Key medical figures:
• 250 patients under treatment for MDR-TB
• 43 patients on first-line ARV treatment
The dual drug-resistant tuberculosis (DR-TB) and HIV epidemics in the Ukrainian penitentiary system are an urgent public health issue.
Overcrowded prison environments and the inadequate healthcare provided to inmates exacerbate the spread of DR-TB. The diagnosis and treatment of the disease in Ukrainian prisons is limited.
Since 2012, Médecins Sans Frontières (MSF) has provided DR-TB treatment to prisoners and ex-prisoners in eastern Ukraine’s Donetsk region. DOTS (directly observed treatment, short course), the treatment recommended by the World Health Organization, is provided in a special prison TB hospital and in three pre-trial detention centres. Antiretroviral (ARV) therapy is given to DRTB patients co-infected with HIV. After the prisoners are released, MSF works to ensure that they complete their DR-TB treatment.
The course of treatment for DR-TB takes up to two years and can result in a number of side effects, some of them severe, including vomiting, nausea, depression and loss of hearing. Counselling is an important part of the patient-centred programme, to help people cope with their diagnosis and adhere to treatment. Inmates often come from deprived environments, with difficult family histories and experiences of social marginalisation.Some have psychological disorders, and many suffer from drug and alcohol addictions. MSF provides laboratory services for rapid, accurate TB diagnosis, adverse effects diagnosis and management, and guarantees an uninterrupted quality- assured drugs supply is available. MSF also lobbies the State Penitentiary Service of Ukraine and the Ministry of Health, at regional and national levels, for the integration of TB and HIV services and multidisciplinary, patient-oriented TB case management in penal facilities.
No. staff end 2013: 62 | Year MSF first worked in the country: 1999