Background: Prisons are known to be high-risk environments for the spread of bloodborne and sexually transmitted infections. Prison officers are considered to have an intermittent exposure potential to bloodborne infectious diseases on the job, however there has been no studies on the prevalence of these infections in prison officers in Ghana.

Although the high prevalence of blood-borne viral infections and syphilis in correctional facilities has been well documented globally, such data are sparse from Africa, and there has been no such data from Ghana. This study sought to estimate the prevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis among prison inmates and officers at prisons in Nsawan and Accra, Ghana. Prisoners and officers in 3 of the 46 prisons in Ghana were surveyed from May 2004 to May 2005. Subjects voluntarily completed a risk-factor questionnaire and provided blood specimens for unlinked anonymous testing for the presence of antibodies to HIV, HCV and Treponema pallidum, the causative agent of syphilis, and the surface antigen of hepatitis B virus (HBsAg). Almost 16 % (3770) of the total of 23 980 prison inmates in Ghana were eligible, and 281 (7?5 %) of those eligible took part, whilst almost 23 % (1120) of the total of 4910 prison officers were eligible, and 82 (7?3 %) of those eligible took part. For the 281 inmates tested, HIV seroprevalence was 19?2 %, 17?4 % had HBsAg, HCV seroprevalence was 19?2 % and reactive syphilis serology was noted in 11 %. For the 82 officers tested, HIV seroprevalence was 8?5 %, 3?7 % had HBsAg, HCV seroprevalence was 23?2 % and reactive syphilis serology was noted in 4?9 %. The data indicate a higher prevalence of HIV and HCV in correctional facilities (both prison inmates and officers) than in the general population in Ghana, suggesting their probable transmission in prisons in Ghana through intravenous drug use, unsafe sexual behaviour and tattooing as pertains to prisons worldwide. INTRODUCTIONThe relation between incarceration and the high transmission of blood-borne viruses, such as human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis, in prisons has been known for several years (Catalan-Soares et al., 2000;Haber et al., 1999;Heimberger et al., 1993;Mutter et al., 1994;Stark et al., 1997), and injecting drug use is the most commonly reported risk factor (Alizadeh et al., 2005;Massad et al., 1999; Taylor et al., 2000; Wield et al., 2000). The other risk factors identified for the higher prevalence of these infections in prisoners are previous imprisonment, tattooing and high-risk sexual behaviours (Haber et al., 1999;Massad et al., 1999;Skoretz et al., 2004;Veeken, 2000). There is growing evidence that HIV, HBV and HCV infections have actually been transmitted to individuals while they were in prison (Haber et al., 1999; Hutchinson et al., 1998;Mutter et al., 1994;Skoretz et al., 2004;Stark et al., 1997;Taylor et al., 1995 Taylor et al., , 2000, although there is also evidence that some had the infection before they were sent to prison. Data on the prevalence of HIV, HBV, HCV and syphilis in prisons are scanty in Africa, and no such information exists on prisoners in Ghana. Outside the prison setting in Ghana, the prevalence of HIV infection is between 1?5 and 3?8 % among blood donors (Ampofo et...

Background: Human herpesvirus 8 (HHV-8), cytomegalovirus (CMV) and Epstein-Barr virus (EBV) are prevalent in Africa, but less common elsewhere and the modes of transmission are still subject to debate. Generally, they rarely cause disease in the immunocompetent host but are highly oncogenic when associated with immunosuppression. Although the high prevalence of HHV-8, CMV and EBV has been well documented in Africa, such data are sparse from Ghana.

A national multicentre cross-sectional study was undertaken on the correlates of hepatitis C virus (HCV) infection in a sample of inmates from eight Ghanaian prisons. A total of 1366 inmates from eight of the ten regional central prisons in Ghana were enrolled between May 2004 and December 2005. Subjects voluntarily completed a risk-factor questionnaire and provided blood specimens for unlinked anonymous testing for the presence of antibodies to HCV. These data were analysed using both univariate and multivariate techniques. The median age of participants was 36.5 years (range 16-84 years). Of the 1366 inmates tested, HCV seroprevalence was 18.7 %. On multivariate analysis, the independent determinants of HCV infection were being incarcerated for longer than the median time served of 36 months [odds ratio (OR) 5.8; 95 % confidence interval (95 % CI) 5.0-6.9], history of intravenous drug use (OR 4.5;) and homosexuality (OR 3.1;. Consistent with similar studies worldwide, the prevalence of HCV in prison inmates was higher than the general population in Ghana, suggesting probable transmission in prisons in Ghana through intravenous drug use and unsafe sexual behaviour.