The objective
of this report is to systematically review the evidence on active case finding
in prison settings, with a focus on the European Union (EU) and the European
Economic Area (EEA) region. The communicable diseases targeted by this review
were not selected a priori, but identified through the retrieved evidence.
A systematic
literature review was performed in PubMed and Embase.com from 1990 onwards and
in Cochrane Library from 1980 onwards. No language or geographical limits were
applied. In addition, the following sources were searched through a pre-defined
website list search and a call for papers from experts: conference abstracts (from
2010), unpublished research reports, protocols and guidelines (from 2005).
From the
peer-reviewed literature, 63 primary articles and one systematic review were
included. Furthermore, 24 conference abstracts/unpublished research reports,
two other documents and 19 guidelines were included. The search of the
literature revealed that most of the existing evidence on active case finding
in prison settings is concentrated on just a few communicable diseases, such as
hepatitis (A, B and C), human immunodeficiency virus (HIV), sexually
transmitted infections (STIs; chlamydia, gonorrhoea, syphilis and
trichomoniasis) and tuberculosis (TB). These findings may be consistent with
the general notion that these diseases are on one hand casing a sizeable burden
of infectious disease in the prison population, and on the other are at higher
risk of transmission within prison settings. Against this background of
infectious disease burden and transmission risk, people in prison are entitled
to a medical assessment upon entry, which offers the opportunity to conduct
active case finding for a number of relevant conditions, and not limited to
communicable diseases
The body of
evidence retrieved through this systematic review was largely composed of
studies conducted in non-EU/EEA countries, and primarily in the United States
(US). A large part of the literature covering active case finding in EU/EEA
prisons was retrieved from grey sources, thus revealing a substantial
publication bias. In addition, very few studies, and even less EU/EEA ones,
investigated interventions to increase the effectiveness of active case finding
in prison settings; and even among those, statistical significance was hardly
ever reported.
Systematic
review on active case finding of communicable diseases in prison settings
Abbreviations
Glossary
Executive
summary
Background
Introduction
Guidance
on communicable diseases in prison settings
Active
case finding
Diseases
overview
Scope
and objectives
Review
methods
Review
objective
Review
questions
Search
and selection strategy
Data
extraction
Evidence
summary
Quality
control
Review
results
Hepatitis
Hepatitis
A
Hepatitis
B
Hepatitis
C
Guidelines
hepatitis
HIV
Sexually
transmitted infections
Chlamydia
and gonorrhoea
Syphilis
Trichomoniasis
Guidelines
STI
Tuberculosis
LTBI
Guidelines
TB
Increasing
testing uptake
Discussion
Main
findings
Hepatitis
HIV
STI
TB
Increasing
testing uptake
Knowledge
gaps
Disease-specific
gaps
Strengths
and limitations
Conclusions
Next
steps
References
European Centre for Disease Prevention and Control and the European Monitoring Centre for Drugs and Drug Addiction
European Centre for Disease Prevention and Control and the European Monitoring Centre for Drugs and Drug Addiction (2017). Systematic review on active case finding of communicable diseases in prison settings. Stockholm: ECDC. https://www.ecdc.europa.eu/en/publications-data/systematic-review-active-case-finding-communicable-diseases-prison-settings
