METHODOLOGY: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. From the relevant articles, we extracted data and conducted a risk of bias assessment of individual studies.
RESULTS: The search yielded 22 and 13 publications on HAV seroprevalence and incidence, respectively. Overall, our findings point to a very low HAV endemicity profile in Thailand and Singapore and evidence of a shift towards low HAV endemicity in Indonesia, Lao People's Democratic Republic, Malaysia, the Philippines, and Vietnam. Only Singapore, Thailand, Malaysia, and the Philippines have existing HAV disease surveillance and reported incidence rates below 1 per 100,000. Several outbreaks with varying magnitude documented in the region provide insights into the evolving epidemiology of HAV in the region. Risk of bias assessment of studies revealed that the individual studies were of low to medium risk.
CONCLUSIONS/SIGNIFICANCE: The available HAV endemicity profiles in Southeast Asian countries, aside from Thailand, are limited and outdated, but suggest an endemicity shift in the region that is not fully documented yet. These findings highlight the need to update information on HAV epidemiology through strengthening of disease surveillance mechanisms to confirm the shift in HAV endemicity in the region.
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.