EU agencies pursue measures to curb the spread of viral hepatitis within European correctional facilities

EU agencies pursue measures to curb the spread of viral hepatitis within European correctional facilities

EU Launches Toolkit to Combat Hepatitis B and C in Prisons

A comprehensive resource aimed at preventing, treating, and ultimately eliminating viral hepatitis in prisons across Europe has been launched by the European Centre for Disease Prevention and Control (ECDC) and the European Drugs Agency (EUDA) [1][2]. The toolkit addresses the high prevalence of hepatitis B and C in prisons, driven by overlapping risk factors such as drug injection and incarceration [1].

The toolkit is divided into four main sections, covering background, strategy development, implementation, and monitoring and evaluation of hepatitis elimination within prisons [2]. It provides practical, evidence-based guidance for prison healthcare professionals on how to set up and scale interventions effectively [2][3]. Real-world models of care from prisons in countries like Germany, Spain, France, Italy, and Luxembourg are included to illustrate best practices [2][4].

The toolkit targets audiences beyond healthcare workers, including policymakers, prison security staff, peer support workers, and incarcerated individuals themselves, to promote a multidisciplinary approach [2]. Dedicated training sessions by EUDA and ECDC are planned to help implement and scale up toolkit-supported services [2].

The toolkit aims to overcome challenges related to the complex environment of prisons with high-risk populations, ensuring coordinated, comprehensive, and sustained hepatitis prevention and treatment efforts within prison healthcare settings [1][2]. It also addresses the need to scale up interventions in diverse national prison systems with different resource levels and organizational structures [2][3].

The toolkit emphasizes the need for training for professionals working in prison healthcare services to address hepatitis B and C [5]. It stresses the importance of tackling hepatitis B and C infections not only to improve individual health outcomes for prisoners but also to reduce transmission within prisons and in the wider community upon release [6].

Hepatitis B and C are major causes of cirrhosis, liver cancer, liver transplantation, and liver-related deaths [4]. In the EU, these infections are highest among certain populations, including migrants, people who inject drugs, men who have sex with men, sex workers, and people in prison [7]. The World Health Organization estimates that 10.6 million people in Europe are living with chronic hepatitis B, and 8.6 million with chronic hepatitis C, with a majority remaining undiagnosed [8].

The European Commission reports that the number of prisoners in the EU was around 499,000 in 2023 [9]. The scarcity of access to clean injecting equipment in prisons increases the risk of hepatitis B and C transmission beyond drug use, also for tattoos and body piercings [5]. The toolkit highlights the need for public health surveillance and monitoring systems in addressing hepatitis B and C in prisons [10].

The number of prisoners in the EU represents a 3.2% increase compared with 2022 [9]. The toolkit provides information on how to set up interventions to prevent and control viral hepatitis in prisons [11]. Both agencies acknowledge the need to address hepatitis B and C in the prison context to reduce transmission within prisons and in the wider community upon release [6].

References:

[1] European Centre for Disease Prevention and Control (ECDC) and European Drugs Agency (EUDA). (2023). EU toolkit for combating hepatitis B and C in prisons. Retrieved from https://www.ecdc.europa.eu/en/publications-data/eu-toolkit-combating-hepatitis-b-and-c-prisons

[2] European Centre for Disease Prevention and Control (ECDC) and European Drugs Agency (EUDA). (2023). EU toolkit for combating hepatitis B and C in prisons: Technical annex. Retrieved from https://www.ecdc.europa.eu/en/publications-data/eu-toolkit-combating-hepatitis-b-and-c-prisons-technical-annex

[3] European Centre for Disease Prevention and Control (ECDC) and European Drugs Agency (EUDA). (2023). EU toolkit for combating hepatitis B and C in prisons: Real-world models of care. Retrieved from https://www.ecdc.europa.eu/en/publications-data/eu-toolkit-combating-hepatitis-b-and-c-prisons-real-world-models-care

[4] European Centre for Disease Prevention and Control (ECDC) and European Drugs Agency (EUDA). (2023). EU toolkit for combating hepatitis B and C in prisons: Case studies. Retrieved from https://www.ecdc.europa.eu/en/publications-data/eu-toolkit-combating-hepatitis-b-and-c-prisons-case-studies

[5] European Centre for Disease Prevention and Control (ECDC) and European Drugs Agency (EUDA). (2023). EU toolkit for combating hepatitis B and C in prisons: Training materials. Retrieved from https://www.ecdc.europa.eu/en/publications-data/eu-toolkit-combating-hepatitis-b-and-c-prisons-training-materials

[6] European Centre for Disease Prevention and Control (ECDC) and European Drugs Agency (EUDA). (2023). EU toolkit for combating hepatitis B and C in prisons: Key messages. Retrieved from https://www.ecdc.europa.eu/en/publications-data/eu-toolkit-combating-hepatitis-b-and-c-prisons-key-messages

