Click a topic below for an index of articles:






Financial or Socio-Economic Issues


Health Insurance



Institutional Issues

International Reports

Legal Concerns

Math Models or Methods to Predict Trends

Medical Issues

Our Sponsors

Occupational Concerns

Our Board

Religion and infectious diseases

State Governments

Stigma or Discrimination Issues

If you would like to submit an article to this website, email us at for a review of this paper


any words all words
Results per page:

“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”



Evaluation of a prison outreach clinic for the diagnosis and prevention of
hepatitis C: implications for the national strategy

Skipper C., Guy J. M., Parkes J., Roderick P., Rosenberg W. M.

Gut. 2003; 52(10): 1500-4


Hepatitis C virus (Hepatitis C Virus) infection is a major public health problem
recognised by the UK National Strategy that proposes that a care pathway
for assessment, diagnosis, and treatment be established in all prisons,
integrated within managed clinical networks. A prison sentence provides the
opportunity to focus on traditionally hard to reach patients.


To evaluate the prevalence of Hepatitis C Virus infection in a UK prison cluster and to
assess the effectiveness of a prison outreach service for hepatitis C.





Male prisoners.


A nurse specialist led clinic within a cluster of adult prisons was
established, offering health education on hepatitis C, advice on harm
minimisation, and Hepatitis C Virus testing. Infected prisoners were offered access to a
care pathway leading to treatment. Outcome measures were uptake of the
service, and diagnosis and treatment of hepatitis C.


A total of 8.5% of 1618 prisoners accepted testing: 30% had active
infection with Hepatitis C Virus. Most were ineligible for treatment due to psychiatric
illness or did not receive treatment for logistic reasons. Injecting drug
use was the major risk factor in all cases. Only 7% of Hepatitis C Virus polymerase chain
amplification positive inmates received treatment in prison.


There is a large pool of Hepatitis C Virus infected prisoners at risk of complications,
constituting a source of infection during their sentence and after
discharge. A prison outreach clinic and care pathway was perceived as
effective in delivering health education, reducing the burden on prison and
hospital services. It provided an opportunity for intervention but had a
limited effect in eradicating Hepatitis C Virus in prisoners and it remains unclear how
this might be achieved.



"Enlightenment does not come 'by imagining figures of light but by making
the darkness conscious.'" (Jung)