1 Medical Department, Tomsk Oblast penitentiary system, Tomsk, Russian Federation, 2Tomsk TB & pulmonary medical Center, Tomsk, Russian Federation, 3Partners In Health, Boston, Massachusetts, United States of America.

Coordinación intra-extrapenitenciariaTomsk, Russian Federation

Tomsk Oblast Population:1,073,600

987

1292

4314

7171

4488

4241

4592

3357

3000

28102193

1993

2170

1966 1902

1785

866 8021198

10011081403

583

879 941790

1962

1569

1624

1558

2720

1983

2165

2014

2599

2368

1699

1328 1266 11341256

1788

0

2000

4000

6000

8000

Among prisoners Detained (just arrested)

DOT

S

DOTS

Plus

384

130

108

011,9 12.1

46.3

11.1

0

43.1 35 25.3 29.9

32.5 31.3

238

181

136112 127 119

10379.2

81.3 8085 92

80.760.8

50

0

50

100

150

200

250

300

350

400

450

TB mortality in Tomsk penitentiary system

TB mortality in penitentiary system of Russian Federation

Coordination

Committee

Tomsk region administrationTomsk region administration

Health Care departments of Tomsk oblast and Tomsk city

TB civilian services Tomsk

Epidemiological

Service

Tomsk

Epidemiological

Service

Penitentiary TB

services

Seversk-city TB

services

Department of Social Support

NGOs: Red Cross, MERLIN,

PHRI, Partners in HealthNGOs: Red Cross, MERLIN,

PHRI, Partners in Health

Siberian State

Medical UniversitySiberian State

Medical University

Regional HIV center; NGOs involved in HIV care

Regional HIV center; NGOs involved in HIV care

Continuity of care between sectorsStage 1. Planning

*Only those who started treatment within DOTS Plus and Global Funded project are

included

105 released to Tomsk oblast

5 arrested

5 cured in prison

90 (85.7%) continued treatment

15 (14.3%) didn’t continued treatment

56 cured incivilian sector

4 failures 5 deaths* 20 defaulted

Final treatment results: cured 61/105 (58.1%) patients

* 1 death from TB and 4 deaths from non-TB causes

12 patients released

5 (41.6%) continued

treatment7 (58.3%) transferred

out, outcome is

unknown

2 cured 3 defaulted

*Only patients who started treatment under DOTS Plus or GF project are

included

19 –continued

treatment

1 defaulted 4 released4 failed

3 arrested again1 cured in

civilian sector

3 cured

3 didn’t continue

treatment

10 cured

22 patients arrested

Final treatment outcomes: cured 14/22 (63.6%) patients

Results of integrated MDR-TB program in Tomsk Oblast

�Improved TB situation

�Increased effectiveness of treatment

�Decrease in TB mortality

�Tomsk prisons ceased to be a source of TB infection in Tomsk Oblast