Infection Control in Correctional Settings - A Systematic Review with an Emphasis on NonCOVID-19 Related Infections and Control Measures. Open Access

Abstract

Introduction: Well over 10.7 million people are incarcerated globally, with more than 2 million in the US alone. This includes those serving sentences and those that are yet to be tried. In carceral settings worldwide, more than half of all countries have over 100% occupancy rate. Hence, most of the world’s correctional and detention systems are overcrowded, which leads to these settings being extremely conducive for the transmission of infectious diseases by various routes. Crowding of vulnerable persons increases the tendency for the occurrence and progression of disease outbreaks. The risk of being exposed to, and acquiring, infectious diseases in a carceral setting surpasses the risk outside by several fold.

Methods: This study presents the findings of a systematic review, conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. It searched the literature for articles on infection control in correctional settings published from 2008 to 2022. Due to the volume of publications responding to rapidly changing recommendations, articles related to COVID-19 infections were excluded.

Results: We found 3,473 articles and synthesized 81 which were most relevant. We described transmission occurrences and outbreaks, as well as interventions and measures initiated and recommended to prevent and mitigate cases and outbreaks of infections in carceral settings.

Conclusions: According to the Mandela Rules of the United Nations, incarcerated persons have a right to healthcare services that prevent infectious diseases or manage them when they occur. Failure to recognize this right, or to provide the needed healthcare, results in negative consequences for them, the communities outside carceral settings, and public health.

Table of Contents

INTRODUCTION 1

METHODS 3

Table 1. Eligibility Criteria 4

Box 1: PubMed Search Statement 5

Figure 1. PRISMA Flow Diagram 6

RESULTS 7

Infections Transmitted or Transmissible Through the Respiratory Route (Airborne, Aerosol,

Droplet Nuclei and Droplet Routes) 7

Tuberculosis 7

Measles 10

Varicella and Herpes zoster 10

Mumps 13

Influenza 13

Chlamydia pneumoniae pneumonia 14

Meningococcal meningitis 14

Leprosy 15

General measures for control of infections transmitted by the respiratory route 15

Infections Transmitted by Contact: Bloodborne Viruses (BBV) and other infections that can also

be transmitted sexually 15

Infections Transmitted by Contact: Skin and Soft Tissue Infections and Infestations 21

Infections Transmitted by Contact: Foodborne, and Other Gastroenteric Illnesses 24

Table 2. Overview of Literature. Infection Control in Correctional Settings 2008-2022 33

DISCUSSION 111

References 115

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	infection prevention and control, carceral settings, correctional facilities, infectious diseases, outbreaks, infectious disease outbreaks, outbreaks in jails, outbreaks in prisons
Committee Chair / Thesis Advisor	Anne C. Spaulding, MD, MPH, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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