ABSTRACT
Objective: the increasing trend of unnatural deaths in custody is a concern globally. So this study was conducted to examine the causes of unnatural deaths in Punjab prisons
Methods: a retrospective review of all available files of unnatural deaths from 2006 to 2009 was carried out in June-July 2010. The death certificates, inquest reports, postmortem reports and fact finding enquiry reports were examined in detail. Facts of each unnatural death were discussed with medical officer and superintendent of concerned jail. Causes of unnatural death were categorized as accidental, homicide, and overdose with substance of abuse or medication and suicide
Results: crude mortality rate for un-natural deaths was 53/100,000 per year. This account for 11 % [111/1007] of the total deaths. All unnatural deaths were among males with mean age of 35 years [Range; 16-90]. Mostly 85% [n=94] were under trial and 15% [n=17] convicted prisoners. Of the 111 unnatural deaths 49% [n=55] were from overdose, suicide 21 % [n=23], homicide 16% [n=18] and accidental deaths 14% [n=15]. Majority of the suicidal deaths was by hanging [20/23]. 50% of all un-natural deaths occur within 1st week of their entry in to jail. Majority [91 %] of those committed suicide have a history of psychiatric illness. Suicidal, homicidal and accidental deaths accounts for 43% of potential years of life loss of these persons. Postmortem of only 35% of cases conducted on the stress of prisoner heiress
Conclusion: among unnatural deaths suicide by hanging and deaths due to substance over dose are dominant. No psychological assessment being done at jail entry. Most of these premature deaths are preventable. Mental health services should be the integral part of primary health care in prisons. Inquest files have incomplete data which limits our study
ABSTRACT
Objective: prisoners as a high risk group are never recommended for blood donations. In Pakistan, prisoners are legally allowed to donate blood and get thirty days extra remission. In Pakistan, there is not much published data on prisoner blood donors. The study aimed to estimate the sero-prevalence of human immunodeficiency virus [HIV], Hepatitis B with [HBV], Hepatitis C virus [HCV] and Syphilis among physically healthy prisoner blood donors in prisons of Punjab
Material and Methods: a retrospective review of record of all prisoner donors who donated blood during camps from January 2007 to December, 2009 was carried out in January 2010. Physically fit prisoner donors were tested for HCV, HBV, HIV and Syphilis by rapid test kits before donation. Those found negative for these infections were allowed to donate blood. Donated blood was retested for anti-HIV, anti-HCV and HBsAg by ELISA and syphilis by VDRL
Results: a total of 3,074 prisoner donors were tested. 3050 [99%] donors were male. Mean age was 28 years [17-57 yr.]. Among prisoners, 235 [7.6%] were positive for HCV, 114 [3.7%] for Syphilis, 111 [3.6%] for HBV and 21 [0.7%] for HIV. Among these, 434 [14%] were positive for at least one of these infections. Three females [12.5%] were positive for syphilis and one [4.14%] for hepatitis B
Conclusion: the prevalence of HIV, HBV, HCV and syphilis is higher in prison donors as compared to blood donors from general population. So prison inmates constitute a very high risk group among blood donors. Stringent screening of blood donors and even testing of donated blood by highly sensitive tests is recommended. We also recommend further studies and then modify blood donation laws accordingly