Resources for adherence to treatment in patients with tuberculosis in the post-penitentiary phase

Abstract

A high proportion of patients who leave Russian prisons without a known treatment outcome (from 26 to 32%) reduces the rate of successful treatment. Some patients who started treatment in prison do not continue it in the public health system after release.

Objective. Using a representative sample of TB-infected inmates, study the need for social support measures that would motivate them to continue treatment.

Materials and methods. One stage anonymous sociological study of 453 TB-infected inmates in 40 regions of the Russian Federation, with fixed answer options that allow for multiple choices.

Results. The need for one-time cash support was 63.4%; 95% confidence interval (CI) 58.8–67.7, ie from 4 to 5 thousand patients annually; assistance with housing — 32.7%; 95% CI 28.5-37.1, ie from 2 to 2.5 thousand; employment — 30.9%; 95% CI 26.8–35.3, ie from 2 to 2.5 thousand; regular food packages — 27.9%; 95% CI 21.2–29.1, ie from 1.5 to 2 thousand; reissuance of documents — 21.0%; 95% CI 17.5–25.0, ie from 1.3 to 1.8 thousand.

Conclusion. There is a need for legislative justification for the establishment of social rehabilitation centers, coordination of their joint activities with the tuberculosis program. The programs for the provision of social support to patients with tuberculosis should envisage one-time payments for tuberculosis patients released from prisons who get linked to medical care, assistance to these patients with employment and interaction with social rehabilitation centers in order to provide patients with a temporary place of residence.