Homogeneity of pharmacological prescription and control measures applied in cases of scabies detected amongst inmates in Catalonia.

OBJECTIVES: To review the homogeneity of pharmacological prescription and control measures applied in cases of scabies in prisons in Catalonia. MATERIAL AND METHOD: Observational, multicenter, and retrospective study. Cases of scabies from March 01, 2021 and March 01, 2022 were analyzed according to the International Alliance for the Control of Scabies (IACS) 2020 criteria: a) confirmed cases; b) clinically probable cases; and c) suspected cases.Epidemiological, clinical, therapeutic and regimental control variables were collected. We checked whether the interventions were homogeneous in each site. The mean and standard deviation were used as continuous variables and percentages and confidence interval (95%) for discrete variables. The Chi-square test was used to determine statistical association. RESULTS: 269 cases were detected (21.2% confirmed, 50.2% clinically probable and 28.6% suspected). 61.3% were treated with permethrin, 18.6% with ivermectin and 20.1% with both. 27.1% of the cases were withdrawn.There were no significant in-site differences in the study of contacts, isolation and treatment of clothing and belongings, but there were significant differences in the prescription of drugs (P <0.001), duration of treatment (P <0.001) and disinfection of the cell (P <0.001). DISCUSSION: The number of detected cases is estimated to be high, and the majority (71.4%) confirmed or clinically probable. Control measures are homogeneous, except for cell disinfection, which was conventional in 59.1%. Pharmacological treatment and its duration varied between prisons. It would be advisable to establish a protocol to standardize control measures applied to new cases in the centers of Catalonia and subsequently evaluate their efficacy.

Reinfection in a large cohort of prison inmates with sustained virological response after treatment of chronic hepatitis C in Catalonia (Spain), 2002-2016.

BACKGROUND: Prisoners and other high-risk patients who show a sustained virological response (SVR) after treatment for hepatitis C virus (HCV) can become reinfected. We aimed to calculate the rate of HCV reinfection in a large cohort of inmates with SVR and to determine factors that predict reinfection. METHODS: We included all inmates treated for hepatitis C in Catalonia (Spain) from January 2002 to December 2016 who achieved SVR and in whom viral load was subsequently determined. The incidence rate was calculated per 100 person-years (100 py) of follow up. Risk factors associated with reinfection were evaluated by bivariate log-rank test and multivariate Cox regression. Hazard ratio (HR) and their 95% confidence intervals (CI) were calculated. RESULTS: 602 patients were included, with a mean age of 37.9 years: 95% were men, 74.1% had a history of intravenous drug use (IDU) and 28.7% were HIV-infected. Patients were followed for a total of 2154.9 years (average 3.58 ± 3.1 years). 63 (10.5%) had HCV reinfection. 41 (65.1%) presented different genotype/subgenotype, 8 the initial genotype/subgenotype, and in 14 (22.2%) the genotype could not be determined. Of the 21 reinfected patients who were interviewed, 20 (95.2%) reported IDU after antiviral treatment, and 7 (33.3%) during treatment. The overall incidence of reinfection was 2.9 cases per 100 py. All reinfections occurred in patients with IDU history. At multivariate level, HIV infection was associated with reinfection (HR = 3.03; CI:1.82-5.04). CONCLUSION: In HIV-infected inmates with IDU history, the rate of reinfection of HCV post-SVR is very high. Prisons play a key role in the detection and treatment of infection and reinfection by HCV and in the post-treatment monitoring in these patients, which should be combined with counseling and the optimization of the harm reduction programs. Effective control of these vulnerable groups favours the elimination of the HCV infection.