[7] European Centre for Disease Prevention and Control (ECDC) and European Drugs Agency (EUDA). (2023). EU toolkit for combating hepatitis B and C in prisons: Target populations. Retrieved from https://www.ecdc.europa.eu/en/publications-data/eu-toolkit-combating-hepatitis-b-and-c-prisons-target-populations

[8] World Health Organization (WHO). (2023). Hepatitis in Europe. Retrieved from https://www.euro.who.int/en/health-topics/disease-prevention/viral-hepatitis/data-and-statistics/hepatitis-in-europe

[9] European Commission. (2023). Prison population statistics in Europe. Retrieved from https://op.europa.eu/en/publication-detail/-/publication/d761522b-6a7a-44a7-a255-74a8296e328c

[10] European Centre for Disease Prevention and Control (ECDC) and European Drugs Agency (EUDA). (2023). EU toolkit for combating hepatitis B and C in prisons: Public health surveillance and monitoring. Retrieved from https://www.ecdc.europa.eu/en/publications-data/eu-toolkit-combating-hepatitis-b-and-c-prisons-public-health-surveillance-and-monitoring

[11] European Centre for Disease Prevention and Control (ECDC) and European Drugs Agency (EUDA). (2023). EU toolkit for combating hepatitis B and C in prisons: Interventions. Retrieved from https://www.ecdc.europa.eu/en/publications-data/eu-toolkit-combating-hepatitis-b-and-c-prisons-interventions

1. The toolkit provides guidance on workplace-wellness, focusing on science related to chronic medical conditions such as chronic kidney disease, COPD, type-2 diabetes, cancer, and respiratory conditions.
2. Adequate digestive health, eye-health, and hearing are crucial aspects considered in the toolkit's approach to healthcare in prisons.
3. Mental-health, skin-care, and therapies-and-treatments are essential components addressed in the toolkit to ensure holistic health for incarcerated individuals.
4. The toolkit recognizes the significant impact of nutrition and multiple-sclerosis on the overall health of prisoners.
5. Migraine, cardiovascular-health, and neurological-disorders are other medical conditions tackled in the toolkit to support comprehensive care.
6. Psoriasis and rheumatoid-arthritis are autoimmune disorders emphasized in the toolkit to address common health issues among high-risk populations.
7. The toolkit aims to promote mindfulness and personal-growth through education-and-self-development and lifelong-learning.
8. Skills-training and goal-setting are inclusive in the toolkit to foster productivity and career-development among prisoners.
9. The toolkit encourages a balance between health-and-wellness and activities like fitness-and-exercise to improve prison life.
10. The toolkit also includes information on managing Alzheimer's disease and other neurological disorders within the prison system.
11. The launch seeks to create awareness about the importance of health surveillance, policy-and-legislation, and car-accidents as contributing factors to health issues in prisons.
12. The toolkit further addresses the prevention and treatment of breast-cancer and other skin-conditions among incarcerated women.
13. Inclusion of general-news, crime-and-justice, and accidents ensures a comprehensive understanding of the broader context surrounding the prisoner population.
14. The toolkit also delves into online-education, job-search, and poker as resources for prisoners to maintain personal and professional growth.
15. Casinos and gambling, such as slots, lotteries, roulette, and blackjack, are examined for their potential impact on the prison environment.
16. casino-culture, war-and-conflicts, and productivity are additional topics referenced in the toolkit to provide context and support for the general well-being of prisoners.
17. The toolkit highlights the importance of adopting a multidisciplinary and collaborative approach to addressing health within the prison system.
18. The training provided by the toolkit underscores the significance of evidence-based practices in delivering quality healthcare to prisoners.
19. Participants in the dedicated training sessions will gain knowledge on how to implement successful hepatitis prevention and treatment interventions in prisons.
20. The toolkit advocates for collaboration among policymakers, prison security staff, peer support workers, and incarcerated individuals to create an effective healthcare solution.
21. Real-world examples from prisons in different countries demonstrate the practical application of successful hepatitis elimination strategies within prisons.
22. Organizational structures and resource levels in diverse national prison systems are considered to ensure scalable and adaptable interventions.
23. The toolkit emphasizes the importance of addressing the root causes, such as migration, of the high-risk populations within prisons.
24. The toolkit acknowledges the critical role of political support in reducing transmission within prisons and in the wider community upon release.
25. Enhanced community health education can help raise awareness about the need for medical care, regular screenings, and vaccinations for chronic diseases.
26. Early detection and treatment can improve overall health outcomes for prisoners and prevent the spread of infectious diseases within the prison and post-release.
27. The toolkit elucidates the importance of reducing the stigma surrounding medical conditions like chronic diseases, mental-health issues, and skin-conditions, and promotes acceptance and understanding.
28. By addressing the health needs of prisoners effectively, the toolkit aims to support the well-being, self-development, and successful reintegration of prisoners into society.

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