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Managing outbreaks of highly contagious diseases in prisons: a systematic review

Abstract:
Background
There are reports of outbreaks of COVID-19 in prisons in many countries. Responses to date have been highly variable and it is not clear whether public health guidance has been informed by the best available evidence. We conducted a systematic review to synthesise the evidence on outbreaks of highly contagious diseases in prison.
Methods
We searched seven electronic databases for peer-reviewed articles and official reports published between 1 January 2000 and 28 July 2020. We included quantitative primary research that reported an outbreak of a given contagious disease in a correctional facility and examined the effects of interventions. We excluded studies that did not provide detail on interventions. We synthesised common themes using the Synthesis Without Meta-analysis (SWiM) guideline, identified gaps in the literature and critically appraised the effectiveness of various containment approaches.
Results
We identified 28 relevant studies. Investigations were all based in high-income countries and documented outbreaks of tuberculosis, influenza (types A and B), varicella, measles, mumps, adenovirus and COVID-19. Several themes were common to these reports, including the public health implications of infectious disease outbreaks in prison, and the role of interagency collaboration, health communication, screening for contagious diseases, restriction, isolation and quarantine, contact tracing, immunisation programmes, epidemiological surveillance and prison-specific guidelines in addressing any outbreaks.
Discussion
Prisons are high-risk settings for the transmission of contagious diseases and there are considerable challenges in managing outbreaks in them. A public health approach to managing COVID-19 in prisons is required.

PROSPERO registration number CRD42020178827
Publication status:
Published
Peer review status:
Peer reviewed

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Files:
Publisher copy:
10.1136/bmjgh-2020-003201

Authors


More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Psychiatry
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Psychiatry
Role:
Author


Publisher:
BMJ Publishing Group
Journal:
BMJ Global Health More from this journal
Volume:
5
Issue:
11
Article number:
e003201
Publication date:
2020-11-16
Acceptance date:
2020-10-06
DOI:
EISSN:
2059-7908


Language:
English
Keywords:
Pubs id:
1145853
Local pid:
pubs:1145853
Deposit date:
2020-11-20

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