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ProblemInputsOutputsOutcomes & ImpactReferences
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Incarcerated population have some of the highest incidence
rates of Tuberculosis globally. The rates are much higher higher in prison as compared to the general population. The TB transmission in the prisons is exacerbated by the crowded settings, low healthcare resources for screening and diagnosis, low human resources. These populations also have a higher prevalence of HIV than the general population and evidnece suggests that the odds of getting infected with TB are three times higher in the individuals living with HIV.Since the incarcerated population is transient the transmission chain continues and can also affect the general population when the inmates are released without diagnosis and treatment. Thus, WHO has prioritized this populations as one of the key populations to strengthen the screening and diagnosis of TB in prisons and acclerating their access to tretament.		1. Integration of AI based chest-xray screening intervention for the accelerated and robust screening for TB in these low resource high burden setting
2. To identify individuals affected by TB (symptomatic or asymptomatic) even in the absence of speciliatists in partnership with our implementation partners Health Through Walls.
3. Local stakeholder enaggement in planning the program and training and building capacity of the staff for the screening program.
4. Ensuring the referral of the TB presumptives (symptomaticand asymptomatic) for microbiological testing, diagnosis and treatment initiation, continuation and monitioring support.		1. Identification of TB presumptives (symptomatic and asymptomatic) and triaging them for immediate microbiological testing referral and isolation.
2. Reduction in the turn around time from screening to diagnosis and access to treatment.
3. Increase in the TB notification.
4. Management of patient records and worklist prioritisation by qTrack.
5.Preventive Treatment access and initiation of asymptomatic and high risk individuals identifies in the screening.
6. Ensured equitable access to screening, diagnosis and treatment cascade irrespective of the gender, race, reliogion etc.		1. Increase in number of prison popluation screened for TB.
2. Increase in the number of individuals integrated in the treatment care cascade.
3. Reduction in the TB burden/incidence rate in the prison population due to the disruption of chain of transmission by robust screening and diagnosis intervention.
4. Health system strengthening for TB identification and care cascade in the low resources and underserved prison settings.
5. Scale-up of TB screening to Lung health screening for other lung abnormalities by AI based chest x-ray screening.		•Cords, O., Martinez, L., Warren, J. L., O’Marr, J. M., Walter, K. S., Cohen, T., Zheng, J., Ko, A. I., Croda, J., & Andrews, J. R. (2021). Incidence and prevalence of tuberculosis in incarcerated populations: a systematic review and meta-analysis. The Lancet. Public Health, 6(5), e300. https://doi.org/10.1016/S2468-2667(21)00025-6
•Dara, M., Acosta, C. D., Melchers, N. V. S. V., Al-Darraji, H. A. A., Chorgoliani, D., Reyes, H., Centis, R., Sotgiu, G., D’Ambrosio, L., Chadha, S. S., & Migliori, G. B. (2015). Tuberculosis control in prisons: current situation and research gaps. International Journal of Infectious Diseases, 32, 111–117. https://doi.org/10.1016/J.IJID.2014.12.029
•Dara, M., Chorgoliani, D., & De Colombani, P. (n.d.). 8. TB prevention and control care in prisons Key points.
•Kanyerere, H. S., Banda, R. P., Gausi, F., Salaniponi, F. M., Harries, A. D., Mpunga, J., Banda, H. M., Munthali, C., & Ndindi, H. (2012a). Surveillance of tuberculosis in Malawian prisons. Public Health Action, 2(1), 10. https://doi.org/10.5588/PHA.11.0022
•Kanyerere, H. S., Banda, R. P., Gausi, F., Salaniponi, F. M., Harries, A. D., Mpunga, J., Banda, H. M., Munthali, C., & Ndindi, H. (2012b). Surveillance of tuberculosis in Malawian prisons. Public Health Action, 2(1), 10. https://doi.org/10.5588/PHA.11.0022
•Key Populations Brief: Prisoners | Stop TB Partnership. (n.d.). Retrieved April 19, 2023, from https://www.stoptb.org/key-populations-brief-prisoners
•Khan, F. A., Majidulla, A., Tavaziva, G., Nazish, A., Abidi, S. K., Benedetti, A., Menzies, D., Johnston, J. C., Khan, A. J., & Saeed, S. (2020). Chest x-ray analysis with deep learning-based software as a triage test for pulmonary tuberculosis: a prospective study of diagnostic accuracy for culture-confirmed disease. The Lancet Digital Health, 2(11), e573–e581. https://doi.org/10.1016/S2589-7500(20)30221-1
•Soares, T. R., Dias De Oliveira, R., Liu, Y. E., Da, A., Santos, S., Pereira, P. C., Luma, S., Soares, R., Lissandra, M., De Oliveira, M., Park, C. M., Hwang, E. J., Andrews, J. R., & Croda, J. (2021). Evaluation of chest X-Ray with automated interpretation algorithms for mass tuberculosis screening in prisons. MedRxiv, 2021.12.29.21268238. https://doi.org/10.1101/2021.12.29.21268238
•Telisinghe, L., Fielding, K. L., Malden, J. L., Hanifa, Y., Churchyard, G. J., Grant, A. D., & Charalambous, S. (2014). High Tuberculosis Prevalence in a South African Prison: The Need for Routine Tuberculosis Screening. PLoS ONE, 9(1). https://doi.org/10.1371/JOURNAL.PONE.0087262
• Velen, K., & Charalambous, S. (2021). Tuberculosis in prisons: an unintended sentence? The Lancet Public Health, 6(5), e263–e264. https://doi.org/10.1016/S2468-2667(21)00049-9
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