Equal access to TB diagnosis and treatment in Ukraine is a key factor in reducing the incidence of this disease. To achieve this goal, innovative approaches to diagnosis are being implemented and the latest treatment regimens are being used, which remain accessible despite the ongoing hostilities in the country.

Oleksiy Zahrebelny, head of the charitable organization FREE ZONE, notes that currently, individuals undergoing TB treatment in places of detention have access to a variety of treatment regimens, including the latest ones.

People with drug-resistant TB also receive appropriate treatment, which is no different from treatment in the civilian sector.

Since 2018, FREE ZONE has been working to create conditions for equal access to medical, social, and essential services for both people in places of detention and those who have been released, in accordance with the best international standards and practices.

Since prisoners and prison staff are at high risk of TB, combating this disease is one of the key areas of FREE ZONE’s work.

To implement this area of work, the organization attracts funding from international partners, including the Global Fund.

According to data from the preventive medicine sector based on signal cards, the incidence of TB among prisoners in 2023 increased by 25% compared to 2022, returning to approximately pre-war levels.

This increase is likely due to a decrease in the detection of TB among convicts and detainees in 2022 due to limited access to diagnostic examinations under martial law, in particular to X-ray and fluorographic examinations.

Thanks to the support of the Global Fund, 28 GeneXpert systems and 5 new X-ray machines were purchased in 2023. In 2024, it is planned to purchase another 5 X-ray machines, which is a significant contribution to the diagnosis of TB among prisoners.

Pilot model for early detection of tuberculosis in prisons: how does it work?

Despite the difficulties associated with the closed nature of prisons, for six months now, FREE ZONE, in cooperation with the TBpeopleUkraine charitable organization, has been implementing a pilot model for early detection of TB in such institutions.

Persons serving sentences are involved in the implementation of the model. Their task is to advise and motivate other prisoners to complete a screening questionnaire on symptoms that may indicate TB.

If high risks of the disease are detected, consultants among the convicts refer the person to the medical unit for further examination, diagnosis, and treatment.

This unique practice allows for the detection of the disease in its early stages, ensuring timely treatment.

The model has already been implemented in 10 correctional facilities in the Vinnytsia, Dnipropetrovsk, Zhytomyr, Odesa, Rivne, Sumy, and Cherkasy regions.

How does it work in practice?

To work in the field of early detection of TB, interested convicts undergo training from FREE ZONE and a knowledge test to ensure effective work.

In total, FREE ZONE involved 10 convicts as social workers in the pilot project. As a result of their work, 74 convicts were referred for TB screening.

In total, over a six-month period, the convict consultants screened 466 people.

The problem of early detection of TB among convicts remains relevant due to the closed nature of the system, which affects the availability and quality of services in the field of prevention, diagnosis, and treatment.

In addition, prisoners themselves rarely take care of their health, which leads to the incidence of tuberculosis in prisons being four times higher than in the civilian sector.

The practice of early detection of TB with the involvement of consultants from among prisoners allows for the timely detection of the disease, saving lives and protecting people’s health.