ABSTRACT
Prisoner department of the Punjab consist of 28 jails, out of which two are situated in Multan. Currently 52,596 prisoners confined in a space with official accommodation capacity of 17,413. To assess, health services provided to the prisoners with pulmonary tuberculosis at central jail hospital Multan, a descriptive cross sectional study was conducted involving 35 prisoners. A semi structured interview questionnaire was designed to determine client's satisfaction. A checklist was designed to assess health facilities and TB case management. Study was conducted in December 2000. All patients who were present at the time of interview were included in this study. Thirty-five prisoners were included in the study and were interviewed. Health facilities being provided to the inmates were assessed to study the current practices and factors affecting the management of sick inmates confined in the jail. Almost 65.7% of the prisoners belonged to the age group ranging from 21-40. Only male prisoners were included in the study. Majority of these prisoners 78% were facing still trials in their concerned courts. Majority belonged to labour and fanner's class and 51.3% were held under section 302. According to conservative estimates one third of the world's Population is infected with the T.B. Bacillus. There are 15 - 20 millions cases of infectious tuberculosis in the word. This infectious pool is maintained by the occurrence of 4 - 5 million new cases[1]. The magnitude of the problem is such that WHO declared it a global emergency in 1993. More recently during 1996, estimated 7.4 million people developed tuberculosis bringing the global suffers to about 22 millions[2]. La Pakistan out of approximately 130jnillion Populations, about 15 millions suffer from T.B. More than 210,000 new cases occur each year[3]. Tuberculosis affects almost every stratum of the society including prisoners visiting the Jails. Due to some unavoidable circumstances prisoners carry a much greater burden of various diseases than other members of society. Like other developing countries prisoners in Pakistan are suffering from a lot of health and social problems. The incidence of T.B. among prisoners has long been recognized as a significant problem. Since 1985 the problem of active T.B. has been exacerbated by the increasing prevalence of HIV. The prevalence tuberculosis of prisoners was 30% and the incidence of new infection attributable to incarceration was 5.9 per 100 inmates per year[4]. The basic health facilities such as adequate supply of essential medicines, necessary diagnostic facilities, provision of specialized care to the needy prisoners and their timely referral to the tertiary care facility, are not upto the required standard to maintain harmony in the prison health services. At times, the prisoners are not being provided with the proper emergency care[5]