Diagnóstico situacional das doenças infectocontagiosas na população privada de liberdade no Rio Grande do Sul (RS).

Abstract

The prevalence of infectious diseases in the Private Population of Freedom (PPL) of Rio Grande do Sul is little known, as are the actions developed by the Prison Basic Attention Teams (EABp) regarding the diagnosis, treatment and prevention of tuberculosis, HIV, syphilis and viral hepatitis. The general objective of this dissertation was to carry out the situational diagnosis related to the prevention, identification and follow-up of the main infectious diseases that affect the Population Deprived of Freedom of Rio Grande do Sul. Article I: SYPHILIS IN THE POPULATION DEPRIVED OF LIBERTY: an integrative review of the literature - Justificative and Objectives: The Population Deprived of Liberty (PPL) is more vulnerable to infectious diseases, including syphilis. The magnitude of the problem is unknown, due to limited data and studies on the subject. The objective of this research is to systematize the knowledge produced about syphilis related to prison health in the last 5 years. Content: This integrative review utilized the DeCS (health descriptors): syphilis, prisons and prisoners and their English equivalents syphilis, prisons and prisoners combined and collected in the month of September 2018 in the LILACS, Scielo and Medline (PubMed) databases. Duplicate articles were deleted. After reading and careful analysis were excluded those who do not approach syphilis in the prison context and articles that did not present results. We selected 16 articles that dealt with the theme: studies developed with inmates of the closed system, studies carried out with prisoners about to be released and prison inmates, studies with women and articles of revision. Conclusion: High prevalence of syphilis in the prison context is associated with risk behaviors and is found in Latin America and Central Asia, women, prisoners about to be released and prisoners of the penal system and immigrants imprisoned in Europe. Article II: BACTERIOLOGICAL DIAGNOSIS OF TUBERCULOSIS IN THE PRIVATE POPULATION OF FREEDOM: actions developed by the Prison Basic Attention Teams - In order to collect data on bacteriological diagnosis of pulmonary tuberculosis in the population deprived of freedom, an electronic questionnaire was sent to 29 criminal institutions in Rio Grande do Sul. The questionnaire was answered by Prison Basic Attention Teams (EABp) of 22 (75.86%) institutions. Sputum smear microscopy was performed by 18 (81.8%) EABp, sputum culture by 16 (72.7%) EABp, sensitivity tests by 10 (5.5%) EABp and rapid molecular tests by 3 (13.6 %) EABp. The results show fragility in the actions of bacteriological diagnosis of tuberculosis developed by the EABp, reflecting the need for capacity building. Article III: Infectious diseases in prisoners in southern Brazil - Objectives: The objective of this research is to identify the prevalence of tuberculosis, syphilis, HIV / AIDS, hepatitis B and hepatitis C, and access to diagnostic and treatment exams in the penal institutions of the extreme south of Brazil. Methodology: Cross-sectional study using electronic form of the LimeSurvey Platform, sent by e-mail to the 29 criminal institutions with Prison Basic Attention Teams located in Rio Grande do Sul. Results: The questionnaire answered 23 (79.3%) Prison Basic Attention Teams. This study found a prevalence of 3,018 cases / 100 thousand inhabitants of Tuberculosis, 4,578 cases / 100 thousand inhabitants of HIV, 9,759 cases / 100 thousand inhabitants of syphilis, 291 cases / 100 thousand inhabitants of Hepatitis B and 2,570 cases / 100 thousand inhabitants of Hepatitis C. Limitations (if applicable): Many teams lack records of infectious disease data. Delay for return of the questionnaires, incomplete and unanswered questionnaires configure the limitations of the study. Practical implications (if applicable): The control of infectious diseases in the population deprived of freedom allows the control of transmission outside the walls and protection of the general population. Social implications (if applicable): Health in the penal system is the responsibility of the State, knowing this reality allows actions based on evidence. Originality: This article presents a situational diagnosis related to infectious diseases in the Private Population of Freedom in southern Brazil. This information is not available in the official information systems. Article IV: ANALYSIS OF THE ACTIVITIES DEVELOPED BY PRISONAL BASIC ATTENTION TEAMS IN THE CONTROL OF INFECTOCONTAGIOUS DISEASES IN PRISONERS IN SOUTH OF BRAZIL - With the objective of analyzing the actions developed by the Prison Basic Attention Teams for the control of infectious diseases in the Population Deprived of Liberty of Rio Grande do Sul, a cross-sectional study was developed. The methodology included an online questionnaire sent by e-mail to the 29 criminal institutions with Prison Basic Care Teams, with information on the diagnosis, treatment and follow-up of tuberculosis, HIV, syphilis, hepatitis B and hepatitis C. questionnaire was answered by 23 (79.3%) teams and analyzed by team type. The Prison Type I Primary Care Teams serve the fewest prisoners and develop few actions to control infectious diseases in PPL. The Prison Type II Primary Care Teams receive 88.89% of the PPL, which includes Prison Health Units, and their actions have a greater impact due to the population served by these teams. The Prison Basic Attention Teams type III are smaller, but each team serves a larger number of inmates. These teams spend more time in the Prison Health Unit and present more effective actions to control infectious diseases. The actions of control of the infectocontagiosas diseases in the PPL must be evaluated by type of team, taking into account its context. Considering the articles presented and the information provided by Prison Primary Care Teams, it was possible to carry out the situational diagnosis related to the prevalence of infectious diseases that most affect the prison population: tuberculosis, HIV, syphilis and viral hepatitis. Differences were identified in the actions performed by the different types of team, their potentialities and weaknesses, regarding the diagnosis, treatment and prevention of these diseases.