TB Time bomb in Siberian prisons

Moscow/Sydney - Of the 25,000 prisoners confined to prison colonies in the Kemerovo region in Central Siberia, 3,900 are reported to be suffering from TB. In this region, prisons are the incubation point from which the disease spreads to the general population. Russian prisoners contract TB 40 times more often than civilians. With an estimated 147,000 new cases in Russia in 1996 and the incidence climbing by 10% every year, a concerted response to dealing with the illness is essential within the context of the global battle against TB. Tuberculosis is a very contagious disease that is lethal if left untreated. Incomplete or partial treatment causes a multidrug-resistant TB (MDR-TB), which is a hundred times more expensive to treat than standard TB treatment. 24 March is World TB Day. To bring TB under control in Russia, financial and medical resources must be allocated. MSF is calling on all involved parties - the WHO, the Russian government and donors - to act quickly and to coordinate their efforts. According to MSF's medical coordinator, Dr Tine Demeulenaere, "Doctors in civilian TB dispensaries throughout Central Siberia estimate that up to 70% of their patients are former prisoners. We suspect that many of them suffer from MDR-TB. We fear the spread of multidrug-resistant TB will have disastrous effects on health and society. Unfortunately, the TB emergency is not being addressed with adequate resources". Of the 3,900 prisoners suffering from TB in Kemerovo region, MSF is treating 1,255 in the Mariinsk Prison Hospital. Upon arrival at Mariinsk, MSF introduced the World Health Organisation's DOTS (Directly Observed Treatment Short-course) protocol. In previous years, frequent interruptions of treatment due to irregular drug supplies had helped MDR-TB develop among the prisoners. Patients with MDR-TB are difficult to cure and continue to infect people in their proximity. At present, more than 2,500 prisoners outside Mariinsk are receiving incomplete or no treatment at all. However, to be effective and reduce the development of MDR-TB, all new TB cases should immediately be treated under DOTS. Currently, this is not the case either in the prison colonies or outside as DOTS has not yet been officially adopted by the Russian National Health Policy. 5 MSF field workers - 2 doctors, 2 nurses, 1 laboratory technician - support the Mariinsk hospital staff in TB colony 33 of Kemerovo region. In the former Soviet Union MSF runs anti-TB projects in Abkhazia, Nagorno-Karabagh, Kazakstan, Ossetia and Uzbekistan. MSF teams also fight TB in Angola, Afghanistan, Cambodia, Ethiopia, Kenya, the Philippines, Somalia, Sudan and Thailand.