Leprosy among female prisoners in Brazil / Hanseníase entre mulheres privadas de liberdade no Brasil

Abstract To estimate the prevalence of leprosy among Brazilian female prisoners and identify factors associated with the disease. Cross-sectional study conducted between 2014 and 2015 in 15 Brazilian female prisons. The data of 1,327 women were collected using Audio Computer-Assisted Self-Interviewing and dermatological and neurological examination to identify suspicious lesions of leprosy. The average age was 33.4 years. Suspicion of leprosy was identified in 5.1% of women in prison, and lifetime self-reported prevalence was 7.5%. The variables that were associated with lifetime self-reported leprosy were: women in prison once being twice as likely to have leprosy; white women were 1.4 time more likely to have leprosy than non-white women; women who knew someone with leprosy was 1.9 time more likely to have leprosy; and women who shared a cell with 11 or more women were 2.5 times more likely to have leprosy than women who shared a cell with two or fewer people. The leprosy prevalence among female prisoners in Brazil were greater than that found in a Brazilian woman of the general population and show the extremely high vulnerability of this population generated through pre-incarceration poverty, as well as potential transmission in prison.

Resumo Objetivou-se estimar a prevalência de hanseníase entre presidiárias brasileiras e identificar fatores associados à doença. Estudo transversal realizado entre 2014 e 2015 em 15 presídios femininos brasileiros. Os dados de 1.327 mulheres foram coletados por meio de autoentrevista assistida por computador e exame dermatológico e neurológico para identificar lesões suspeitas de hanseníase. A idade média foi de 33,4 anos. A suspeita de hanseníase foi identificada em 5,1% das mulheres na prisão, e a prevalência autorreferida ao longo da vida foi de 7,5%. As variáveis que se associaram à hanseníase autorrelatada ao longo da vida foram: mulheres presas uma vez com duas vezes mais chance de ter hanseníase; mulheres brancas tinham 1,4 vez mais chance de ter hanseníase do que mulheres não brancas; mulheres que conheciam alguém com hanseníase tinham 1,9 vez mais chance de ter hanseníase; e mulheres que compartilhavam uma cela com 11 ou mais mulheres tinham 2,5 vezes mais chance de ter hanseníase do que mulheres que compartilhavam uma cela com duas ou menos pessoas. A prevalencia de hanseníase entre presidiárias no Brasil foi maior do que a encontrada entre mulheres da população geral e evidencia a vulnerabilidade dessa população gerada pela pobreza pré-reclusão, bem como o potencial de transmissão na prisão.

Presas pelas drogas: características de saúde de presidiárias em Salvador, Bahia / Prisoners due to drugs: health characteristics of female prisoners in Salvador, Bahia / Presas por las drogas: características de salud de presidiarias en Salvador, Bahia

A caracterização sociodemográfica e de saúde é um importante aspecto a ser considerado na formulação depolíticas públicas, tendo em vista a melhoria da qualidade de vida de uma população ou de determinado gruposocial. Trata-se de pesquisa exploratória, de abordagem quantitativa, com o objetivo de identificar as característicassociodemográficas e de saúde de mulheres presidiárias em Salvador, Bahia. Os dados são do tipo secundário eforam obtidos por meio de consulta, no período de junho/outubro de 2011, aos prontuários de saúde e à relaçãode internas disponibilizados pela instituição. A análise foi realizada por meio de frequência simples. Os resultadosmostram predominância de mulheres jovens, da raça negra, com baixo grau de escolaridade, com ocupação debaixa remuneração e que foram encarceradas pelo tráfico de drogas. Quanto às características de saúde, os registrosmostram que a maioria consumia alguma substância psicoativa, possuía cartão de vacina e mantinha relaçõesheterossexuais sem uso frequente de preservativos. As características sociodemográficas das presidiárias de Salvador(BA) têm similaridade com presidiárias de outras regiões do país. Os dados oferecem informações que devemser contempladas na assistência social e de saúde direcionada às presidiárias visando à reinserção do grupo nasociedade e a prevenção de doenças e agravos sociais, bem como a promoção da saúde.

The socio-demographical and health characterization are important aspects to be considered when formulatingpublic policies, taking into account improvement in the quality of life of a population or a certain social group.This is an exploratory research, of quantitative approach, with the purpose of identifying the socio-demographicaland health characteristics of female prisoners in Salvador (BA). The data is of a secondary type and was obtainedthrough consultation of the health records and of the list of interns made available by the institution during the periodfrom June to October 2011. The data analysis was carried out through simple frequency. The results demonstrated a predominance of young black women with limited education, low income who were in prison due to drug trafficking.In respect to health characteristics, the registers show that most of the women used some sort of psychoactive substance,had a vaccination card and held heterosexual relations without the use of condoms. The socio-demographicalcharacteristics of female prisoners in Salvador (BA) are similar to the characteristics of prisoners from other regionsin Brazil. The data offers information that should be considered in social and health assistance directed to prisonerswith the aim to reinsert this group into society and to prevent diseases and social problems, as well as promotinghealth.

