Twenty (20) health officers from correctional facilities in Lesotho comprising nurses, enviromental specialists, pharmacists, health managers and monitoring and evaluation oficer, were trained as trainenrs on TB infection control for corectional services, in line with international standards for TB control in correctional services. The training took place in Mohale district in Lesotho, from 19 – 23 March 2018.
The training was an initiative from the kingdom of Lesotho. The East, Central and Southern Africa Health Community (ECSA-HC), under the Southern Africa TB and health system support project (SATBHSSP) helped coordinate a training facilitated by national and international stakeholders engaged on TB infection control. The 5-day training targeted health officers from 11 correctional facilities, regional and central level units of the corrrectional health services. The training was facilitated by the country team, namely, Ministry of Health-NTP and Lesotho Correctional Services, in collaboration with the East, Central and Southern Africa Health Community (ECSA-HC) and Biomedical Research Institute from Zimbabwe (BRTI).
Correctional facilities or prisons are an important reservoir of TB infection in most parts of the world, but particularly in countries that have a high incidence of TB and HIV, such as Lesotho. TB burden in correctional facilities or prisons can be up to 100 times higher than in the general population. Worldwide, 24% of MDR-TB cases are from prison settings. Overcrowding, poor hygiene and inadequate ventilation contribute to the spread of infection. In addition to this, factors such as poor human resources (number and skills), largely contributes to perpetuation of infection cycle and to the unbearable burden of TB in inmates and staff in correctional facilities.
One of the mandates of the SATBHSS project is to “Mobilize communities to enhance active TB detection in key populations and strengthen their linkage to care” and correctional inmates are a key target group in the project. In addition to bearing a high burden of TB, correctional inmates are part of the community and are a highly mobile population, posing a significant risk to their families and communities.
The training was aimed at providing a framework and general guidance for effective prevention and control of TB in correctional facilities; and strengthen the capacity of correctional facilities’ health staff to deliver training on infection control and reinforce implementation of measures in correctional facilities.
The trainees were very motivated and actively participating. There were important gaps identified in the implementation of infection control measures, standardization of procedures, infrastructure compliance with infection control standards, and collaboration with health department.
By the end of the training trainees developed a draft infection control plan for each facility and a cascade training plan; a draft SoP to standardize the procedures in correctional facilities was developed and discussed; and recommendations and follow-up actions to strengthen advocacy to improve infrastructure development and collaboration between correctional facilities and public health departments were agreed.