Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Exp Med. Mar 20, 2024; 14(1): 87551
Published online Mar 20, 2024. doi: 10.5493/wjem.v14.i1.87551
Prevalence and features of SARS-CoV-2 infection in prisons in Tuscany
Cristina Stasi, Martina Pacifici, Caterina Milli, Francesco Profili, Caterina Silvestri, Fabio Voller
Cristina Stasi, Martina Pacifici, Caterina Milli, Francesco Profili, Caterina Silvestri, Fabio Voller, Epidemiology Unit, Regional Health Agency of Tuscany, Florence 50141, Italy
Cristina Stasi, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena 53100, Italy
Author contributions: Stasi C interpreted the data, wrote the paper, and revised the manuscript critically for important intellectual content; Pacifici M analyzed and interpreted the data; Milli C collected the data; Profili F recorded the research data and revised statistical analysis; Silvestri C and Voller F conceived and designed the study and revised the manuscript critically for important intellectual content.
Institutional review board statement: The study was performed in accordance with the Declaration of Helsinki (revised in Edinburgh, 2000). According to the Italian legislation on data confidentiality, the dataset used is not openly available (Decree No. 196/2003).
Informed consent statement: No identifiable human data were used for this study.
Conflict-of-interest statement: All the authors report having no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cristina Stasi, MD, PhD, Research Scientist, Epidemiology Unit, Regional Health Agency of Tuscany, Via Pietro Dazzi, 1, Florence 50141, Italy. cristina.stasi@ars.toscana.it
Received: August 21, 2023
Peer-review started: August 21, 2023
First decision: November 28, 2023
Revised: December 18, 2023
Accepted: December 26, 2023
Article in press: December 26, 2023
Published online: March 20, 2024
Processing time: 211 Days and 2.7 Hours
ARTICLE HIGHLIGHTS
Research background

Prisons can be a reservoir for infectious diseases, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), due to the very intimate nature of the living spaces and the large number of people forced to share them. Therefore, in this place infectious diseases, including SARS-CoV-2, can be amplified and spread.

Research motivation

The main motivation was to improve epidemiological knowledge, aimed at better understanding what action could be taken to improve the health status of the detained population.

Research objectives

Based on these premises, this study evaluated the epidemiology of SARS-CoV-2 infection in prisons.

Research methods

This is a cross-sectional study, with health status assessed at a single point in time. The study population was represented by all the inmates present in the prisons of Tuscany on 15 February 2021. Data collection included information on prisoners who underwent nasopharyngeal swab testing for SARS-CoV-2 and the results. Nasopharyngeal swab tests for SARS-CoV-2 were performed between 15 February 2021 and 31 May 2021 for prisoners with symptoms and all new arrivals to the facility. Another section included information on the diagnosis of the disease according to the International Classification of Diseases, Ninth Revision, and Clinical Modification.

Research results

A high percentage of prisoners agreed to take the swab. This high adherence was probably due to a perception of risk. A significant association was found only for the risk of SARS-CoV-2 infection among foreigners compared to Italians but the SARS-CoV-2 incidence rate among prisoners is significantly lower than in the general population in Tuscany, probably due to the high level of attention of prison staff towards this public health problem.

Research conclusions

Although the control and management of SARS-CoV-2 infection in some prisons was similar to that outside, campaigns to improve disease prevention and screening, and rapid access to health care for the migrant population in prisons are critical to limiting transmission of the virus and subsequent morbidity and mortality in this vulnerable population.

Research perspectives

Future research is needed to definitively establish a screening program to manage organized screening programs for high-prevalence infectious diseases in the prison population.