La caracterización socio-demográfica y de salud es un importante aspecto a ser considerado en la formulaciónde políticas públicas, llevando en cuenta la mejoría en la calidad de vida de una población o de determinadogrupo social. Se trata de una investigación exploratoria, de enfoque cuantitativo, con el objetivo de identificar lascaracterísticas socio-demográficas y de salud de las mujeres presidiarias en Salvador (BA). Los datos son de tiposecundario y fueron obtenidos por medio de consulta, en el periodo de junio/octubre de 2011, en los históricosclínicos de salud y en los registros de internas dispuestos por la institución. El análisis fue realizado por medio defrecuencia simple. Los resultados muestran predominancia de mujeres jóvenes, de raza negra, con bajo grado deescolaridad, con ocupación de baja remuneración, que fueron encarceladas por tráfico de drogas. Cuanto a lascaracterísticas de salud, los registros muestran que la mayoría consumía alguna substancia psicoactiva, poseíatarjeta de vacuna y mantenía relaciones heterosexuales sin el uso frecuente de preservativos. Las característicassocio-demográficas de las presidiarias de Salvador (BA) presentan características análogas con las presidiarias deotras regiones del país. Los datos ofrecen informaciones que deben ser contempladas en la asistencia social y desalud orientada a las presidiarias visando la reinserción del grupo en la sociedad y la prevención de enfermedadesy agravios sociales, así como la promoción de la salud.

La importancia del apoyo social para el bienestar físico y mental de las mujeres reclusas

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Abstract: Introduction. Social support has been useful as a key axis for different approaches on how positive human relations and social networks help the individual to achieve states of relative well-being and overcome stressful events which they have to cope with in their lives. This is particularly important in the case of imprisoned women, who generally lack social support, since many of them are abandoned by their relatives and friends with the consequent impact that this has on their physical and emotional well-being. Support from family and friends during imprisonment can imply an enormous difference in the living conditions of imprisoned women. It has been proved that the social support individuals receive through their social networks is a key factor for their well-being, specially at times of stress, transition or crisis, and protects them from the emergence of physical and psychic disorders. For these reasons, the objective of this article is to identify the main sources of social support in convicted women at two penitentiary centers in Mexico City and to determine whether the presence or absence of social support has an impact on their physical and mental well-being. Method. This is a descriptive field study carried out at two women's prisons in Mexico City: The East Preventive Center for Women and the Tepepan Center of Social Readjustment for Women. The type of sampling was non-probabilistic and selected by convenience. The final sample comprised of a total of 212 women. This study included current and lifetime female abusers of alcohol, tobacco and drugs, aged between 18 and 65, who could read and write. The exclusion criteria used were having a psychiatric disorder or a physical disability that would prevent them from completing the interview. The instrument used for compiling the information was a semi-structured interview consisting of 62 pages on various areas from the lives of female prisoners. The following sections of the questionnaire were analyzed for this article: a) sociodemographic characteristics, b) social networks, c) depression, and d) perception of physical and emotional health. The procedure followed to gather information on the female prisoners began with the establishment of an agreement with the General Administration of Prevention and Social Readjustment of the Federal District. Through this agreement, the mental health team, comprising psychiatrists, psychologists and anthropologists -previously trained in the use of a structured interview-, were granted access to the correctional facility. The interviews were carried out after the women had given their informed consent and told of the objectives of the study. The interviews lasted two hours on average, although on some occasions they took up to four sessions of two hours. The field work lasted two years. Results. Socio-demographic profile: The majority of the interviewees were under 40 years old (84%). They had low schooling (with only 41% having completed elementary school), were unmarried (48.6%), and most of them did not live either with a partner or an offspring (40.5%). A total of 58.6% had left home when they were young and nearly 40% lived on the streets. Before being admitted to the institution, they had been shopkeepers (29.5%), employees (21.9%), housewives (13.8%), manual workers(7.1%) and informal workers (5.7%). Contact with relatives and friends in the past month: A high number of the women in prison reported not having received any visits during the past month, with only a small percentage receiving daily visits. Almost 60% of the women declared not receiving any visits from significant figures, such as their partners or children. Frequency of visits and perception of physical and mental health: A third of the women rated their physical and mental health as not so good. When frequency of visits was linked to the women's perception of health, it was found that women, who had not received any visits over the past month, tended to evaluate their physical health more negatively (bad-mediocre) than those who received visits (43.5% versus 38.5%). A similar percentage was observed in the evaluation of their mental health (47.8% versus 45.3%). Frequency of visits and depression: When relating the frequency of visits to the presence and/or absence of depression, it was found that women who had not received visits during the past month experienced more depressive episodes (72.7% versus 61.1%). Nevertheless, these differences were not significant. Discussion. One of the most outstanding aspects observed in this study was the high level of abandonment suffered by the inmates, which confirms findings from other studies about women being abandoned by their loved ones more often than men after commiting a crime. The study found that in terms of accessibility, the physical location of penitentiary centers, is not a factor that fully explains the abandonment suffered by these women, since most of the inmates' relatives and friends live in the same city and even in the same neighborhood where the penitentiary center is located. A high presence of present depressive episodes was also observed in female prisoners, both among those who reported receiving visits and those who did not. A possible answer here is that imprisonment itself is a highly stressful event for those undergoing it and the support received from relatives and friends is not enough to offset the effects of confinement. Conclusions. The results of this study indicate there is a certain positive association between the social support female prisoners received from relatives and friends and their physical and mental well-being. Nevertheless, this cannot be considered a causal relationship, a conclusion which agrees with other reports regarding the positive influence of social support on prisoners' well-being. However, it is also suggested that this is a complex relation that must be investigated more in depth, since this support does not necessarily has the same effect on all individuals. One of the main recommendations deriving from these results is the need to make prisoners' relatives aware of the importance of promoting and maintaining a continuous and permanent contact with them, since this type of support usually brings about an enormous benefit for their physical and emotional well-being. It is also necessary for penitentiary institutions to reconsider the suspension of visits as a means of punishment and control, since this entails a series of negative consequences for the internal population and the institution itself.