A paisagem em mudança: características geoespaciais, epidemiológicas e doenças infecciosas de privados de liberdade vivendo em uma região com alto número de prisões, Brasil

Abstract

Brazil has the third largest prison population in the world. The risk of infectious diseases is higher in prisons than in the general community. We determined the geospatial and epidemiologic characteristics and prevalence of HIV, tuberculosis, viral hepatitis, syphilis, and co-infections in inmates in 28 prisons located in the western and northwestern regions of São Paulo state. Data were obtained through a standard questionnaire from inmates diagnosed with an infection. Locations of prisons and highways were obtained from shape file databases. Data on inhabitants, population growth, and Human Development Index were obtained from public agencies. Of 37,497 inmates, 741 (1.97%) were diagnosed with an infection. HIV was the most prevalent disease (0.68%), followed by tuberculosis (0.66%), syphilis (0.2%), HCV (0.2%), and HBV (0.04%). HIV-syphilis was the most prevalent co-infection (odds ratio, 63.7; 95% confidence interval: 41.4, 96.7). Mean age was 35.82 years (SD, 10.41 years) and 57.9% had been in prison previously. Construction of large prisons beside the radial highways changed the landscape and prevented migration of people from small to large cities. This is one of the biggest studies in Brazil, and the prevalence of infectious diseases among inmates was lower than countrywide. Therefore, improvements in health care are necessary, mainly in screening for infectious diseases.