title: Universal access to DOTS in Delhi Prisons: Where do we stand?
abstract: Universal access implies that all tuberculosis (TB) patients in the community should have access to early, good quality diagnosis and treatment services that are affordable and convenient to the patient in time, place, and person. To achieve universal access, all affected vulnerable and marginalized population like prison inmates should have access to TB diagnostic and treatment services.
  
  
  
  To assess the TB control activities in prisons of Delhi, the capital of India, and to suggest interventions for strengthening the program based on the observations.
  
  
  
  Study was conducted at Tihar Prison, Delhi. TB case notification data from the Revised National TB Control Program (RNTCP) between 2008 and 2012 and log process framework were used to assess various parameters.
  
  
  
  Mean number of patients initiated on TB treatment was 120.6 annually between 2008 and 2012. The RNTCP has been implemented in Delhi Prisons since 2002; however, gaps were identified in human resource, training needs, case finding, diagnostic and treatment services, and supervision on situational analysis. Coordination between prison authorities and RNTCP authorities in relation to initial screening and discharge process appeared to be weak.
  
  
  
  Because of the restricted access, vulnerability of the prison population, increase in drug-resistant TB, the TB control activities in the prison require restructuring. Initial screening for early diagnosis and treatment and "Discharge planning" needs to be devised so that there is sufficient time before release or transfer of individuals from prison. This needs strong commitment from the prison health authorities and RNTCP staff.
authors.affiliation: Assistant Director, National Centre for Disease Control, Shamnath Marg, New Delhi 110054, India. Electronic address: miradhuria@gmail.com.
authors.forename: Meera
authors.initials: M
authors.lastname: Dhuria
authors.affiliation: Director Professor, Department of Community Medicine, Maulana Azad Medical College, New Delhi 110002, India.
authors.forename: Nandini
authors.initials: N
authors.lastname: Sharma
authors.affiliation: Director, New Delhi TB Centre, JLN Marg, New Delhi 110002, India.
authors.forename: K K
authors.initials: KK
authors.lastname: Chopra
authors.affiliation: WHO RNTCP Consultant, RNTCP Delhi, New Delhi, India.
authors.forename: Shivani
authors.initials: S
authors.lastname: Chandra
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000600:supply & distribution / Q000627:therapeutic use; D023801:Directly Observed Therapy; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007194:India / Q000453:epidemiology; D017053:Infection Control / Q000458:organization & administration; D008297:Male; D008853:Microscopy / Q000706:statistics & numerical data; D008875:Middle Aged; D011329:Prisoners; D011330:Prisons / Q000458:organization & administration; D013183:Sputum / Q000382:microbiology; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy / Q000635:transmission; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents
keywords: DOTS; Prison; Tuberculosis; Universal access