Can patient groups lead diagnosis and treatment in prisons of resource limited settings? We are doing it!

Author: Rajkumar Nalinikanta, Ningombam P

Theme: Models of Care Year: 2019

Prevalence of HCV can be as high as 52% among PWID in Manipur, India. Drug-related penalsentences
of PWID (and incarceration of PWID by family members) contribute to significant numbers of PLHCV
in local prison settings. Healthcare services in these prisons are extremely limited.
Description of model of care/intervention:
CoNE approached the prison authorities to implement an intervention targeting HCV literacy,
diagnosis and treatment of PWID inside a local prison. Prison authorities contributed medical
manpower for monitoring of treatment in consultation with our physician. Several other
stakeholders were engaged in the initiative, including: a local laboratory providing free technical
support; an NGO working in the prisons help identify and link with PWID inside the prison; CoNE
through its provision of pre & post-test counselling. Furthermore, the main physician provided his
time and effort pro bono. The medicines are purchased from donation of local philanthropist and
supporters of CoNE.
Those confirmed as RNA positive were assessed for APRI score. Sofosbuvir & Daclatasvir were given
for 12 weeks to inmates with a score below 1.5; 24 weeks to those inmates with score of more than
150 of the 800 prison inmates were identified as belonging to the PWID community and were
therefore offered the opportunity to take part in the awareness camp. Out of the 147 of the
individuals provided voluntarily HCV antibody testing, 58 were antibody reactive. 49 were confirmed
via RNA confirmation to have chronic HCV infection; 45 were initiated on treatment.
Conclusion and next steps:
Community organization can strongly demonstrate that HCV treatment is possible inside the prison
with simplification of diagnostic through mobilization of different stakeholders. The protocol for this
intervention provides a blueprint for scale up to other prison settings. The feasibility of replication is
boosted by the Indian government’s recent launch of a well-funded national hepatitis response.
Disclosure of Interest Statement: No conflict of interest to share

Download abstract Download presentation Watch video