COVID-19 pandemic in prisons in Spain: characteristics of cases and implemented control measures, March 2020-June 2022.

OBJECTIVES: Our aim was to describe the epidemiological characteristics of COVID-19 cases in prison inmates in Spain and the control measures implemented to response to this public health challenge. STUDY DESIGN: Retrospective observational study. METHODS: All COVID-19-confirmed cases reported to the Spanish information system in prisons between March 2020 and June 2022 were analyzed. Prevention plans and protocols established by penitentiary and health authorities were reviewed. Likewise, information on vaccines administered to prison inmates was described. RESULTS: A total of 8500 COVID-19 cases were reported to penitentiary public health surveillance. The overall cumulative incidence (CI) was 2054.18 cases per 10,000 inmate population. By epidemic periods, the average weekly CI was 1.15 per 10,000 inmate population during the first period, 6.91 during the second, 25.18 during the third, 3.53 during the fourth, 23.27 during the fifth, 34.72 during the sixth and 25.68 during the seventh period. The median age of cases was 49.2 years, 69.1% was born in Spain, 64.1% was asymptomatic and 16 cases died. Ninety-four percent were vaccinated. Control measures such as lockdown, suspending visitation rights and confining inmates in their cells were adopted at the beginning of the pandemic. These measures changed in accordance with the COVID-19 situation in the general population with a view to restoring the inmates' rights. CONCLUSION: The COVID-19 pandemic has had a moderate incidence in Spanish prisons. Hospitalization and CFR were lower than the general population. The control measures adopted against COVID-19 have contributed to preventing and controlling the number of cases in prisons.

Elimination of hepatitis C. Positioning document of the Spanish Association for the Study of the Liver (AEEH).

The Spanish Association for the Study of the Liver (AEEH) is convinced that the elimination of hepatitis C virus (HCV) in Spain is possible as long as we are able to use the resources and tools necessary for it. This document reflects the position of the AEEH regarding the elimination of HCV, establishing a wide range of recommendations that can be grouped into five categories: 1) Screening of HCV according to age, of the existence of classic acquisition risk factors of infection, active search of previously diagnosed patients and development of microelimination strategies in vulnerable populations; 2) Simplification of HCV diagnosis (one-step diagnosis and diagnosis at the point of patient care); 3) Simplification of patient treatment and improvement of care circuits; 4) Health policy measures, and, finally, 5) Establishment of HCV elimination indicators.

Elimination of hepatitis C. Positioning document of the Spanish Association for the Study of the Liver (AEEH). / Eliminación de la hepatitis C. Documento de posicionamiento de la Asociación Española para el Estudio del Hígado (AEEH).

The Spanish Association for the Study of the Liver (AEEH) is convinced that the elimination of hepatitisC virus (HCV) in Spain is possible as long as we are able to use the resources and tools necessary for it. This document reflects the position of the AEEH regarding the elimination of HCV, establishing a wide range of recommendations that can be grouped into five categories: 1)Screening of HCV according to age, of the existence of classic acquisition risk factors of infection, active search of previously diagnosed patients and development of micro-elimination strategies in vulnerable populations; 2)Simplification of HCV diagnosis (one-step diagnosis and diagnosis at the point of patient care); 3)Simplification of patient treatment and improvement of care circuits; 4)Health policy measures, and, finally, 5)Establishment of HCV elimination indicators.

The prevalence of mental disorders in Spanish prisons.

BACKGROUND: The prevalence of mental disorders among prisoners has been researched in a few countries worldwide but never previously in Spain. AIM: Our aim was to estimate the lifetime and last month prevalence of mental disorders in a Spanish prison population. METHODS: This is a descriptive, cross-sectional, epidemiological study of 707 male prisoners. Sociodemographic, clinical and offending data were collected by interviewers. Offending data were confirmed using penitentiary records. Mental disorders were assessed with the clinical version of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition Axis I Disorders, and personality disorders were assessed through the Spanish version of the International Personality Disorders Examination. RESULTS: The lifetime prevalence of mental disorder was 84.4%. Substance use disorder (abuse and dependence) was the most frequent disorder (76.2%) followed by anxiety disorder (45.3%), mood disorder (41%) and psychotic disorder (10.7%). The period (last month) prevalence of any mental disorder was 41.2%. Anxiety disorder was the most prevalent (23.3%) followed by substance use disorder (abuse and dependence; 17.5%), mood disorder (14.9%) and psychotic disorder (4.2%). CONCLUSION: Although period prevalence figures, which are those generally provided in research into rates of mental disorder among prisoners, are useful for planning improvements to services within prisons, the fact that almost all of these men had a lifetime prevalence of at least one mental disorder suggests a much wider need for improving services, including community services, for this group.

Screening of inmates transferred to Spain reveals a Peruvian prison as a reservoir of persistent Mycobacterium tuberculosis MDR strains and mixed infections.

It is relevant to evaluate MDR-tuberculosis in prisons and its impact on the global epidemiology of this disease. However, systematic molecular epidemiology programs in prisons are lacking. A health-screening program performed on arrival for inmates transferred from Peruvian prisons to Spain led to the diagnosis of five MDR-TB cases from one of the biggest prisons in Latin America. They grouped into two MIRU-VNTR-clusters (Callao-1 and Callao-2), suggesting a reservoir of two prevalent MDR strains. A high-rate of overexposure was deduced because one of the five cases was coinfected by a pansusceptible strain. Callao-1 strain was also identified in 2018 in a community case in Spain who had been in the same Peruvian prison in 2002-5. A strain-specific-PCR tailored from WGS data was implemented in Peru, allowing the confirmation that these strains were currently responsible for the majority of the MDR cases in that prison, including a new mixed infection.