Overcrowded prisons spread TB source

Overcrowded prisons, a shortage of medical staff and a shortage of money ensure that the efforts to combat tuberculosis (TB) in prisons fail. The 422 prisons in Indonesia are currently more than 140,000 prisoners, but while these were designed for only 80,000 prisoners, according to the Ministry of Justice.

The government already began in 2004 with a program to combat TB in prisons by using the so-called Directly Observed Treatment, Short-course or DOTS, a strategy for detention and treatment from the World Health Organization.

But to date, only 17 of the 122 prisons in 33 provinces in the country benefited from the DOTS program, which receives support from the Global Fund, said Daniel Rashid, head of TB control in the prison system.

"The biggest problem is overpopulation," says Rashid. "Overcrowding in prison makes it easier for diseases to spread. It spreads a disease like TB is much simpler than, for example HIV because TB is no direct physical contact is necessary." The fight against drugs caused a significant increase in the number of prisoners, especially so in large cities, most inmates convicted of drug-related offenses, he said.

If a person is not treated, can in turn 10 to 15 people per year infect others. Data from the Ministry of Justice, deceased in 2009 a total of 90 persons on TB in Indonesian prisons. This was in 2008 150. Indonesia has the third highest TB burden in the world, according to the WHO.

Every year some 140,000 Indonesians die of TB, Stop TB Partnership Indonesia said. TB in Indonesia This is the second biggest killer after heart disease for all ages in the country, according to the Ministry of Health.

Although little is known about the current state of TB in Indonesian prisons, showed a survey of the Ministry of Health from 2005 show that 1.7 percent of the prisoners had TB, said Tjandra Yoga Aditama, head of infectious diseases of the Ministry. That number was 16 times higher than the rate measured sick throughout the population, he said.

Aditama said that outside the overcrowded prisons is also a shortage of medical staff, poor hygiene, poor control of prisoners and lack of awareness among employees of prisons for spread of TB care. "Prevention and control of TB can not be performed adequately because of poor condition of the buildings and infrastructure," said Aditama.