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Hepatitis most prevalent disease in incarcerated patients

Over 93% of reports of infectious diseases in prisons are due to hepatitis B and C, a new report by PHE on the inequalities of healthcare in the penal system has found.

Over 93% of reports of infectious diseases in prisons are due to hepatitis B and C, a new report by PHE on the inequalities of healthcare in the penal system has found.

The report, Health and Justice 2014/15, showed that 1174 out of the 1268 cases of infectious disease diagnosed in prisons in 2014 were strains of hepatitis. The report estimates that the prevalence of hepatitis in prisons is four times higher than in the general population, with 8% of prisoners diagnosed with the disease, compared to 2% of the UK public. The prevalence of hepatitis in prisons has doubled since 2011, when 549 cases were diagnosed.

Professor Kevin Fenton, director of health and wellbeing at PHE said: 'Improving the health of prisoners delivers a "community dividend" by benefiting the areas to which most prisoners eventually return. By intervening in prisons we can help prevent the spread of infectious diseases, lighten the burden on the NHS from long-standing problems, and reduce re-offending linked to poor health.'

The report suggests that the increase in diagnoses is due to changes in the way that testing for hepatitis and other bloodborne viruses in prisons is conducted. Many prisons and related facilities are in moving from an 'opt-in' to an 'opt-out' policy for patients to help reduce transmissions, and improve the accuracy of screening for the condition in the prison population.

The report cites results from prisons that have already introduced the 'opt-out' policy, with the number of tests for blood borne viruses doubling after the change. These organisations report 21% of new entrants were tested for hepatitis C and 22% for hepatitis B in the first phase, compared to 11% for hepatitis C and 12% for hepatitis B when the 'opt in' procedure was in place.

Professor Fenton added: 'This principle underpins our work in prisons and is no more evident than in our vital work on blood-borne viruses which will help reduce infection rates inside and outside prison walls.'

A problem with the integration of community and prison health services was also identified in the report, with inmates often being released without being signposted to community and primary healthcare providers to continue their treatment.

Ann Norman, the RCN professional nurse adviser for nursing in criminal justice services said: 'It is vital for nurses and other professionals to get informed consent from patients so they can be directed to services and ensure the continuity of their care. In prisons, patients often are not signed up with a general practice, or have lost contact. It is important for us as nurses to make sure that we reconnect patients in prisons with healthcare providers.'