Barriers to completion of tuberculosis treatment among prisoners and former prisoners in St. Petersburg, Russia.

SETTING

St. Petersburg, Russian Federation.

OBJECTIVES

To identify barriers to the completion of tuberculosis (TB) treatment among prisoners and former prisoners in St Petersburg, Russia.

DESIGN

Questionnaires were administered to 60 prisoners and 40 former prisoners. Interviews were performed with prison and TB dispensary staff. Treatment follow-up rates were estimated by matching prison release records against attendance records from all 17 St. Petersburg-based TB dispensaries over an 18-month period.

RESULTS

Of 80 released prisoners with active TB in 2002, 21 (26.3%) appeared in dispensary attendance records. Barriers to the completion of TB treatment overall were homelessness, unemployment, alcoholism, drug addiction and difficulty tolerating TB medications with co-morbid illnesses such as human immunodeficiency virus and hepatitis. Prisoners and former prisoners ranked help with obtaining an internal passport and money first, followed closely by food and a job, as the most desirable incentives to completing TB treatment.

CONCLUSIONS

A future program for soon-to-be released and released prisoners in St. Petersburg that offers an array of desirable flexible social welfare services and incentives has the potential to attract and retain patients within TB treatment, but continued efforts must also be made to include drug treatment, job training and keeping former prisoners out of prison.