmann R, Altice FL, Kinner SA, Dolan K, Farrell M

Int J Prison Health, 2022 Jan 25;18(1):66-82.
PMID: 35401772 DOI: 10.1108/IJPH-02-2021-0018

PURPOSE: People in prison are at a higher risk of preventable mortality from infectious disease such as HIV/AIDS, HBV, HCV and TB than those in the community. The extent of infectious disease-related mortality within the prison setting remains unclear. Our aim was to collate available information on infectious disease-related mortality, including the number of deaths and calculate the person-time death rate.
DESIGN/METHODOLOGY/APPROACH: We searched databases between 1 Jan 2000 and 18 Nov 2020 for studies reporting HIV, HBV, HCV, TB and/or HIV/TB-related deaths among people in prison.
FINDINGS: We identified 78 publications drawn from seven UNAIDS regions encompassing 33 countries and reporting on 6,568 deaths in prison over a 20-year period. HIV/AIDS (n=3,305) was associated with the highest number of deaths, followed by TB (n=2,892), HCV (n=189), HIV/TB (n=173), and HBV (n=9). Due to the limitations of the available published data, it was not possible to meta-analyse or in any other way synthesise the available evidence.
ORIGINALITY/VALUE: To our best knowledge, this is the first scoping review focused on deaths due to these infections among people in prison internationally. The gaps identified form recommendations to improve the future collection and reporting of prison mortality data.
RESEARCH IMPLICATIONS: To inform targeted efforts to reduce mortality, there is a need for more, better quality data to understand infectious disease-related mortality in custodial settings. Increased investment in the prevention and management of infectious diseases in custodial settings, and in documenting infectious disease-related deaths in prison, is warranted and will yield public health benefits.