Azerbaijan, Baku, April 14 / Trend K. Zarbaliyeva /
The work on the continuation of treatment of released prisoners with drug-resistant form of tuberculosis has been launched in Azerbaijan, the Ministry of Justice Chief Medical Office head Rafael Mehdiyev said in an interview with Trend.
"Treatment is held under control for released prisoners with drug-resistant form of tuberculosis to be fully treated. We want to expand the scope of activities in this regard, " the department head said.
Mehdiyev said that the activity to continue treatment after release of prisoners with a resistant form of tuberculosis is based on the agreement reached by the Chief Medical Office, Institute for Lung Diseases and the International Committee of the Red Cross (ICRC).
"The prisoners is a special category of people with mentality, requiring an individual approach. In some cases, detainees released under various pretexts, begin to shy away from treatment. It was agreed to achieve full recovery of these individuals to avoid such facts. Therefore, the corresponding work is being held", the department head said.
The number of death from tuberculosis among prisoners reduced by 32.5 times in Azerbaijan compared to 1995. The total number of deaths among them has declined over this period by 11.4 percent.
"This is the result of reforms implemented in the prison system by the Ministry of Justice in recent years and especially over the past ten years. For example, in 2009, the number of tuberculosis patients was reduced by half compared to the previous year", Mehdiyev said.
According to the Head of Department, at present, there are about 700 people in a specialized facility for tuberculosis patients. About 150 are under medical observation, more than 500 under the treatment and medical supervision.
Tuberculosis has been recently reduced in the penitentiary system, Mehdiyev said. He said that most people having tuberculosis are older than 30-35. Tuberculosis is most common among prisoners, re-serving a term, not complying with hygiene regulations, malnourished, patients - carriers of the hepatitis C virus, HIV.
Mehdiyev said that new staff, methods of instrumental studies and the most modern methods of laboratory research have been used in the fight against tuberculosis as a result of reforms conducted in this direction.
"A modern laboratory for diagnosis of tuberculosis operates in our facility for treatment of tuberculosis. This laboratory was certified by a supranational laboratory in the German city of Borstel. That is, studies conducted in our laboratory over the past five years, have been verified in this laboratory and the results are fully confirmed. One can detect not only the TB bacillus, but also the sensitivity to anti-TB drugs I and II in our laboratory. Tubercle bacillus is revealed by not only bacteriological, but also by seeding. About 700 investigations of sputum were conducted in this lab. Requests for them were received from the civilian sector. That is, sputum of patients from institutions to combat tuberculosis were conducted in our laboratory. They operate in the civilian sector. Sensitivity to anti-TB drugs in patients has been verified. The presence of the tuberculosis bacillus was confirmed, " official representative of the department said.
Mehdiyev said that earlier diagnose for TB bacilli was confirmed by bacteriological studies during four months in the prison system, now it is conducted within fifteen days thanks to a new laboratory and equipment. In 2007 laboratory equipment BACTEC MGIT was used for the first time in a special facility of the Penitentiary Service in the country. In 2008 HAİN tests were used.
Modern equipment "GeneXpert", which is currently at the demonstration stage, has been tested in the lab since late 2008 on the basis of an agreement reached with the Swiss organization FİND, functioning under the care of the WHO.
"Tuberculosis bacillus can be detected with this equipment within an hour and a half. The sensitivity to the two anti-TB drugs, which contributes to early detection of tuberculosis of resistant forms can be determined. Such equipment is available only in five countries. It is at the demonstration stage.
Presenting total results of our research to WHO, FİND will address with a broad introduction of this equipment in primary health care system. I am sure that this will be the most modern equipment in the field of detection of tuberculosis," the department head said.
Combat tuberculosis has been started in the prison system since 1995 with the support of the ICRC. As a result of achievements in this area in recent years the committee is moving away from this activity in the prison system.
"In fact, the ICRC limits its activity rendering only technical support and recommendations during the last three or four years. But we keep working together and achieving good results. We hope that it will be so in future. Our achievements in the fight TB began in 1995 with the introduction of the project DOTS. In 2007 we started to introduce therapeutic method DOTS+. The essence of this method is based on the application of resistant forms of TB drugs of II type in the treatment. Our achievements in treatment, significantly higher than the goal set by WHO. This work is carried out by a special program on the basis of WHO recommendations. Projects for this work are also sent to the Global Fund project, " Mehdiyev said.
He said that efforts to combat tuberculosis in the penitentiary system are highly appreciated by international agencies. The experience of Azerbaijan in this sphere is an example to other countries.
Comabt tuberculosis is the responsibility of society as a whole. There is a need of a serious education and advocacy in this area, the doctor said.
"Mycobacterium Tuberculosis as a result of treatment lost sensitivity to traditional antibiotics. Resistant forms were formed. Tubercle bacilli, which are insensitive even to anti-TB drugs of II type have been formed. The problem will be resolved effectively if the spread of tuberculosis is prevented quickly, patients are brought to treatment in time, treatment of such patients is completed, and system of education will be properly constructed, " Mehdiyev said.